063. How to Manage Stress and Burnout with Mindfulness and Breathwork with Dr. Nissa Keyashian

This episode offers a unique perspective on building resilience and self-care practices for high performers. Join us as Dr. Nissa Keyashian, a psychiatrist, life coach, and meditation and yoga instructor, dives into the  principles of mindfulness. Explore the science behind breathwork and meditation, and their effectiveness in cultivating awareness and promoting mental well-being. Dr. Keyashian will also discuss the practical benefits of self-care practices, including improved focus, emotional regulation, and self-compassion – all essential tools for healthcare professionals and those passionate about well-being. 

Don’t miss this opportunity to learn strategies to enhance your own resilience and better support your patients. Tune in and take charge of your well-being – you deserve to perform at your best.

Key Points From This Episode:

  1. The seven principles of mindfulness
  2. Why should people care about breathwork and meditation?
  3. What results should you expect when you practice self-care and mindfulness?
  4. Living in the present moment is important.
  5. Through meditation, you can build awareness.
  6. Building awareness behind thinking.
  7. The self-compassion break exercise.
  8. Other types of self-care techniques for recovery.
  9. Why should people care about breathwork?
  10. Silencing inner and external noise through breathwork.



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63 - How to Manage Stress and Burnout with Mindfulness and Breathwork with Dr Nissa Keyashian
Swinging Christmas

00:05 Dr. Ann Tsung Are you struggling to advance your career and sacrificing time with your loved ones because of endless to-dos, low energy, and just not enough time in the day? If so, then this podcast is for you. I am your host Dr. Ann Tsung, an ER critical care and space doctor, a peak performance coach, a real estate investor, and a mother of a toddler. I am here to guide you on mastering your mind and give you the essential skills to achieve peak performance. Welcome to Productivity MD, where you can learn to master your time and achieve the five freedoms in life.

00:51 All right. Welcome to Productivity MD Podcast. I am your host Dr Ann Tsung. Today I have Dr. Nissa Keyashian. She is a board-certified psychiatrist, and she’s also a coach as well. We’ll be talking a lot about — I talk about grit to recover and activating your parasympathetic system, and that’s what we’ll be mostly be talking about. Because if you don’t recover, if you don’t activate your parasympathetic system, you’re not going to be able to keep up your peak performance or productivity all the time. So, again, Dr. Keyashian, thank you for being on the show. Can you tell the audience a little bit more about why do you do what you do? How did you pivot to become a coach, and what do you coach on specifically?

01:35 Dr. Nissa Keyashian Sure. I’d love to. Thank you so much for having me on. It’s really exciting to be here talking to you. So I started loving everything mindfulness and yoga mostly back in 2008. So I finished medical school, and I matched into internal medicine. Me and my ex-husband moved to Sacramento. I bought a house. And a couple weeks into residency, I was miserable. I ended up leaving. I was in a very difficult place. I had a couple of $100,000 in loans, and I wasn’t sure what I was going to do next. I was dealing with a lot of anxiety and depression. And I found a book that was on our bookshelf called Calming Your Anxious Mind. It was a mindfulness book for anxiety. And so I started reading it. And in the book, they talked about the seven principles of mindfulness: acceptance, patience, trust, letting go, non-judging, non-striving and beginner’s mind. And something deep down inside me, this inner wisdom, knew that I needed these principles, that I had been pretty much living the first 27 years of my life in direct opposition to those principles.

03:01 And so I started meditating. I started doing the practices in that book. I actually also started going to therapy. And at one point, my therapist was like, “What did you want to do before you went to medical school?” I was like, oh, I wanted to be a psychiatrist. And I was just like, oh my goodness. I went home, and my dad was over. I was like, “Dad, I’m going to be a psychiatrist.” He’s like, “Why? You want to work with crazy people?” I had this understanding, like, oh. I’m like, “Yeah, I do.” And so I ended up matching into psychiatry. I started psychiatry. I’ve been practicing for the past 10 years. Then a couple years ago, I found coaching, and I just fell in love with it. I was coming out with my first book Practicing Stillness. I knew I needed help in promoting myself because I had a contract with the publisher, and I was struggling to promote myself. I saw Sunny Smith’s advertisement for EWP, and that inner wisdom inside me was, like, click. And so I signed up, and I have just absolutely fallen in love with coaching since. I went through LCS and became a certified coach in 2022. I’m also a yoga and meditation instructor. I just recently became a breathwork facilitator as well.

04:22 Dr. Ann Tsung Nice. So for those of you guys who don’t know what LCS is, that’s a Life Coach School. And, yeah, I agree that coaching for me has led me to become a coach myself, too, just because I gained so much from it. Would you tell us a little bit of why people should care about, you know, they have their busy life. They don’t have time to meditate or do any breath work, do a yoga. It’s really hard to schedule. Why should they care about this and actually intentionally schedule this in?

04:54 Dr. Nissa Keyashian Yeah, there’s a saying about meditation that if you don’t have any time to meditate, you should probably be doing it twice as long. I think that this saying applies to so many of these self-care practices. That if your life is so hectic and crazy, you probably would benefit from even more meditation. But then, on the practical level, even just carving out two minutes, it’s best to do it at the same time every day. I love doing it first thing in the morning before my kids wake up and before all the other responsibilities come up. I use the bathroom, take medicine, and I just set my timer.

05:31 You can do guided apps. A lot of people like guided meditations to begin with. But you don’t need to. You could just set the timer on your watch or your phone for two minutes, and you can just find a comfortable seat with your feet flat on the floor. If you feel comfortable, you can close your eyes. Then you want to focus on your breath, and you want to feel your breath where it feels most pleasantly in your body. And your mind is going to jump because that’s just what the mind does. The mind produces thoughts like the mouth produces saliva. It’s not that you’re doing it wrong. I hear this all the time from people: “I’m not a good meditator. I think too much.” That’s not personal to you. Everybody has that challenge. And so you just, when your mind wanders, you just gently and kindly notice. Then just come back to your breath. That beginning again is one of the most healing practices of meditation.

06:22 Dr. Ann Tsung And what results should they expect? Okay. Not that they should expect anything. I’m just curious. Say, they begin this practice in a week, a month, how frequently are we talking? What can they kind of sense the difference might be if they begin any sort of self-care mindfulness practice?

06:44 Dr. Nissa Keyashian Yeah, I mean, I can speak to the benefits it has had in my life. You know, it’s interesting. Because what I mentioned earlier with the seven principles of mindfulness, one of them is non-striving, right? So we tend to have this tendency to always be wanting to get to the next moment. Meditation is all about living in the present moment. The present moment is the only moment we have. It’s never the past or the future. Those are just thoughts in our head. The present moment is the only moment that we have true connection, or love, or inspiration, or creativity.

07:17 And so this practice is a practice of coming back to the present moment. Because when we spend so much time in our head thinking about things that happened in the past, or anticipating, or worrying about things happening in the future, we miss this moment. Spending that time in our head also perpetuates things like anxiety and depression. And so when we notice that our mind has left — another one of my favorite sayings is: the mind is an excellent servant but a poor master. So when we need to be thinking, like if we’re at our desk and we need to be thinking, we’re working, great. But if you’re walking somewhere, if you’re communicating with somebody, if you’re doing another activity, a lot of times, we don’t need the thinking. The thinking just takes us away from the present moment. So when we meditate, it’s not to have less thoughts, but it’s to change our relationship to our thinking so that it is a servant and not a master. So that we choose when we’re thinking and when we don’t need thought, we’re not being thought. We can be a lot more intentional with our thinking.

08:20 Dr. Ann Tsung You mean like if I’m having negative spiral living in the gap type of thing thoughts where things are not done, you’re saying that things are not done correctly or not as perfectly as I instructed, you’re saying that with meditation you can decrease that, or you can turn around faster?

08:41 Dr. Nissa Keyashian You can build awareness around when you are in those places. Then you also start to feel like, how does that feel in my body? Are my shoulders coming up to my ears? Am I very tense or stressed out? And so you become more aware of those thoughts and then you might also begin to develop that beginning again. So you notice that, and then you come back to the present moment. There are some grounding practices, because your sense perceptions are always in the present moment. So you can come back. You can feel where your body is making contact — with the floor, or a chair, or a couch, or a bed. You can feel your breath where it feels most pleasantly. Then your mind might go right back to that spiral, right? Because that’s just what the mind does. And we don’t want to judge ourselves for that. That’s that non-judging principle. But we just notice. And sometimes we notice after 30 seconds, and sometimes we notice that after three hours. It doesn’t matter. When you notice, you just gently and kindly come back to the present moment.

09:42 Dr. Ann Tsung And you would say that’s a form of what they call metacognition, being able to think about your own thoughts? Correct? Okay.

09:50 Dr. Nissa Keyashian Yeah.

09:51 Dr. Ann Tsung And so you’re more aware with meditation. You can be more aware of your thoughts. You can think about your thoughts a little bit more, the reason behind you are having those thoughts. Emotions pull yourself back to the present. Because it does happen a lot in my clients and in the physicians I talk to. That they start thinking about things that have been done that they haven’t made progress on, that’s been stacking up, actually. And it causes them to be super anxious, breathing rapidly, fight and flight response, and then just go down like a spiral. So they’re either having negative self talk on themselves. Like, why they have made this progress and then just kind of — I guess, yes, there’s negative self talk and beating themselves up and unkind to themselves. And so you’re saying that they could just, instead of pull back, feeling something solid on the ground or noticing their breath to be able to stop that spiral a little bit better, if they can begin this practice.

10:47 Dr. Nissa Keyashian Yes, all of that. Then one thing I just want to clarify is that, yes, the metacognition, we can think about our thinking. But I think this practice is more about building the awareness behind the thinking. Because if we think about our thinking, we’re just adding more thought. And Einstein — I don’t know it verbatim — he says we can’t solve problems at the level at which they were created, right? I don’t think that more thinking is ultimately going to help our thinking issues. I think it’s the awareness behind the thought.

11:21 And I’m sure you are familiar with a negativity bias. So we have evolved with a negativity bias. Our ancestors, the ones that were obsessed about staying alive and staying safe from predators and other threats, those were the ones that survived and passed down their genes. But now, here in the 21st century, we don’t have tigers around the corner. We have plenty of food. But we have this very strong negativity bias where we just really focus on what’s wrong. Like, what we could do better? And that, I think you were just speaking to, is really discouraging. It’s really paralyzing. And so that’s why the practice of gratitude is so powerful. Because we shift out of that negativity bias into being grateful. For example, people get really focused on what they feel like is wrong with their body, or the weight they want to lose, or imperfections. Whereas, like, are your kidneys working? Is your heart pumping? There’s so much right going on with your body. And if we come from this place of love and gratitude that gives us the power to keep moving forward towards our goals.

12:38 Dr. Ann Tsung Yeah, I think just living in the game, not the gap. It takes effort to live it every day. And I’m curious that maybe that moves us a little bit to the how portion, the small little practices. What would you suggest for people who are busy every day to start building in, so they can activate their parasympathetic, live in the game through breathing, through gratitude or just tactics that they can enact, resources that you have? We can talk about the short ones for now, and then we’ll dig into something that’s deeper that they can pursue.

13:14 Dr. Nissa Keyashian Yeah, I would say, if you don’t have a meditation practice, I would recommend doing two minutes of meditation. Some people start out with 15 or 30 minutes, and that can be really difficult to go from zero to that long. Guided meditations can help you, support you in that. But even just carving out two minutes of time. Some people tell me, “Oh, I always do a sleeping meditation.” Those are great. But also, sometimes if you could just even do two minutes where the point is to stay awake, I think, is also helpful. And like I said, you could just do mindfulness of breath exercise.

13:53 Then the other practice that I find to be incredibly helpful is the self-compassion break by Kristin Neff. So she is a researcher and draws a lot of inspiration from some of my favorite spiritual teachers, people like Jack Kornfield, Sharon Salzberg, Tara Brock. The self-compassion break is an exercise. You can Google it, watch YouTube videos on it. But basically, whenever you’re dealing with strong, difficult emotions, you can do this practice. It can take you just even 30 seconds to do. That can really help calm, like you said, activate your parasympathetic nervous system if you are in a fight-flight-freeze system. It can really kind of soothe you and come back to that—

14:45 Dr. Ann Tsung And it’s self-compassion break by who?

14:48 Dr. Nissa Keyashian Dr. Kristen Neff.

14:50 Dr. Ann Tsung N-E-F-F.

14:52 Dr. Nissa Keyashian Yes, there’s a couple different components to it. One of the most healing components to it is soothing touch. If you’re in public, you could even give your hands like a loving squeeze in your lap. Nobody needs to know that you’re doing it. If you’re alone, you can give yourself a hug or put two hands on your heart. One hand on your heart, one on your belly. This is because the other pieces are language. And so even if the language doesn’t land because maybe you are enraged or so anxious or terrified or just totally in despair, this releases oxytocin and this soothes our nervous system. So it’s holding this loving touch.

15:30 Then there’s three components. There’s a mindfulness piece where you’re just affect labeling. You’re just like, there is anxiety, or there is fear, or there is anger, or whatever it is. You’re just saying what’s present. The second piece is common humanity. For example, let’s say somebody had a breakup. I’m not the first person to ever have a breakup, and I won’t be the last. In fact, there are billions of people around the world right now dealing with breakups, right? Because sometimes when we’re suffering, we feel so alone, right? The common humanity is to realize all of our interdependence with each other. Then the third piece is the self-compassion piece. This is saying something very loving to yourself. I usually say: I love you, Nissa. You’re doing awesome. I promise to be here for you. When I wasn’t there for myself in the past, I would be like I’m sorry. I wasn’t there for you in the past, but I promise I’ll be there for you.

16:23 Dr. Ann Tsung Yeah, I think the last part, I’ve done that exercise before, and it’s always makes me feel a lot better. Like, what is the kindest thing that you can say to yourself right now? And just that a little bit of self-love, self-forgiveness would be enough to kind of calm you down. So thank you. I will have to do this after our recording. A lot of times, we can intellectualize those. We know this. But to put it into practice, I mean, I always slip back all the time and I noticed it. So it does take work and intention to keep up with this. So thank you. And so those are quick practices, either two-minute meditation or like a longer guided meditation, and then the self-compassion meditation. It’s a type of meditation as well. Now, what about other type of self-care techniques or things to activate your parasympathetic? If people want to take this further and recover further, what else can they do?

17:22 Dr. Nissa Keyashian Oh, I love yoga. Some people have trouble with seated meditation. So yoga is this beautiful moving meditation. Often when we talk about yoga, we’re talking about the physical practice of yoga. But there’s actually eight limbs of yoga. The physical practice is just one limb of the eight limbs. Basically, it is a moving meditation. There’s multiple other limbs of yoga. So taking a yoga class can be really powerful. Walking meditation, if you don’t want to do seated meditation, you can find inside or outside somewhere. Hopefully, you won’t be too disrupted. Maybe about 6 to 10 feet and just walking back and forth and really bringing your attention to how you feel in your body, how your right foot feels as you lift up your left foot, and your mind is going to go. And you just gently and kindly just keep coming back to this moment.

18:16 Dr. Ann Tsung Okay. So is there a type of yoga that you recommend for beginners versus advanced? Because I know there are so many different types of yoga.

18:25 Dr. Nissa Keyashian I would recommend to do the yoga that works for you. Some people can’t go into a studio. There’s tons of online yoga that you can do. Some people just want to do a YouTube video, just do a YouTube video. Being in a class is lovely. If you can make it to a studio, there’s tons of beginner classes that you can go to. If you are more advanced, you can go to advanced classes. Find a yoga retreat. There’s tons of them. So I feel like there’s so much out there.

18:56 Dr. Ann Tsung Yeah, just pick one near your area. Or, maybe, yes, if you don’t have time, what I’ve done is I just pull — I really love the channel Heart Alchemy Yoga. It does have mindfulness work. It really actually has self-compassion built in to the practice, so I think it’s really awesome. Because I’ve done a lot of videos where you’re just going through the movement. But this video or this channel talks about self-compassion even when you can’t do the movements throughout, being present throughout and things like that. So I really love that. I wonder. Do you have any thoughts about the actual movement and being able to cross your body? Because yoga is all about crossing the body. For some reason, it helps. But I don’t really understand the mechanics between it. Do you have any thoughts on that?

19:43 Dr. Nissa Keyashian I don’t know. I know what you’re referencing, and I know it’s really important piece. But I don’t know if I know much more than you do about that particular piece. It makes me think of Jill Bolte Taylor. Do you know Jill Bolte Taylor? I think she was a neuroscientist. She had a stroke, and when she was having the stroke — so she understands a lot about that, and she writes about that. So I wonder if in some of her books, she might comment on that piece. I don’t know.

20:11 Dr. Ann Tsung Yeah, you’re right because it’s similar thing, where this is like another case. But a case of a preemie, developmentally delayed. The mom was making training or raising the preemie baby to cross as much as possible and now develop a mentally normal, essentially. So there’s something with that I just haven’t dug into. All right. So I know you said that you’re also a breathwork facilitator. Can you tell me a little bit more about that breathwork? Because there are so many different types of breath work. What is the type that you facilitate, and why should people care or do this?

20:50 Dr. Nissa Keyashian Yeah, so I trained in neurodynamic breathwork. Basically, neurodynamic breathwork was developed by Michael Stone who was a Holotropic Breathwork facilitator. So Holotropic Breathwork has been around for decades. Dr. Stanislav Grof, a psychiatrist from the Czech Republic, was studying LSD back in the ’50s and expanded states of awareness. But when that became illegal, the funding dried up. He noticed that when people were coming down from their LSD trips, people were breathing in a certain way, high ventilation way, to continue their expanded states of awareness. And so he then began to study this type of breath work. Basically, it’s a breath work where you’re moving a lot of air, and you’re also doing it to a very specific type of music set. So they trained us to develop these music sets. There’s multiple different parts of the music set. So the first part is very high rhythm to help you get your breath going. The middle part, there’s still a lot of rhythm but there’s more melody. It takes you on a journey. Then the final third is more integrative, meditative, helps you integrate the experience in your day-to-day life.

22:12 And basically, when you breathe in this way — I fell in love with this because what I noticed is, I was reaching places in 20 minutes in breath work, that it would take me several days on a silent meditation retreat to get to. So I was like, oh my gosh. Life hack, right? I loved it because it’s such a powerful way to quiet down our left brain thinking mind, that ego. I don’t know if you’re familiar with spiritual teachers who speak about the ego. It’s different from the ego that Sigmund Freud talked about. But basically, it’s our small self. Eckhart Tolle says the song of the small self is I Can’t Get No Satisfaction by Rolling Stones. So it’s the part of us that lives in fear, that doesn’t ever feel like we are enough or that other people are enough, scarcity, always judging ourselves, perfectionism. And so it quiets down that chatter in our head. I just found that breath work was this beautiful way to quiet that down so that you can start listening to your innate guiding intelligence or your inner wisdom, your higher self or soul, whatever word you want to give it.

23:23Dr. Ann Tsung Do you happen to know why it does that? If you have hyperventilation, why does your brain quiet down?

23:33Dr. Nissa Keyashian There’s a lot of theories, and there is some research into it. But basically, when you breathe this way — I hope I’m going to get this right. Basically, it causes your carbon dioxide to fall which causes vasoconstriction in your brain. There are several theories as to why. And I’m not sure if you’re familiar with the default mode network. It’s basically a network in our brain that has been very much correlated to our ego, our small selves. So the DMN is very active in people that have anxiety and depression. Basically, it’s that inner voice that’s always kind of judging and criticizing ourselves. And so there’s a lot of theories that maybe that vasoconstriction is just those certain parts of the brain. And so maybe quieting those parts allows others to come on board. But a lot of that is just theory and conjecture, and we need a lot more research.

24:39 Dr. Ann Tsung That’s very interesting. Because, yeah, I do love breath work myself and sound bath. For my bachelorette, I actually surprised my girls with a breath work session. Then one of them, right after the experience, she was crying because she was like, “My mind has never been so quiet ever. I didn’t know what it was like to be silent in my head.”

25:04 Dr. Nissa Keyashian That’s so awesome. What a great bachelorette party.

25:10 Dr. Ann Tsung Yeah, it was like we had a woman circle. Yeah, we had different — it’s kind of like a sound bath on that really. Then I have somebody come do the breath work. It was a male who was good looking, good body. And they were like, is that the stripper? I’m like, no.

25:27 Dr. Nissa Keyashian Man, I’m going to the wrong bachelorette party.

25:32 Dr. Ann Tsung It was really fun. It was a nice surprise. They were just staring at each other. They had no idea what was in store for them. But yeah, she had the quieting of the default mode network, like you said. I think for a lot of people who have never experienced silence or lack of chatter in their head, you just don’t know what you’re missing out on because you never had it. So where can people find breathwork facilitators? I know there are virtual ones, but what do you recommend? Seeking out in-person, one for the first time, what are your thoughts?

26:09 Dr. Nissa Keyashian I think that’s totally up to the person. I am going to be offering some breath work sessions, so people are welcome to find me if they want. So Holotropic does breath work in-person. Their sessions tend to be all day. So Michael Stone developed the neurodynamic breathwork to be a little bit more accessible, if you didn’t want a 12-hour day. The Holotropic is awesome. And if you’re very interested, I would highly recommend it. But if you felt like that was a little bit too much to start, then you might find somebody who is certified in neurodynamic to maybe do a shorter set. That network is growing. So you can look in your community and see if there’s anyone around. Then there’s lots online as well.

26:55 Dr. Ann Tsung So you would search specifically ‘neurodynamic breathwork facilitator?’

27:01 Dr. Nissa Keyashian If you wanted a shorter session, if you wanted to start out maybe with an hour or an hour-and-a-half session versus like an all-day 12-hour session. So the breath work session for Holotropic is three-hour sessions. Then somebody is a sitter, and somebody is a breather. And then you switch. And so it’s really like an all-day long experience.

27:25 Dr. Ann Tsung And when you say these experiences — okay. We have the silencing. But what else can I experience other than the silencing?

27:35 Dr. Nissa Keyashian Basically, when you silence that left brain-thinking mind, you start to get much more in touch with your innate guiding intelligence or your inner wisdom. Basically, it’s easier to silence that noise, both internally and then also the external noise, like expectations that other people have of us, the conditioning maybe that we had growing up. We’re able to let go of that noise and tap into our hearts and what we truly want out of this relatively short time that we have here on this planet. Our time is limited, and we are all miraculously here together at this one point in time. And so, as Mary Oliver said, what are you going to do with this one precious life?

28:26 Dr. Ann Tsung Yeah, so it really allows you to listen to your own intuition, your true voice, instead of worrying how others might judge you, and therefore making decisions based on the fear of judgment.

28:42 Dr. Nissa Keyashian Yes, and there’s so much more to it as well. There’s transpersonal experiences that people have. I’ve had several completions with people, and also my dog who passed away. A lot of people have experiences with people who passed away, and that can be really healing. Some people that are dealing with complicated grief around that. You don’t necessarily want to have an agenda going into the breath work. You want to be open to everything. But people can have past life experiences. People can have insights into current problems they have. Because when that left brain thinking noise chatter dies down, you have this really powerful inner wisdom that comes online. And suddenly, you have insights into issues that maybe you’ve been struggling with for a long time.

29:32 Dr. Ann Tsung That brought up a question. I’m just curious. Do they ever measure the brainwaves and what states they’re in during this breath work as in beta, alpha, theta? I’m just curious. Have they done anything like that before?

29:42 Dr. Nissa Keyashian I think they have. I’m not as familiar with that research. There’s been some small studies on this. I think that I have seen that, but I don’t remember the specifics.

29:52 Dr. Ann Tsung That’s because, yeah, what you’re talking about is the reason why I do sensory deprivation tanks in the float tank. Because I drop into alpha and then to theta. That’s when I make the connections to aha moments. You start connecting different regions of the brain and come up with novel solutions when you don’t have all the stimulations around you, the external and internal.

30:15 Dr. Nissa Keyashian Well, also, I feel like I have some of my most powerful insights when I’m doing yoga. So I think any time that we can carve away from our responsibilities, whether it’s like a walk in nature or playing with our kids or exercising, you know, I think it’s so important. One of my favorite quotes Ram Dass said: “The only thing I can do for you is work on myself. And the only thing you can do for me is work on yourself.” And as women, we have been conditioned to believe that we have to put ourselves last, right? Like, work, family, other responsibilities, and then we’re last on the to-do list. Then often, it just keeps getting pushed back and back and back. And so even if you can’t do breath work, or you can’t do some of these things that we’re suggesting, what can you do? Focus on the small chunks of time that you can carve out for yourself. Because if you can carve this time out and take care and show up for yourself in these radically loving ways, you are going to be able to show up so much more profoundly for the people around you in your life.

31:17 Dr. Ann Tsung Yeah, I definitely agree. That’s what I realized after I had my first son. In two months in, I was like, oh, my god. How am I going to make any progress? Then, really, my coach at the time was just, “You focus on yourself. You get whatever help you need to focus on yourself, to get back into weightlifting three times a week, and my chiropractor and my massages, et cetera, et cetera.” So I agree. Then I got a lot of help. Then finally, I’m at a good place. But yes, it takes extreme intention to actually do that.

31:48 A little bit more about the breath work in terms of these experiences you’re talking about. I’ll share that when I did a breath work one session, I had a visualization of this strange symbol of this flower with six petals. I didn’t know what it was. I’ve never seen it before. But it was like golden flower with six petals. Very, very clear with my eyes closed. Then until I talked to my facilitator, it turned out it was what we think is the flower of life. I don’t know if you’re familiar with the flower of life. But it was the flower with geometric shapes connected together, but it has six petals. They’ve seen it in a lot of different civilizations in their drawings and paintings and their artwork and things like that. So it was just crazy that I saw it too.

32:37 Dr. Nissa Keyashian That’s awesome. That’s so awesome.

32:39 Dr. Ann Tsung Yeah, and I even had it 3D printed. Oh, it’s not here right now. But because of that, I had it 3D printed and just kind of carry around me. It essentially symbolizes that everything is interconnected from what I remember, right?

32:55 Dr. Nissa Keyashian Oh, I love that. That’s so beautiful.

32:57 Dr. Ann Tsung Yeah, so for those of you guys who have not experienced breath work, I really highly recommend it. I think you’ll just have to experience it for yourself, right? Because it does take some effort and work and determination and discipline to push through, right?

33:14 Dr. Nissa Keyashian Yes.

33:17 Dr. Ann Tsung So if you can find somebody in person as a facilitator who could push you, you hear other people around you pushing through, and that’s really the best way. So I know we talked about a lot of different modalities. What would you say would be a one take away and one action for the audience who’s listening to this?

33:35 Dr. Nissa Keyashian So one takeaway for me, the biggest, is take care of yourself. If you invest in yourself, everyone around you will reap the benefits from that. One action is, see if you can carve out two minutes a day for a seated meditation.

33:54 Dr. Ann Tsung All right, maybe googling that self compassion one.

33:58 Dr. Nissa Keyashian Or self-compassion break. Absolutely.

34:01 Dr. Ann Tsung Yes, and can you tell us a little bit about who you coach, what you coach on? Is it one-on-one? Is it group? What do you offer, and where can people find you?

34:11 Dr. Nissa Keyashian Yeah, so I am on Facebook. My personal page is Nissa Marie. Then my business page is A Mindful MD. I’m on Instagram as @amindfulmd. You can find my website coaching.amindfulmd.com. I do all different kinds of coaching. I do thought work coaching that is very similar to a lot of The Life Coach School, the CTFAR model. But I also do somatic coaching, which is this beautiful combination of meditation and really being in your body and can be really powerful in helping you process traumas, and work through maybe things that you’ve tried to think through and you’re having difficulty thinking through the thoughts. A lot of us have very strong intellects, and our intellects are often have been a safe place for us in our lives. So when we have big emotions, we often run to our thinking. A lot of times, we can get stuck in our thinking. But some of the deep, profound change can be more somatic or emotional. And so this type of coaching kind of gets you into your body. I also coach on businesses. I would love for people to reach out.

35:31 Dr. Ann Tsung Awesome. Well, thank you so much for your time. Then for those of you guys who have an interest at any of the topics, please go ahead and go on the website. Go on Facebook, or just send a contact form. I really appreciate your time in explaining so many various things, from the busiest people to people who want to dig deeper, all those different tactics. I’m curious some of these things myself. So thank you so much for your time and attention today.

35:59 Dr. Nissa Keyashian Thank you so much for having me. It was lovely getting to know you a little better.

36:03 Dr. Ann Tsung All right. No problem. And for those of you listening, of course, everything we talked about is going to be in the show notes at productivitymd.com. And just remember that everything we need is within us now. Thank you.

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