Ep 27 Podcast - Dr Maura Kenny
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[00:00:00]
Speaker: Today on Recalibrating with Sharee Johnson, I had the pleasure of talking with Dr. Maura Kenny. Dr. Maura is a psychiatrist, recently retired 12 months ago, and I just loved this conversation so much. We talked a lot about retirement, about what that feels like, how it might be different to what's expected, and the need for deep rest after a long career in medicine.
Speaker: Maura [00:01:00] uses the word that many doctors use to describe medicine, which is to say medicine is brutal. We talk about mindfulness, uh, a life-changing experience for Maura in her practice, for her patients, and also for herself. came to understand mindfulness as part of treatment in her psychiatric practice, um, at the very beginning of when mindfulness was being talked about in medicine, and it really changed a lot for her in her practice, and it also changed things for her personally. So we talk about that. We talk about self-compassion and self-care, and the, the deep need for that to be a part of the medical curriculum throughout a career.
Speaker: The things that people need early in their career for self-care are not the same as when you're a new consultant later on in your career and when you approach retirement. So we talked about those things from Maura's perspective. We also talked [00:02:00] about mentorship and the, the really valuable role that mentorship, generous mentorship that's given with kindness and goodwill and spirit,
Speaker: The positive impact that that can have in a person's career. And we also talked about the chief wellbeing officer position. That hasn't really got going in Australia. I think we have currently three chief wellbeing officers in our whole public health system, uh, the first of whom has been in her role for 10 years.
Speaker: So we talked about, you know, where is that going? What's happening? Why hasn't that caught on more in our, in our system?
Speaker: And Maura points to quite a lot of resources and research. So, uh, all of those will be in the show notes. I hope that you enjoy this conversation with the absolutely charming and delightful Dr. Maura Kenny.
Sharee Johnson: Dr. Maura Kenny had a 40-year career as a consultant psychiatrist. She delivered and researched a range of therapeutic approaches in both clinical [00:03:00] and organizational settings with a focus on CBT, mindfulness, and self-compassion. Her bespoke six-week mindful self-care course for healthcare professionals was taken up in a range of South Australian local health networks, as well as in other healthcare and university settings around Australia, the UK, and Asia.
Sharee Johnson: She has held a teaching partner position with the Oxford Mindfulness Center, co-founded an Australian New Zealand Mindfulness Teacher Training Institute, And completed the Stanford Medicine Chief Wellness Officer course in 2023. In recent years, Dr. Maura was employed in the area of staff wellbeing, becoming the inaugural director of staff wellbeing for 17,000 staff in the public South Australian health system. Only the second such appointment in Australia within public health. Maura has spent the first year of her post medical life living between Australia, Italy, and [00:04:00] Scotland.
Sharee Johnson: She has been traveling a lot, walking in nature sometimes for days at a time, and enjoying the space to garden, read, and have more meaningful time with family and friends. In this conversation, Dr. Kenny shares reflections on the different phases of her career and the transitions to be negotiated on retirement, and we are very, very lucky to have some time with you, Maura.
Sharee Johnson: Welcome to Recalibrating with Sharee Johnson.
Dr Maura Kenny: Oh, thanks, Sharee. It's a real pleasure and a bit of a challenge to kind of go back there given the life I've been leading over the last 14 months or so. So it's been quite interesting to sort of think back. Oh, yes, I did have a, a good job at one point, and it was quite an important one.
Sharee Johnson: Yeah, a very important one. And, um, I appreciate that, asking you to think back when you're in, quite a different mode is a big deal. So- Mm ... um, let's start with now, and then we'll step back into those [00:05:00] earlier medicine years. You're officially retired and, uh, I guess the simplest question is what's it like on the other side?
Dr Maura Kenny: Well, it's different.
Sharee Johnson: Mm-hmm.
Dr Maura Kenny: And it's almost indescribably different from the life you have. So I'm fascinated by the process of changing one's identity from being, um, you know, a person with position and responsibilities and a certain amount of prestige and status to someone, especially when I'm in Italy, where I'm not very good at Italian at all, um, and it's a very tiny place we live.
Dr Maura Kenny: There's probably about eight permanent residents in this little hamlet that we live on right up near the top of a mountain. Um, to be so, um, irrelevant in some ways. And I remember talking to, um, some people at the AMA and somebody was stepping down from his position [00:06:00] and he said, "Oh, I think I'm gonna have NRLS."
Dr Maura Kenny: And I said, "What's that?" And he said, "No longer relevant syndrome." Um, it's the first time I'd heard of it, and it's like, oh, yes, aha. Um, and so I think for me as a, somebody that studies Buddhist, you know, teachings and has had, had a very long-standing mindfulness practice, I'm already very familiar with the concept of non-self and how our self is constructed by our context and wherever we are, that kind of shapes who we, who we are and how we respond.
Dr Maura Kenny: We're much more, um, we're much more shaped by that stuff than we realize, actually. Um, and so, um, you know, I'm aware of the temporary nature of self to some extent, and so can cope with being a non-Italian speaker in a tiny place like this, although it has its challenges, which we might talk about later.
Dr Maura Kenny: The other thing about retirement is that, um, another wise friend [00:07:00] said to me, "You will sleep solidly for about six months, 'cause you don't realize how tired you are." So I deliberately gave myself a year of planning absolutely nothing, apart from a little bit of an unpaid consultancy, which I loved a few months ago, and just, um, love being able to sleep when I need to sleep, and to sleep in, which I do most mornings and take my time to get on with my day.
Dr Maura Kenny: Because our whole life has been so, um, driven by the need to be there for early morning meetings and the demands of the day and, and sometimes late nights as well. So- I think there's something about having the time to fully catch up on your sleep debt Mm-hmm ... and kind of get your physiology a little bit more aligned.
Dr Maura Kenny: That's just something I could say about it. There's so much one could say about this [00:08:00] process, yeah.
Sharee Johnson: Do, do you think of it as recovery, Maura, this, this period of sleep?
Dr Maura Kenny: Some of it's recovery. Some of it... I mean, medicine's a brutal profession. There's no doubt about it. And the things asked of us are extraordinary, and unlike any other job.
Sharee Johnson: Mm.
Dr Maura Kenny: Completely unlike any other job. And we're just, from the minute we start medical school, we're just inculcated into the idea this is how it's done, this is how it's always been done, this is how it always will be done. And so you either join in with that or you leave. Um, it feels very stark.
Dr Maura Kenny: There's two choices, that one or... And so, um, you just absorb all of these kind of silent rules about how you go about your life. And some of them are, like, damaging as, you know, as I know personally and professionally, they're damaging. So I think there is a process of recovery, and I think what's also been intriguing for me is, um, having never hardly ever had nightmares, [00:09:00] I had quite a lot of nightmares at different times in that year.
Dr Maura Kenny: Very nonspecific, mainly about interactions with people, but not real-life scenarios, if you know what I mean. But clearly something about- Um, the dance of interactions that we're engaged in with people, um, and I'm not talking about patients either.
Sharee Johnson: This is, , really speaks to the identity work or the identity shift to my way of thinking.
Sharee Johnson: Mm. I'm intrigued about that in terms of adult development, I guess, and-
Dr Maura Kenny: Mm ...
Sharee Johnson: and, uh, what's happening there when there's, almost when there's space or room. Because there- Yes ... isn't much room. You were working full time, I think, right up until, pretty much until you retired. Yeah.
Dr Maura Kenny: Is that right?
Dr Maura Kenny: Yeah, that's right. Yeah, yeah.
Sharee Johnson: So there's not much
Dr Maura Kenny: space. Yeah. Essentially part-time. But yeah, you know what it's like with any part-time job, you're doing other things on the side, and so soon, suddenly it builds up to being full time, [00:10:00] um, even though your FTE might not say full time.
Sharee Johnson: We could call it fully occupied.
Sharee Johnson: Your occupation was fully taking up all the space.
Sharee Johnson: Yes. And so, um, you know, you worked for decades as a doctor, as a psychiatrist. You worked in public and private practice. With the benefit of hindsight, what's, what do you want to remind the rest of the people who are still fully engaged in the health system, working in the health system?
Sharee Johnson: What can you see in hindsight that you might share with, with them, with us?
Dr Maura Kenny: Um, gosh, so many things. Um, I think we have completely underestimated the need for self-care and, and professional development that isn't just about increasing your knowledge and clinical skills, but having, you know, a, a proper training in how to look after [00:11:00] one's self across the course of a career should be mandatory.
Dr Maura Kenny: It absolutely should be mandatory. Not a nice add-on, but absolutely crucial. If we don't look after our people, um, then, you know, health services will not perform at their best. Uh, so I mean, that was my whole raison d'être around this staff wellbeing job and getting that up.. And I think particularly, that it can't be a one-size-fits-all, you know, course that you do once and never do again, because the challenges at each stage of your career is so different.
Dr Maura Kenny: For example, if you're an intern, ... and, or a junior doctor, it'd be really good to get, um, tips on how to manage the circadian rhythms that are affected by shift work. I think that would be, um, like really important and learning something about... It won't land. When you're a junior doctor, it doesn't land.
Dr Maura Kenny: Perfectionism and, you know, high standards that you've had that drummed into you, just think that's how it's done. But later on [00:12:00] when you're kind of moving into that stage of maybe junior consultancy and you've got young kids maybe, or you're juggling home life and, um, work-life balance, which is, you know, a phrase that is just so frustrating as if you can achieve this, and once you've achieved it, you know, you've landed it.
Dr Maura Kenny: It, it's an ongoing juggle. So there's different things that you need, and then there's things that start to happen when you become more senior in your career, the responsibilities, um, and then of course the phase into retirement. - The sort of self-care ingredients that, that will work across all of those transitions are the same.
Dr Maura Kenny: Good old cognitive behavior therapy. So glad I trained in that. Um, mindfulness of course, so much I could say about how that just very quickly actually regulates you. Mindfulness is like a superpower. It really is. Self-compassion and learning how to not take the thoughts that we have so seriously and to learn how to be kind, not just to [00:13:00] oneself, but to one's team and your colleagues, which is very hard at times 'cause they'll press your buttons.
Dr Maura Kenny: But when you've got a culture that's kind and safe and compassionate, people do really well, even if resources are constrained. Um- And let's be clear, I'm not saying that's, let's just do that and then you can carry on working under difficult circumstances. I'm just saying that if the culture is wholesome and, and kind and healthy, then people will flourish really well in those circumstances.
Dr Maura Kenny: So, I mean, that's, that's not a neat little mantra for you there. That's a kind of a long-winded answer. I understand that. But I'm really thinking about myself at each stage of my career and the different juniors and medical staff that I've worked with across the phases of their career and realize how you can't just put one thing in place.
Dr Maura Kenny: But there's still such a resistance in medicine to the idea that we need to look after [00:14:00] ourselves. Really, the, the feedback I got from doctors all the time was, "Just fix the system and we'll be fine." It's like, "Well, okay. Good luck with that."
Sharee Johnson: I think you're right. The, the, the challenge always is that the people are the system and, you know, i- in Victoria at the moment, the doctors, the public health doctors are, are striking periodic, um, rolling- Mm ... industrial action. Um, and whilst nobody wants to see that happen, there is something about seeing that collective action and that collective voice that's encouraging because the culture, as you described right at the beginning, is so strong.
Sharee Johnson: It really is be in the culture or get out.
Dr Maura Kenny: Mm.
Sharee Johnson: And I think that's less than when I started doing this work, and you have a longer history, a longer knowledge than I have. But I think that's less than it was. Uh, it's still very strong, and it starts, as you said, from medical school.
Dr Maura Kenny: Yeah. Yeah. It does. And even before medical school, just the way society views doctors- Yeah[00:15:00]
Dr Maura Kenny: or at least used to, that, that might change. I think the worry is that, um- When, when we strike, which we need to do at times, we f- we should have the same industrial rights as, as other professions, that, um, it's seen as wanting more money and we're already perceived as being very well off, and some, some professions are.
Dr Maura Kenny: Um, or, like, being lazy or being too soft for medicine. These are some of the stories that are around, and, and how, you know, industrial action gets covered by the press can reinforce some of these unhelpful ideas sometimes. We're in a real transition in medicine. Like, what we really saw with the junior doctors coming through was, "We're not prepared to do it the way you did it."
Sharee Johnson: Yes.
Dr Maura Kenny: And of course, the old guard would say, "Well, you're too soft. Just get out." Um, and I would always be, sort of feel like I was balancing the needs of the junior doctors with some of the senior colleagues saying, "Well, it was miserable what we did. Why would we expect them to do it like [00:16:00] that?" You know. So it's, um, we really are at a point of reconfiguring the whole profession, I think, which is exciting, but comes with some challenges and, and needs to be managed carefully.
Sharee Johnson: Yeah. I, I, I'm sorry to sound like a stuck record, but we're at identity again. I think that, you know, there's a certain identity that's held by the different generations within medicine. And as you know, a- as humans, we like familiarity, and it's very easy to just kind of keep doing the familiar thing, often even when it's not good for us.
Sharee Johnson: Yes. And so I think, you know, we see- Yeah ... we see some of that happening. Let's go back a little bit Maura to the beginning. Not the very beginning. Mm-hmm. But how did you come to be in medicine? Did you know at school you wanted to be in medicine? How did that happen?
Dr Maura Kenny: Yeah. It's multifac- factorial the reasons.
Dr Maura Kenny: I really loved biology. I l- I really loved it, and I was good at it. And, and then I was reading things about, oh, well, you know, you can do things with applied biology and that kind of knowledge, and I really looked seriously at becoming a dietician for a long time. [00:17:00] Um, in fact, even before that, bizarrely, my partner would laugh, um, home economics, you know, was, was kind of...
Dr Maura Kenny: I had a really great home economics teacher, as it turned out. And, um, and so I... You know, you kind of get passionate about things that, you know, good teachers are passionate about. But you should be careful that that, you know, doesn't end up being your direction if it's just based on one individual. And I'll come back to that question you had about the choice of specialty.
Dr Maura Kenny: Maybe we'll revisit that. But anyway, then I looked at, um... Then I thought, oh, maybe something a bit more clin- you know, clinical. And then I was reading novels about careers, and I read a lot when I was a young person. And, um, and I thought, well, maybe I'll do medicine. That sounds really like applying this kind of knowledge to, you know, to people clinically.
Dr Maura Kenny: And the other big factor in my life was that my father, who was a primary school headmaster in Glasgow, um, and a very [00:18:00] passionate educator, in fact, quite a leader in terms of introducing things into really, you know, poor areas of Glasgow. Like chess championships and, um, soccer teams, and a prefect system, which was unheard of in the Gorbals in Glasgow.
Dr Maura Kenny: You know, he, that was what he was like. But he was a very devout Catholic and really believed in service. Quiet, unrecognized service. And so he also did a lot of work with, um, an organization in our church that looked after the poorer people in the parish, and he did that every Friday night. He would go to the meetings.
Dr Maura Kenny: I'm sure my mother loved that. Um, every Friday night he'd go to meetings and then during the week, as well as all the other stuff he did, he would go out, be visiting poor people and taking them things or make sure their needs were being met. So there was that kind of built-in idea of service-
Sharee Johnson: Mm ...
Dr Maura Kenny: that I think is strong anyway in the Scottish culture about caring for one another.
Dr Maura Kenny: Um, so all of those things kind of pointed me in this direction. [00:19:00] Yeah.
Sharee Johnson: And so you went to medi- medical school in Glasgow?
Dr Maura Kenny: Yes.
Sharee Johnson: And you got on about your medical career also in Glasgow at the beginning? Yeah. Yeah. And When was the first kind of redirection or shift or change
Sharee Johnson: Was that when you were deciding specialty, or what was the, what was the first moment of, "Ooh, I've gotta make a decision"?
Dr Maura Kenny: Um, I think it was around, I think it was in fourth year we did a placement in psychiatry and- I thought, "Oh yeah, this is really interesting. It's really, really interesting." Um, and before that, in following my father's footsteps and at his encouragement, I'd been doing some volunteer work with a heroin addict day center that just started in the '80s when there was this boom, this huge rise in heroin, um, usage in Glasgow.
Dr Maura Kenny: And so, um, I was already quite interested in the kind of psychology of addiction. And, you know, I did a, a kind of clinical [00:20:00] placement in the summer, an elective in drug and alcohol, and thought, "Oh, maybe I'll do drug and alcohol." Um, but in order to do that, you train in psychiatry. And the very first consultant I had, who always called me by my surname, he was an ex-army psychiatrist , um, never called me by my first name.
Dr Maura Kenny: That's, you get the feeling of what medicine was like. Um, he said, "You can't do addiction psychiatry. That's not a specialty. That's not real medicine." And it was like, "Okay. Um, thank you for that unasked for feedback." Um, but then, you know, just as I went through psychiatry, I got interested in other things. I was very fortunate to be introduced to cognitive behavior therapy by a leading light in the field who'd gone off and trained with Beck in the States.
Dr Maura Kenny: And so she came back, um, and set up a clinic, and I was like... There's a couple of us registrars invited to do that. That was like, okay, so psychiatry's not just about diagnosing and prescribing. There's this whole other field of therapy different from psychoanalysis, [00:21:00] um, that is very practical and useful for people.
Dr Maura Kenny: Um, so it kind of, you know, evolved in that way. Um, yeah. That's, that's how the switch to psychiatry, and then always keeping a subspecialty that became my main specialty later of psychotherapeutic approaches for anxiety and depression, 'cause they're the ones that respond best to psychological therapies.
Sharee Johnson: Yeah. Was it difficult to make that specialty decision, or was it clear? Did you feel like once those things had happened you knew the specialty you were going in?
Dr Maura Kenny: Yeah. Yeah. It was clear to me. Um, it was clear. But I, I, I might use that... I was telling you before about a quote that I came across much later in life.
Dr Maura Kenny: I'm just gonna read it to you 'cause I think I've seen so many junior doctors struggle with this. Um, so it's a, it's a quote by Thomas Merton, um, the Trappist monk, and he said, "People may spend their whole lives climbing the ladder of [00:22:00] success, only to find once they reach the top that the ladder is leaning against the wrong wall."
Sharee Johnson: Yeah. I love that, that whole idea of, every ladder's the wrong ladder if it's on the wrong wall.
Dr Maura Kenny: Yeah, yeah. Yeah. I-
Sharee Johnson: There's a lot of pressure, isn't there? A lot of pressure to get onto a program. There's a bottleneck in a lot of the colleges, the specialty programs in Australia and New Zealand and, and I think in other countries.
Sharee Johnson: What's the kind of advice or the space we can hold for our, uh, early career doctors who are trying to make this decision based on what they're interested in, but also based on what they might get into?
Dr Maura Kenny: Yeah. Well, there's a lot more flexibility than people realize, 'cause once you're in a particular training program, all the people in that training program are doing that specialty, right?
Dr Maura Kenny: So they're utterly committed to it, and they, they feel like that's the path, and trainees just need to go on that path and learn what they've got to learn and, you know. Um, and there's not a lot of discussion about is this a [00:23:00] specialty for you? Is it lighting your fire? Is it really interesting? Um, are you willing to keep on making the sacrifices that will be required?
Dr Maura Kenny: Um, and, and if not... I mean, I should just correct myself. There are many fantastic clinical supervisors who have those really good, engaged conversation with the trainees. Um, and I think psychiatry does that particularly well. I know that firsthand, that they have those conversations, and we might have those conversations with our trainees in supervision if we feel that they're struggling.
Dr Maura Kenny: Um, but there's also clinical directors that will or- Supervisor, directors, I mean, who will help them. Um, some specialties I think are probably a bit more one-eyed about things. If you don't meet this, then, you know, we're not interested or you've failed. And I think it's learning to hold those kind of thoughts really lightly, um, and not buy into them too much.
Dr Maura Kenny: There are many ways to live one's life. You've only got one life. Live it well. Do what you [00:24:00] want to do that really, you know, is, is of interest to you because you will need to have that passion to carry you through some of the difficult times. And I've seen trainees make the transition, um, to other specialties and been much happier.
Dr Maura Kenny: But I really wish they'd been able to do it without all the angst and the depression and the, the self-criticism and the worry.
Sharee Johnson: This idea, this really pervasive idea of sunk cost, isn't there?
Dr Maura Kenny: Yeah. Yeah, yeah, and of course, y- you're young, you don't have that sense of how time will stretch out, and you're a very short time as a trainee and a very long time as a consultant , or a GP, depending. You've got to want to like what you're doing 'cause you're gonna be doing it for a very long time.
Sharee Johnson: Yeah. I think we heard from Janice Tan last week on the podcast who was talking about passion as well. She's very interested in digital health, and , she's a GP.
Sharee Johnson: But she was talking about on the tough days, the passion is what gets you through.
Dr Maura Kenny: Mm. [00:25:00] Mm-hmm.
Sharee Johnson: I thought that was- Absolutely ... a nice way to describe it. You mentioned supervision as well there, Maura, and, um, you know, as a psychiatrist that's built in. You have supervision and you're, you're doing therapeutic supervision essentially.
Sharee Johnson: Um, other specialties don't have that. They have supervision in the traditional sense of signing the logbook, if you like. Um- Mm. Which is a bit different- Mm ... to the way that psychologists and psychiatrists think about supervision. Sometimes doctors- Mm ... ask me, why don't doctors have supervision like psychologists do?
Sharee Johnson: And I think it's a really good question. I'm not sure about the workforce to provide the supervision, but, um, I, I wonder what your reflections are on that in particularly perhaps through those early trainee years and first consultant years. There's quite a lot of people who come to us for coaching in that first year particularly of consultancy, where suddenly, you know, I thought I would be free and relaxed and I've passed through all the hurdles, but ooh boy, now I've got all this responsibility that I didn't really appreciate.
Dr Maura Kenny: Yeah.
Sharee Johnson: Yeah. What's your reflection about supervision as [00:26:00] a- Um, tool as a process, as a process for early career doctors?
Dr Maura Kenny: Yeah we used to talk about this a lot with supervision in, in particularly in psychiatry, um, which I can only speak to that. But that we have to be careful not to turn it into the trainee's therapy.
Sharee Johnson: Mm.
Dr Maura Kenny: Um, that's not actually the contract and we have to be respectful of those boundaries. But, and I think we actually are, most people are pretty good at that. Saying, "It sounds like there's something going on. It might be good to go and have your own therapy and get help because I want to help you become the best therapist or a psychiatrist you can be in this rotation.
Dr Maura Kenny: I want you to pass this rotation. So, so let's, you know, I'm gonna focus on your skills, but if there's things that are getting in the way of that, that needs to be dealt with elsewhere." Um, and that's respectful and it's boundaried and it's kind, um, because otherwise it can get a bit messy. And I think we've gotten a lot more sophisticated about that [00:27:00] over time.
Dr Maura Kenny: So that's the sort of difference between helping somebody develop their skills and also making sure they get the help they need personally. Um, but there's another area of mentorship which I think is incredibly important. Um, and that used to be, I think- Built in a lot more. The camaraderie of medicine, um, is something we have to be careful of that we don't throw that baby out with the bathwater as we reconfigure careers.
Dr Maura Kenny: Because you used to get tremendous, generous support from senior colleagues in that way. Um, and people might ... And then our college has got a specific mentoring system where you can sign up and get assigned a mentor at different stages of your career, and that's just free, kind advice and guidance rather than different from coaching, different from therapy.
Dr Maura Kenny: Much more just a space to ventilate or get some advice from somebody who's been there, done that, could [00:28:00] try this or what about that. Um, I think that's incredibly important. I think a lot of people do that informally. Um, they might do it in their peer supervision groups, but that's quite different from having a one-on-one with somebody who's really interested in how you're getting on.
Dr Maura Kenny: And I've had a lot of informal mentors in my career that have been enormously helpful at different times.
Sharee Johnson: I love that. I wonder if you can share a little bit more about that because, um, people, uh, you know, when, when a mentoring relationship works like that, when it's kind of operating on goodwill essentially- Yeah
Sharee Johnson: it's very powerful, and I've had mentors like that in my life, too. Mm-hmm. But I know there's a lot of hospitals, big systems hospitals, that have a mentor program where a mentor is assigned, but the, but the, the two never shall meet. The mentee- Yeah ... and the mentor, you know, in theory on paper are connected.
Sharee Johnson: And maybe they- Yeah ... meet one time. But there's not that investment through generous spirit or- Yes ... and from the mentee, that kind of, um, [00:29:00] psychologically comfortable looking to the mentor. It's only on paper. Yes. I, I think there's, I think there's huge scope for more here.
Sharee Johnson: - Definitely ... one of the things that I bump into when I've talked about this with, with doctors is there's no time, or time is the barrier. I wanna say I'd like us to try harder than that. What, what's your- Yes ... your reflection? Oh,
Dr Maura Kenny: definitely. It's worth its weight in gold.
Dr Maura Kenny: Um, it's a good investment in time. Time is short. That's one of your good investments. Um, and you know, it's things like going out for a quick lunch or a coffee or a glass of wine after work or a dinner after work, you know, that kind of thing. Um- It's, it doesn't have to be another hour of your day at the end of a long clinic.
Dr Maura Kenny: It's something that should be enjoyable and relaxed and informal anyway. But you know you've got complete permission to talk about your work situation for the whole time and, and not have to spend half of it engaging in pleasantries. Like, it's very clear that that's what the focus of the meeting is. [00:30:00] Um, and if you can't find time to have a coffee with a colleague, you're in deep trouble really.
Dr Maura Kenny: Maybe you need time management, or maybe you've got a life that is so over, uh, overly organized or overly committed that, you know, that needs to be looked at in its own right.
Sharee Johnson: Yeah. I think, willingness to just be present together for, as you said, a, a known stated agreement, this we're gonna be talking about work and work stuff, , it's sort of uplifting anyway.
Sharee Johnson: It's just uplifting to think that there's a willingness and that we're going to meet, and there's something generous, or it's about goodwill, or it's just two humans looking after each other. It- Yeah ... has that thing, that Jonathan Haidt idea of goodness built in.
Dr Maura Kenny: It's, yes.
Sharee Johnson: That it's, it's somehow good all by itself- Yeah
Sharee Johnson: inherently.
Dr Maura Kenny: Yeah. It was such a precious part of medicine. I, I, I do remember when I graduated, the difference between being a medical student and a doctor was that you felt you'd been taken into a [00:31:00] community, and then when you go from being a trainee to a consultant, the same thing happened again. Um, and- You know, I mean, you can be lucky or unlucky depending on who your colleagues are.
Dr Maura Kenny: But I was lucky in both of those transitions to be welcomed warmly into the profession by people who genuinely kind of looked after me, um, most of the time, you know, within, within our understanding of looking after people back then, you know.
Sharee Johnson: Yeah, there's pros and cons, isn't there? Medicine's very tribal in some ways and, Yeah
Sharee Johnson: there is, there are benefits to that. A lot of, uh, doctors will talk about the cohort that they came through medical school with or that they came through their traineeship with and, and that they still have their best friends from that group. Uh, and- Mm ... of course there's a, a competitive pressure that, you know, I'm not keeping up with my cohort that's the flip side, the, the downside.
Sharee Johnson: Yeah. I think, I wonder if we are more overt and, and make these things known and speak to them if we can have [00:32:00] more of the benefits and less of the, of the downside.
Dr Maura Kenny: Yes.
Dr Maura Kenny: Yeah. I think one thing I want to say here, and that I've been thinking about quite a lot, and I said this, I was asked to give a last lecture, at the college, which is a, a series of,
Dr Maura Kenny: It's something that came out of the States from some, a very well-liked professor who was dying of a terminal disease quite young and he was asked to give a last lecture. So imparting the things that he'd learnt in his career. So quite a lot, you know, other places have taken it up and I, I did one. And one of the things I said was, "Don't stretch yourself and your mortgage.
Dr Maura Kenny: Do not get a huge house with a huge mortgage just because that's what all your friends are doing." This is again part of this unhealthy, if I'm really making it in medicine, I've got a big house in the right suburb with blah, blah, blah and blah, blah, blah. Um, because once you're, you're stretched financially, that adds such a feeling of being trapped, um, that...
Dr Maura Kenny: And then people feel, "I can't switch career, I can't take time out, I can't, um, [00:33:00] cut back because, you know, I've got all these costs to meet." Um, and one of the things that happens when you're worried and anxious is that your thinking shrinks and you can only see the negative and you don't realize that mortgages do get paid off in time and, you know, or you can sell your house or whatever and downsize at an appropriate time.
Dr Maura Kenny: There's more flexibility around that stuff. We get far too caught up in having the status that goes with being a doctor and I've always I've never bought into that just for whatever reason. I've never bought into that idea. Never wanted a swimming pool and a tennis court. And, um, and so because I remember when I was...
Dr Maura Kenny: I wanna talk about a difficult time I had in my career when I had, um, my first child, or maybe it's also when my second child came along, and I was working part-time in private practice 'cause I thought it would give me more flexibility. All it did was actually just make me more isolated from people, 'cause everybody else in these consulting [00:34:00] suites I was in was just kind of basically running their own practice.
Dr Maura Kenny: There wasn't time to come together. Um, I was working long hours to try and, you know, have the money to pay the mortgage, and I felt absolutely trapped. And I remember, um, an older colleague saying, "Well, you can cut down." And I was like, "No, I can't cut down. I need this money," you know, blah, blah, blah. Um, and of course now when I know how comfortable and fine I am now, I...
Dr Maura Kenny: Just cut back for a bit. You've got young people. You don't need to, talk to your bank, you know? And maybe I'm saying things that people already know, but nobody said that stuff to me. Um, it's a delicate area, money. People don't like to talk about it. But I think it's the kind of conversation that can be really useful to have.
Dr Maura Kenny: Because otherwise, I remember very clearly, sorry to change tack halfway through, working with a lovely, uh, colleague, um, so stressed, [00:35:00] came, did the mindfulness course- And was still really stressed. And I said, "Why don't you cut back?" And he said, "Maura I've got a very large mortgage." Mm. And I just remember my heart just breaking for him.
Dr Maura Kenny: Was thinking, "Oh my God, like, mate."
Sharee Johnson: Yeah.
Dr Maura Kenny: You know, that's just what a trap you're in, and I wasn't in ... I wasn't his therapist. I wasn't working with him clinically. So, you know, it wasn't up to me to say, "Let's examine some options here." But I could just feel the burden of that mortgage on that guy, and how it was affecting every area of his life.
Dr Maura Kenny: Mm. And his clinical work in particular. So sad.
Sharee Johnson: Oh, it's so sad. It's a heavy weight, and that's that belief, that story that I'm trapped, is-
Dr Maura Kenny: Mm ...
Sharee Johnson: really painful for people. Very painful story.
Dr Maura Kenny: Mm. Mm.
Sharee Johnson: When you had your children and you were feeling that way, were you in Australia or where were you then?
Dr Maura Kenny: Yeah, I was in Adelaide. I had no [00:36:00] family of my own around. And I think that's another thing I would ask people to think about seriously. With our careers in medicine, we will often move with our jobs- Mm ... um, either 'cause we want to do other training opportunities or, you know, whatever. Um, so you can find yourself cut off from supports you would normally have around, um, looking after young kids. And I mean, I was really blessed with an amazingly fantastic childcare center, but you know that phone call, "Can you come get your child?
Dr Maura Kenny: They've got conjunctivitis." Like, are you sure? Are you absolutely sure? 'Cause I'm gonna have to leave a clinic or, you know. Um, and my husband at the time was also in a job he couldn't leave easily, and so it was an enormous pressure to not have a grandparent that could just sweep in and... or a, a sibling or a neighbor or somebody that would, you know, be able to help out.
Dr Maura Kenny: Um, and that is, that is again, a pressure on young families and [00:37:00] young doctors that is often not talked about, but it's like grow your community of helpers. We're so used to helping other people, it's a big block in the self-compassion work. The compassion to self, compassion to others, compassion from others to oneself, that's often where people, doctors especially, struggle to, to accept offers of help.
Dr Maura Kenny: When I remember getting an offer of help from a friend's mum, and I said, no. Pride, uh, discomfort, I don't know what that was about. It was, could have made my life a hell of a lot easier.
Sharee Johnson: Yeah. Let that be heard by all parents of young children. Yes.
Dr Maura Kenny: If somebody offers, just
Dr Maura Kenny: say yes. Yes.
Sharee Johnson: You're taking me back to when I had my counseling practice and the young women that just were so stressed, and it was mostly women at that time, um, and believing that there was something wrong with them, and really not understanding that they're under so much pressure.
Sharee Johnson: There's a lot. A lot of [00:38:00] people suddenly need you, and you're responding to nighttime and daytime, all these little, little people needs.
Sharee Johnson: Can you tell us Maura about when you came to Australia? What was the thing that brought you to Australia, And maybe anything that was different about the medicine that you were, the, the culture change that happened there in that process?
Dr Maura Kenny: Yeah. I came to Australia for a year 36 years ago. It was a one-year training position.
Dr Maura Kenny: Um, they had these things called occupational training visas back then. So you basically worked as a registrar in a system. And, uh, I had finished my membership in the UK. Had got my membership, and the next stage at that point was to apply for a senior registrar job that usually would lead you straight into a consultant job.
Dr Maura Kenny: So the way they organized the numbers in the UK was if you got an SR job, senior registrar job, in say Birmingham, then you would likely get a consultant post in Birmingham, and there you would remain for the rest of your career.
Dr Maura Kenny: Hmm.
Dr Maura Kenny: Which at the [00:39:00] age of 28 was an absolutely horrifying prospect. I mean, maybe Birmingham's a lovely place to live, but I didn't want to be there for the rest of my life.
Dr Maura Kenny: And the other thing was if you moved consultant jobs, you were seen as, quote-unquote, "a wandering psychopath."
Sharee Johnson: Oh, wow. Yes,
Dr Maura Kenny: I know. So ... Which is ridiculous. If you had two or more consultant jobs, you know, you were seen as a wandering psychopath, somebody who couldn't settle down and just got on with things. I mean, it was, the thinking in the, in the NHS was so rigid. The culture was so old and patriarchal and inflexible. Anyway, um, so I thought, "Well, I don't want to end up. I'll make that choice later, but I'm just gonna go and have a year in Australia." And a very lovely professor I worked for basically phoned up somebody he knew, and he said, "Oh, yeah, we'd love Maura to come and work in this place."
Dr Maura Kenny: And they just made it all happen. Um, and as soon as I got to Australia, I mean, apart from the glorious weather and the lovely time I was having, I [00:40:00] was just struck, the culture of medicine was so different It was so much more flexible. Um, people were kind, encouraging. They weren't pulling you up and finding fault, which was the sort of default mode of education in the UK.
Dr Maura Kenny: Um, and there was lots of social things that were done that were really great. Um, like one of my consultants I worked for said, "Oh, there's a big wine and food thing on in the McLaren Vale. I'll take you, um, there." And it's like, "Wow, really?" Um, so it was... And it was great. You know, it was relaxed and it was fun.
Dr Maura Kenny: So, and also there was the thing that you, if, in the UK, if you did adult psychiatry, then basically you had a catchment area that you were responsible for. You provided the general psychiatric services, and if you were lucky, you might be able to develop a tiny little side interest. And my interest was already in CBT and psychological therapies.
Dr Maura Kenny: Whereas when I- in Australia, I realized that people could set up a [00:41:00] private practice and basically run it. This is back in the days before psychologists had Medicare items. You could run a private therapy clinic if you wanted to. Um, I thought, "Wow, this flexibility is extraordinary," so I stayed.
Sharee Johnson: Mm. Lucky us.
Dr Maura Kenny: Well yeah. I didn't have my So- ... to help with the kids though, did I? So
Sharee Johnson: Yeah, that's right. That made it very complicated, for sure. Yeah. So, um, I, I really want some time to talk about mindfulness and your wellbeing role, so let's move along a little bit- Right ... into your history. I know there'll be lots more twists and turns that I'd love to have five hours to hear.
Sharee Johnson: You have a very particular interest in mindfulness and, years ago now, it's probably eight or maybe it's 10 years, I'm not sure how long ago it was. But, um, I was at the Meditation Australia conference, and there was a doctor there, uh, who was a mindfulness expert. It was like a very exciting moment for me to learn that you existed and to know that you were there.
Sharee Johnson: Can you tell us about how you, how you [00:42:00] came, I suppose, to have this particular interest in mindfulness? And, and how was that in those early days in medicine when you were talking about mindfulness? Craig Hassed was doing some work at Monash in those times. Yep. You were probably the only other person who was really very outspoken in medicine in those early times about mindfulness.
Dr Maura Kenny: . Well, there was also Graham Meadows at, at Monash- Oh, yeah ... as well, who was doing a lot of really fantastic research around mindfulness and depression. So, um, I think Craig had come to it earlier than us through y- his other pathways. But Graham and I came to it because it was a development out of CBT.
Dr Maura Kenny: And when I went to my first workshop on it, um, and I'll never forget, 15th of March 2002, .. it was a Friday. Uh, I usually didn't work on a Friday at that point, and I had my kids out of childcare. And so if I went to this workshop, I was gonna have to put my younger son back into childcare for the day.
Dr Maura Kenny: So that was ... I nearly didn't go. [00:43:00] Um, but this, it comes back to the thing about kindness, because the professor that was delivering the workshop was Mark Williams from Oxford. Um, and he had actually been in Newcastle- doing CBT and had left just before I joined that CBT clinic, and people kept saying, "Mark Williams is an enormously kind and wonderful human being."
Dr Maura Kenny: And that was part of the reason why I went, 'cause I thought, "I've gotta meet this Mark Williams character that everybody was raving about." Um, and the workshop was just superb because he's an extraordinary academic, brilliant mind. And so the morning was about theoretical reasons why mindfulness and meditation, and its invitation to come back to the present moment non-judgmentally, disentangling yourself from your thinking, some of which is just, you know, pointless, you know, kind of chatter in the mind, and some of it which can be deeply damaging self-critical thinking.
Dr Maura Kenny: Stepping out that [00:44:00] thinking, coming into the present moment again and again, um, there was a real theoretical basis why this would be helpful in preventing relapses of depression. So he just articulated that so well, and then - in the afternoon, presented the research they'd done. They also already had a couple of RCTs showing that it was effective.
Dr Maura Kenny: So, you know, I was persuaded intellectually by it. And then in the afternoon he led some practices, and then I was just having all of these aha moments all afternoon through the different practices. And I thought, "Oh, this just makes so much sense personally and professionally, clinically." 'Cause I had a lot of patients who had done courses of CBT, recovered, done well, and then relapsed despite having had CBT, despite being on maintenance medication.
Dr Maura Kenny: And I thought, "What to do with them?" And then of course this is all about interrupting the cycles of rumination that keep us trapped in, in worry and depression, and so this makes [00:45:00] perfect sense. So I just got in touch with Mark, another generous mentor, who said, "Yep, that's great. I'll support you." And I started running MBCT courses, and just saw the most remarkable shifts in people who were no longer falling into relapses the way they'd done before.
Dr Maura Kenny: And then I'd collected some data, Mark and I published it. Um, it, you know, had still gets cited as it was most read article, la, la, la, you know. Um, and then I said to Mark, "Well, you must have had loads of letters like these most read article in the last five years of this big journal." And he said, "No, I've never had that."
Dr Maura Kenny: I was like, "Oh my goodness. I'm so chuffed for both of us." Yeah.
Sharee Johnson: How exciting. It's exciting on so many levels because , the fact that the, people you were working with were having the benefits right before your eyes.
Dr Maura Kenny: Yeah. Yeah, yeah.
Sharee Johnson: That, that, that, you know, that's the thing, that's part of the passion of getting up every day, isn't it, and going to work?
Dr Maura Kenny: Yeah, yeah, yeah. It was just, it was such a game [00:46:00] changer in my practice. I loved, I loved that and I loved the community of mindfulness teachers. They're really extraordinary, wise, good, kind people. And I realized that actually the secret ingredient that nobody really spoke about in their mindfulness practice was their huge levels of kindness and heartfulness and compassion.
Dr Maura Kenny: They were kind, non-reactive, steady human beings. And of course, Paul Gilbert and his group, which went on to do further training with him and his, his staff, were, was really about taking that notion of compassion quite separate from mindfulness and meditation and, and using that as another way of managing our thinking and our relating to other people.
Dr Maura Kenny: So the theory has to make sense for me. I think for most doctors, they need good theory, they need good science, they need good evidence, and then we can engage in its application. Um, and so clinically it was a real, it was such a, a, a [00:47:00] enjoyable time because people were getting better. Um, not everyone of course. It's not panacea. But for those who practiced and for who it sort- it suited their particular, uh, conditions, then, you know, they did really well. And then of course, I was giving talks about it, and people were saying, "Oh, I like the sound of that. Can I come and do that?" And so I started running courses for, for, uh, non-patients and just modified the mindfulness-based cognitive therapy, um, for managing stress in everyday life.
Dr Maura Kenny: And out of that came my shorter course because people were not able to commit to 40 minutes of meditation a day, and all the junior doctors were falling asleep the minute they laid down on the floor to do a body scan. They were asleep within seconds. Uh, well, this isn't, you know, this isn't the course for them.
Dr Maura Kenny: No, but their- They
Sharee Johnson: need something ... their body was telling them exactly what they needed.
Dr Maura Kenny: They need to sleep. Yeah. Absolutely. Quite right too.
Sharee Johnson: It comes about that there were a few people, I, I don't know, do you know Tony and [00:48:00] Jo, Dunin?
Dr Maura Kenny: Yes, very well. Yeah.
Sharee Johnson: So, you know, they were also, for the listeners, Tony's an orthopedic surgeon, retired now too, and his wife Jo is a nurse, also were running mindfulness programs in Victoria.
Sharee Johnson: Um, and, and there are a couple of others around. Did that help you either psychologically yourself or, or practically in terms of the delivery to know that there were some other medical people who were also discovering that this was kind of rippling out and there were more medical people thinking, talking, using mindfulness?
Dr Maura Kenny: I mean, I love Jo and Tony. Um, and, and it was great what Tony was doing with, you know, being an orthopedic surgeon as well. Um, I don't think I've ever personally felt the need that it's, I need to have a medical community to make this okay somehow. Um, somebody once said I was a first adopter. I don't know if you've ever heard that term.
Dr Maura Kenny: Like somebody will bring in a new- Yeah ... um, uh, idea, and then there are some people who will [00:49:00] jump on the bandwagon really quickly if it makes sense to them. And, and so that was me with mindfulness and, and, uh, it just made sense to me, and I was convinced professionally that it was right, and so that's all I needed personally.
Dr Maura Kenny: I think there, there might be other people that need other medical staff to be doing it. I don't think so. I think we were all just pleased that we could lend some credibility to the work because of the way people perceives, perceive doctors and their training and their rigor. So that, that bit was wonderful.
Dr Maura Kenny: Um, but my other colleagues at that time, of course, I was then working with Timothea Goddard, and she and I started up, um, the first mindfulness teacher training institute in Australia. Um, and Graeme had been doing training in MBCT, in Melbourne, but we were running something across Australia, then New Zealand, that was MBCT and mindfulness-based stress reduction, the two courses.
Dr Maura Kenny: So I had a really strong community with [00:50:00] them for a long time- um, which was very nourishing.
Sharee Johnson: It's lovely to hear that. I'm, I'm noticing an assumption or a bias in myself because a lot of the medical students who I've taught, uh, at, year three and year four, um, I guess have responded in a way that's it's sort of too simple
Sharee Johnson: And I think some of that has been that they h- haven't been examined on it, and I think that's another thing that happens in medical school that, if I'm not examined on it, I haven't got any time or energy for it. Um, and so, uh, this kind of revisiting. And then when people come to our recalibrate program, and we start with mindfulness, we always start with mindfulness, and we do a lot of self-compassion work too, and, and there is a real dawning for people.
Sharee Johnson: And again, it's maybe what you just pointed to very briefly early on about, Well, sometimes we talk about it as readiness, but this, um, there's not enough to hang it on early o- in your career perhaps. And by the time the people are coming to recalibrate with us, they're mid-career mostly, and they've got- Mm-hmm
Sharee Johnson: a lot of stories about what's working and what's not working. [00:51:00] And there's a- Yeah ... and there's a, a curiosity about mindfulness- Mm ... that even though they've heard about it before, it might not have made any sense to them earlier, and now there's this moment where, "Okay, that sounds interesting."
Sharee Johnson: And then, "Oh, this is really helpful."
Dr Maura Kenny: Yeah. Yeah. I think with junior doctors, um, and medical students, there's so much about just learning and being examined and, and almost as you say, if it's not examinable, then it's not important. Um, and having said that, there are some for whom it lands so strongly and is a bit of a life-changer moment for them.
Dr Maura Kenny: In fact, you know, I've had two or three young, uh, doctors say that to me, and they were men. ... So surprising, um, how much they got it. And then, then another one who I met years ago, later, and he said, "Oh, I did that course with you. Was, was there something about a raisin in there?" Uh. It's like, was it- I've had, I've
Dr Maura Kenny: had
Sharee Johnson: that, I've had that too. So- [00:52:00]
Dr Maura Kenny: Did we take away that memory of that course? That's hilarious.
Sharee Johnson: I wanted to, , give you the chance to speak to, you know, you referred earlier to the, the Buddhist thinking that, uh, a lot of- Mm ... mindfulness comes from there. There's been an explosion of research into mindfulness in the, in the Western sense, um, in the last 20 or 25 years.
Sharee Johnson: But of course there's- Mm ... it's an ancient practice in many ways, and most of the religions have contemplative practice within them.
Dr Maura Kenny: Yes.
Sharee Johnson: How's the movement of that for you in terms of making it really accessible to people, all kinds of people?
Dr Maura Kenny: In the early days of training in mindfulness, there was a huge amount of rigor around you needing to go on retreats and, um, have, uh, exposure to Buddhist teachers.
Dr Maura Kenny: Uh, there was a real concern that mindfulness taken out of its, its context would demean it somehow. And of course, that's exactly what's [00:53:00] happened. You know, we then had the whole kind of thing of you stick mind in front of any activity and it's a marketing exercise to sell something. Um, and it was, you know, it was frustrating to watch this, um, because that's not mindfulness.
Dr Maura Kenny: You know, that's other, something else. Um, and so I was really lucky to sit retreats with a lot of extraordinary, wise, knowledgeable people, some of whom were lecturers and, uh, university lecturers in Buddhism. So I had, sat with a group in Adelaide who had studied the sutras. And so the richness, um, and complexity of that part of mindfulness was something I was exposed to very early on, and was so, so interesting.
Dr Maura Kenny: So interesting. Um, and you know, these ideas of non-self and what on earth is that all about? And as I say, you know, there's this very practical, useful [00:54:00] element of this when I retired and I thought, oh, I'm no longer that self. I'm now another self, or I'm a particular self in Italy, I'm another self in Scotland, and I'm another self in Australia.
Dr Maura Kenny: Um, and just understanding, you know, what Buddhists would call dependent arising, but is, you know, basically- I'm diluting it, you know, contextual shaping. Um, and, and so the rich Buddhist psychology, as Mark Williams once said in a lecture, is two and a half thousand years old. Modern day psychology's only 150 years old
Dr Maura Kenny: You know, it's like there's so much that they understand about the way the mind works, and everything I was hearing fitted perfectly with, you know, childhood development stuff and, um, adult cognitive psychology and, um, the work of Paul Gilbert. Like, it, it merges beautifully because it's a- an accurate appraisal of how we human beings function.[00:55:00]
Dr Maura Kenny: Um, a- and just some very good, you know, very good guides for living that came out of exposure to those kind of things. Like the idea of, you know, and the non-judgmental acceptance that people talk about with mindfulness, you do meet each moment non-judgmentally, that some people think, well, anything goes, and it's like, no, no, there's a, a wise discernment in there that, um, that you learn from your good teachers.
Dr Maura Kenny: Like, sometimes being endlessly compassionate is just actually indulging bad behavior. Like we don't, every time our kids want a, a lolly, we don't say, "Yes, I compassionately want to give you this lolly till you have compassionately wrecked your teeth," you know. That there's something in there about boundaries and wisdom and discernment that comes through when you sit in retreats and, or you're meeting Dharma teachers who have been helping people grapple with being a human be- being in the world [00:56:00] for a long time.
Dr Maura Kenny: Um, so it's not just, it's not just focusing on the breath, although that is so powerful in itself to just sit as, um, Amishi Jha found, 12 minutes a day So 12 minutes a day has benefits. Anything below that does not. Um, and so there's this enormously powerful practice, and then there's enormously complex and wonderful psychology that lies behind it, and philosophy.
Dr Maura Kenny: So I just find that intellectually so interesting apart from anything else.
Sharee Johnson: Mm.
Dr Maura Kenny: Um, but then when the science, you know, sits with that really well, then, you know, it's a very persuasive argument. And one of the things that I encounter again and again when I talk about mindfulness to different groups is that I know that they're going to say and feel, "This is a Band-Aid.
Dr Maura Kenny: Fix the system, don't fix us. Why are you victim blaming?" And so, you know, you address all of that right up front and say, "Well, look at how hard it [00:57:00] is to fix the system and how long it takes. So it's pretty good to have a few other things up your sleeve in the meantime." Mindfulness, self-compassion, CBT being those things.
Sharee Johnson: It's really both/and in that regard, isn't it?
Dr Maura Kenny: So much the case. So true.
Sharee Johnson: Yeah. Yeah. So, uh, again, I could talk to you about mindfulness. Let's just keep talking about mindfulness. It's really, up my street, as you know. And let's, talk about doctor wellbeing.
Dr Maura Kenny: Mm-hmm. Mm-hmm.
Sharee Johnson: And, um, doctor as leader, I'm interested, you know, you, you were chief wellbeing officer, for want of other words, in South Australia.
Sharee Johnson: Second only, I think the third one in Australia was appointed while you were in that role in Canberra. Mm. But it's taken us, it's taking us a long time. I think Bethan Richards has been in the role in Sydney for about 10 years. Mm. So it's taking us a very long time as a system-wide to adopt these roles.
Sharee Johnson: What's that about, do you think?[00:58:00]
Dr Maura Kenny: I am worried at the moment, Sharee, that it's a fad in Australia and it will, it will pass away again. That's my worry. Um Australia is an ex- an, a really interesting country to work in, I think, compared to the UK, which, you know, I've talked about some of the negatives of the rigid, inflexible thinking that goes on, but they also have very high standards, and once something is adopted, uh, with good reason, then it is, you know, if it's accepted into the NICE guidelines, then there is a mandate for training to be offered in it, for example, um, for any new evidence-based clinical intervention.
Dr Maura Kenny: So here-
Sharee Johnson: I think that's what ... Or sorry to interrupt. I think that's what happened with mindfulness. Once there was a NICE, report about mindfulness, it was now prescribable across the whole NHS.
Dr Maura Kenny: Yes. Uh-huh, uh-huh. And just for your, for your listeners, NICE means the National Institute for Clinical Excellence.
Dr Maura Kenny: Okay. Yeah. So, um, and it's, it's very powerful in determining [00:59:00] what commissioners will or won't, you know, um, approve to be offered in their health networks or trusts. So, um, we don't have that here, and we suffer. We have clinical guidelines. Each college, I, I'm sure, as s- certainly a psychiatrist does, has clinical guidelines for the best evidence-based treatment of, say, depression, and MBCT will be in there.
Dr Maura Kenny: Um, but, uh, it's, it's just very hit-and-miss as to whether that's offered or taken up or funded. Um, we kept the longest running MBCT program going in Australia in the public, the one and only place where it was offered in the public mental health system free of charge for patients in our clinic, um, for 20 years.
Dr Maura Kenny: And then when I retired, um, it's gone.
Sharee Johnson: It's heartbreaking. That stuff is heartbreaking. Yeah. Yeah.
Dr Maura Kenny: It's the nature, nature of impermanence, is it not? Yeah. Um, but I think in, I think Australia, we're particularly, we're flexible at taking things up, but [01:00:00] it also means that things can pass away just as quickly.
Dr Maura Kenny: Things aren't regulated or accredited as rigorously as they are in the UK. Um, so, uh, and, uh, and, and I think that's cl- in clinical settings, and I ... And that's not always a bad thing. Sometimes things need to change and move on. But I think, I mean, I might be wrong, I could be wrong, I hope I am wrong, that the director of staff wellbeing positions might be adopted by one CEO who sees the value and, and appoints that position, but CEOs turn over, and each CEO comes in with their own ideas and models and offerings, and it might not fit with their thinking or how they see things being done.
Dr Maura Kenny: Um, and so, with the turnover in CEOs that we tend to see in this country in healthcare settings, you know, something that one person believes in might not be what the next person believes in, and so it can be gone. Um, so it'll be [01:01:00] interesting to watch the space because it's very difficult to get big changes happening.
Sharee Johnson: Can you tell us Maura, a little bit about your experience when you were the chief wellbeing officer at CALHN (Central Adelaide Local Health Network) in in Adelaide? .. For, for the listeners who don't know about the role, it's not, we're not talking about like the school nurse.
Sharee Johnson: We're talking about- No ... a really strategic position, and I, I remember very clearly seeing Bethan talk one day and she was talking about, , having a direct line to the CEO. And certainly Tait Shanafelt, who runs the Stanford, program to, to teach about chief wellbeing officer, says that you must have a seat at the table with the executive.
Sharee Johnson: If you, if every decision isn't being run through the lens of that role, then they can't do their strategic work. Can you, um, share some reflections about how easy, hard, what, what was it like to try and be 'cause you weren't, you were not part of the executive team.
Dr Maura Kenny: No. I was a kind of level below that.
Dr Maura Kenny: Um, I think that's definitely a barrier if you're not [01:02:00] at the table making, um, decisions at an executive level, because a whole lot of conversations are happening that you're not part of. Um, and learning to relate to executives is a, a whole new skill set, it was a very steep learning curve for me to understand how they think and behave and act and what drives them and what they'll listen to.
Dr Maura Kenny: And, um, you know, one of the things I said in that last lecture was get to know your execs, befriend them. They think differently from you. Both of you are right. Both of you are wrong. Um, the way clinicians think is not the way executives think, even though a lot of executives have been clinicians in the past.
Dr Maura Kenny: So, um I think The Australia picked up, like they were early adopters, but they didn't pick up the way Stanford would [01:03:00] have liked them to pick up. As Tait said, you've got to have a place on the table. It was a kind of one step below. And while, you know, I had a lot of meetings with the executive and could talk to them and meet with them and present to the board and all the rest of it, it was, um, it made it harder to shape or get that conversation happening at the table all the time.
Dr Maura Kenny: Having said that, there were things that strategically we could put in place, like the, the lovely circle they have of, uh, the three contributing elements to professional fulfillment being culture that we work on, our personal capacities, and the context or clinical practice context that we work in. Those three things are all quite equal.
Dr Maura Kenny: Getting your stuff together and your personal resiliencing is not going to outweigh the weight of the other two-thirds if they're not right. So we always said to people it's 80% systemic, 20% [01:04:00] personal, so be very clear we're not telling you to fix yourself so you can continue to operate in a dysfunctional system.
Dr Maura Kenny: . But that also leaves you to put things in place. Under culture, we did a lot of stuff around peer training, peer support training, uh, compassion and kindness and, the whole incivility movement-
Dr Maura Kenny: Chris Turner's work, and we had him out to talk about the impact of incivility on clinical outcomes and patient mortality and all the rest of it. So we did a lot of work where we could around culture. We did a lot of work around, um, providing things for some personal wellbeing strategies, um, little mini wellbeing workshops that we developed and took around the system and were able to get little quick, um, on-the-spot data about how people were actually traveling as opposed to what the big, two yearly, surveys showed.
Dr Maura Kenny: Uh, and people were actually, according to those little mini hotspot data [01:05:00] sets, were actually doing better than the surveys were showing, which was good to know. Um, and then the last piece around efficiency of practice, you know, we would go in and do... If a team was struggling, we would go in and do the diagnostics.
Dr Maura Kenny: They say it's all about resources. Give us more beds, give us more staff, and it's like, well, that might be true. Let's do a, a considered analysis of that. And sometimes it was true, and sometimes, you know, more FTE might be allocated. Sometimes it was actually a really toxic culture that was going on, and nobody was being efficient because it co- So it was a kind of diagnostic exercise along with management strategies.
Dr Maura Kenny: So we put all of those things in place. Um, and they were... You know, we could start to see some teams who'd really been struggling. We probably... I think at one point I did the data and we had about 25 teams at one point, teams or units or departments referred to us. And we were able to do some work with them and, and discharge most of them.
Sharee Johnson: [01:06:00] Mm.
Dr Maura Kenny: You know, so you could go into a piece of work and then come out and then another team would pop up.
Sharee Johnson: Again, just to, uh, help the listeners with that. , This work is, is done in units, whichever, as, as Maura just said, departments or, or sections or units, but it's localized to that extent.
Sharee Johnson: It's not about rolling out one thing across the whole system. Yeah. And then it's mapping and tracking what the intervention is in each of those units. And following the Stanford model, you might have 100 units and you, and you have a sense of where they all are, the ones that you're working with, and how things are improving or not improving.
Sharee Johnson: I, I think that's a really good way of demonstrating the strategic-ness or the idea of the role being strategic. I'm wondering about the future of it and how it can happen, and you've kind of spoken to that already. There's been 13 or 20 or, you know, quite a lot of Australian, New Zealand doctors who've gone and done the Stanford course.
Sharee Johnson: Um, but then they come back and there's no actual role to apply for. So, so that's- Yeah ... that's where we are.
Sharee Johnson: Let's keep moving on to the retirement, um, question. We'll [01:07:00] finish where we started, Maura. You, you finished that job. You have moved out now. You did your last lecture and you've moved out into retirement, and you said at the beginning that there's been some bigger shifts in that than maybe we appreciate before we retire.
Dr Maura Kenny: Yeah.
Dr Maura Kenny: Yeah.
Sharee Johnson: Share some more reflections about that with us
Dr Maura Kenny: Well, yeah, I think... I mean, I had been prepared for the fact there would be a rest and recovery phase and the need to sleep and- Mm ... you know, not have the kind of freedom to not have an agenda or somebody else's agenda to follow, including my own.
Dr Maura Kenny: Um- And that is lovely. It can leave you feeling a little bit, um, ungrounded. Uh, and that's where my mindfulness practice has been enormously helpful. Like, if I don't practice for a while, if we have people coming to stay with us or we're away on holiday, then it's easy to stop doing your daily practice.
Dr Maura Kenny: And when I do d- stop that, I do [01:08:00] notice I don't sleep as well, I feel more restless and dissatisfied. And when I practice, I feel grounded again. And Then I can use that groundedness to work out how to best meet the challenge of no longer being in the roles I've had. Um, as I say, being the only non-Italian speaker in this little area that we live in, um, is deeply frustrating for my neighbors who want to talk about the garden all the time, and I don't understand.
Dr Maura Kenny: Um- Piccolo piccolo, grande
Sharee Johnson: grande. That's the, that's the extent of my
Dr Maura Kenny: Yeah, yeah. So, uh, anyway, so I did... So I used the groundedness of the practice to put, um, some things in place. Good old behavioral activation from CBT. So I have a structure. After breakfast, I do do my Italian lessons now and start, you know, expanding my vocabulary and [01:09:00] understanding and then, you know, we'll exercise.
Dr Maura Kenny: Incredibly important that we go walking or I'll do Pilates online or whatever. Um, and then, uh, you know, then there's things in the day that I might actually want to get done or need to get done or, uh, or I might spend the afternoon in the garden, but it's-- I'm not just shifting from thing to thing at will, which sounds lovely after a structured career, but actually, as I say, can leave you feeling a bit, excuse me, a bit sort of chaotic and, uh, not sure what you've achieved at the end of the day.
Dr Maura Kenny: Um, and we're so used to achieving things, it's very interesting to a life- have a life where achievement is not part of it. Um, so that's actually been really good and, and then has given me some space to do some reading around retirement transitions and there's a lot more coming through because more of us, of course, are, um, having a good 20 or 30 years after we retire.
Dr Maura Kenny: So there's much more coming through. Netflix, [01:10:00] dramas, you know, movies, books, films. Um, and so I've been dipping into that and finding that quite fascinating.
Dr Maura Kenny: One of the questions you sent me was, what do I miss about my life? And when I did that little unpaid consultancy, um, a few months ago in Melbourne, uh, I hadn't been to a meeting for a year, and this was gonna be three days or-- of meetings, and I was like, "Oh my God."
Dr Maura Kenny: And I loved it. I absolutely loved it. I love using my brain. I love working with other like-minded people. We had a report to write, you know. There was an output, there was a, a contribution. I just found that so interesting. Um, uh, learned a lot. You know, it was, it was great. So, um, s- something's bubbling up about what I do with this knowledge and experience I've accumulated.
Dr Maura Kenny: I'm not [01:11:00] quite sure what that looks like yet, but I feel like something's coming and, uh, you know, that notion of passion and how, uh-
Dr Maura Kenny: It can clarify things for you and give you energy and direction. Uh, I mean, I think it's an overused word because sometimes we need to cultivate the passions. It's not like you wake up, spring out of bed every day full of passion and energy. That'd be nice, but, you know, other days you have to kind of just grind through the day and get things done.
Dr Maura Kenny: Um, but sometimes it's lovely to have the space to open up and say, "Right, where to now?" Like, what's, what's the next thing? Um-
Sharee Johnson: Yeah. And, and you said something at the beginning before we started recording about the, the romanticism, I guess, of traveling around the three countries and, you know- Yeah, yeah
Sharee Johnson: that sounds fabulous. How is it in reality?
Dr Maura Kenny: Well, that's, yeah, it's such, you know, 'cause people say all the time, "Well, that sounds lovely, telling Scotland, [01:12:00] Italy Scotland, Australia." The thing about retirement is I think you do need to have a bit of a structure. Mm-hmm. And endless, for me, endless traveling just feels a bit hedonistic and empty after a while, which is not the case for everyone.
Dr Maura Kenny: Um, some people love it. They just love travel. My lovely partner loves travel. I have probably been, had far too much, um, ingrained in me about service and duty and responsibility and you know, all that stuff, um, which is all part of medicine. But, uh, I, I, I, I like, I would have liked to have experimented in some ways of being in each place for a whole year, so you get to do the whole arc of the seasons, and you watch your garden, which I love gardening, um, in a whole year and what to plant and what not to plant.
Dr Maura Kenny: And so there's something about shifting every few months that can be a little bit discombobulating, [01:13:00] um- Which I found was quite an interesting thing to discover. The point you get my suitcase out and my heart sinks, you know?
Sharee Johnson: Yeah. The thing I, thing I'm, I'm noticing as I'm listening is it's an experiment.
Sharee Johnson: It's all an experiment, and, and it's in the reflection and the self-awareness and the observing that you get to learn about these other parts of yourself.
Dr Maura Kenny: Yeah.
Sharee Johnson: Or these other possibles, possibilities of, of yourself, of your environment and yourself. And, and then maybe you get to have a longer arc in one or all of those places if, if that's the next experiment.
Sharee Johnson: Yeah. I think it's really important for our, the, the, certainly the doctors we work with, I, I'm always encouraging them to consider things as an experiment and gather the data.
Dr Maura Kenny: Yeah.
Sharee Johnson: Yeah. That's how, that's how we find out, isn't it? That's, that's an evidence-directed procedure.
Dr Maura Kenny: Yes, absolutely. You know, basic CBT.
Dr Maura Kenny: Yeah. Go and do a behavioral experiment and see what you discover. Yeah. Being in my, the tax laws of the different countries mean that you can't always [01:14:00] spend a whole year there because you're a tax resident somewhere else. So- Yeah ... you know, there's some of these things you start to learn that you never have thought about before.
Sharee Johnson: So, so it's like- Yeah ... like all the things in life, there's pros and cons, and it's about understanding which are the ones that you can live with and can't live without.
Dr Maura Kenny: Indeed. Indeed. Yeah.
Sharee Johnson: Yeah. What's, what's sustaining you, Maura? And, and in hindsight, what, what do you think sustained you in the 40 years of medicine?
Sharee Johnson: What were the two or three things that were really vital to sustaining you? And, and are they the same now, or are they are they different now?
Dr Maura Kenny: Well, I think I've said a few times that, um, I'm just amazed at the power of cognitive behavior therapy, mindfulness, and self-compassion. That no matter what stage of life you're in, they all have something to offer you.
Dr Maura Kenny: And, um, and that's my bedrock. Other people it might be their religious faith or their friendship group or whatever, whatever. That's my foundation for [01:15:00] life, and I find that, you know, they're all enormously beneficial in different ways at different times. Um, I really do feel that mindfulness meditation is a superpower, and, people might be surprised just how much it can help change things.
Dr Maura Kenny: The simple practice of coming to the breath for 12 minutes every day, what an investment in time that is, you know?
Sharee Johnson: A woman of my own heart. And you've, you've spoken already a little bit about have-- the importance of mentors. Is there anything else in the conversation that you've noticed today that you want to put a pin in or go back to,
Sharee Johnson: any untended threads?
Dr Maura Kenny: Um Maybe for anyone who's retiring or has retired and who's struggling, um, at times, just to say that's normal. That when we're distracted, we... and busy, we can ignore parts of our life that did actually need some [01:16:00] attending to, and that when you've got lots of time, that they'll reemerge in different ways or emerge maybe for the first time, and not to be too freaked out about that.
Dr Maura Kenny: Sometimes it's just a phase and it will pass. Sometimes it's saying maybe, you know, maybe that relationship with, you know, your partner, your daughter, your son, your neighbor does need a little bit of care, um, given to it. And if you don't know how to do that, you're still allowed to go and get some help.
Sharee Johnson: Well said.
Dr Maura Kenny: Yeah.
Sharee Johnson: And any mantra that helps you keep going?
Dr Maura Kenny: Um, be kind to yourself first and then to other people. And when you're panicking, just remember that it will all get done. Mm-hmm. That's what I've realized. It will all get done.
Sharee Johnson: Yep. Beautiful. Okay. Dr. Maura Kenny, thank you so much for your time today and for all the wisdom that you've shared with us, and may the future be bright and [01:17:00] happy and have just enough structure in it.
Dr Maura Kenny: Thank you, Sharee. It's been such a pleasure to talk to you.
