8 Ways to Heal from Chiropractic Practice Burnout 

Practical Tools to Get Your Energy and Passion for Practice Back

Nearly 40% of us face some level of emotional exhaustion and chiropractic practice burnout during our careers. As business owners in the chiropractic profession we face unique challenges in the realm of living a flourishing life. Many of us face struggles in the juggle of trying to balance our personal, family and professional lives. In all the busyness of our days and caring for others, it can be easy to forget to also care for ourselves. This handbook presents a series of activities and practices of varying time commitments and durations that draw from concepts of Acceptance and Commitment Therapy (ACT), Mindfulness and Positive Psychology.

What follows is a description activities backed by research that help support your body heal from chiropractic practice burnout by focusing on emotional health through the activation of the vagal nerve, elimination of the internal effects of stress, and improved mental clarity, resilience and relationships. Included are suggestions and recommendations on how to implement these practices that promote flourishing not only for yourself, but also with your family, staff and practice members/patients.

The Quick Reset

Mindful Breathing/Heart Focused Breathing

What it is:

Mindful breathing involves taking a moment to breathe a little more slowly and deeply while devoting your attention to one of the following areas:

1) Pay attention to the air passing in and out of your nose. Focus at the openings of your nostrils and pay attention to the temperature change as air moves in and out of your nostrils. This is known as mindfulness breathing and is commonly taught in Acceptance and Commitment Therapy (ACT).

2) Focus your attention on the area of the heart. Imagine your breath flowing in through your heart and out through your solar plexus. This is a HeartMath technique known as Heart Focused Breathing. It is a variation of mindful breathing that shifts your attention to the area of the heart and can settle your nervous system.

What it does:

Calms your nervous system and promotes a state of coherence (syncing between your central nervous system, brain, heart and stomach). Promotes emotional regulation and resilience.

When to use it:

• In moments of transition (arriving at the office/home, between patients, before shifting to a new activity)
• Before team huddles, staff meetings or conversations
• Upon waking/before going to bed.
• Before or even during difficult conversations
• Before reacting to misbehaving kids
• Where else can you see it being useful?

How long it takes:

Regular short moments of mindful breathing throughout your day lasting anywhere from 30 seconds to 2 minutes can start to impact your nervous system.

Three Good Things

In our day-to-day lives balancing practice and home life, it’s easy to get caught up in the things that go wrong-ie the things that causing us to feel chiropractic practice burnout in the first place. At the same time, we tend to adapt to the good things and people in our lives, taking them for granted. We also as chiropractors can have a tendency to practice “toxic positivity”-pretending everything is amazing at the office when really we feel anything but.

As a result, we often overlook everyday beauty and goodness—a kind gesture from a stranger or the warmth of our heater on a chilly morning. In the process, we frequently miss opportunities for happiness and connection. This practice guards against those tendencies.

What it is:

Each day, write down three things that went well for you that day, and provide an explanation for why they went well. It is important to create a physical record of your items by writing them down; it is not enough simply to do this exercise in your head.

• Give the event a title (e.g., “patient or practice member shared an amazing healing win”)
• Write down exactly what happened in as much detail as possible, including what you did or said and, if others were involved, what they did or said.
• Include how this event made you feel at the time and how this event made you feel later (including now, as you remember it).
• Explain what you think caused this event—why it came to pass.
• Use whatever writing style you please, and do not worry about perfect grammar and spelling. Use as much detail as you’d like.
• If you find yourself focusing on negative feelings, refocus your mind on the good event and the positive feelings that came with it. This can take effort but gets easier with practice and can make a real difference in how you feel.

What it does:

Remembering and listing three positive things that have happened in your day—and considering what caused them—you tune into the sources of goodness in your life. It’s a habit that can change the emotional tone of your life, replacing feelings of disappointment or entitlement with those of gratitude—which may be why this practice is associated with significant increases in happiness.

When to use it:

• At the end of your day before bed
• To start or end team huddles or meetings
• As an activity for practice members/patients to write (anonymously) their good things for the day or week on a card/sticky note to be displayed on a wall of “Good Things” in the office.
• With your kids, spouse/partner before or after dinner.
• Where else can you see implementing it?

How long it takes:

No more than 10 minutes a day.

The Inner World Reconnect

Noticing and Naming

This exercise is taken from Russ Harris’ book The Happiness Trap and is part of a process he refers to as ‘unhooking’. In the busyness of life, we tend to be disconnected from our inner world. This is a piece of the process that takes us to burnout. Learning to reconnect with our emotions and body sensations helps us to reengage with our own needs.

What it is:

Spend time each day noticing and naming your thoughts, feelings and body sensations with curiosity and no judgement. After observing your inner world, reengage in what you’re doing.

What it does:

When we notice and name our thoughts and feelings, especially the difficult ones, it reduces their effect on our behavior.

By noticing and naming what we’re feeling, we create a degree of separation between our thoughts and feelings and stop struggling with them. They also have less control over us. To do this state the words “I’m noticing…,” or “Here is…”

When to use it:

• Anytime you’re feeling hooked by an emotion or are ruminating on an event or situation.
• Anytime you’re going through a challenging time or feel yourself charged by a situation either at work or home.
• As part of your day to day routine as a way to check in with yourself.
• To bring yourself present while adjusting or engaging with your staff, practice members or family.
• As a guided exercise to help practice members or staff who are struggling with big emotions.

How long it takes:

As little as a few seconds to a few minutes.

Mindful Body Scanning

Many of us live in a state where we are completely disconnected from ourselves and our inner world and emotions. Especially if you are on the road to burnout or have already arrived, you can also have reached a point of numbness where we’ve entered a state of emotional freeze.

What it is:

A practice of sitting in quiet while scanning through the body, beginning at the top of the head and working your way down to the tips of your toes and back up. There are a few things to be aware of while you’re doing this:

• Begin with mindful or Heart Focused Breathing to center your nervous system.
• Move in small 1″-2″ spots beginning at the top of your head and moving down on your front side and arms, and then back. If you don’t feel anything in certain areas at first that is okay. It will come.
• Use Noticing and Naming to notice any thoughts and emotions that come up while you are scanning, but don’t engage with them. Stay focused on the area.
• Quite a bit of research has shown this is most effective when practiced for at least 30 minutes twice a day, but any amount of time will be a start.
• Another route you can go to scanning is focusing on the areas of your chakra’s or energy centers. For a digram of these, follow this link.
• There are more advanced techniques for body scanning that can be learned as you start feeling more at the surface level. To learn about this more in depth check out Bruno Cayoun’s book on Mindfulness-integrated CBT for Personal Well-being and Growth.

What it does:

Mindful body scanning can help us to start to reawaken our inner world and reconnect to it. It also increases our heart coherence and serves to help the body release some of the effects of longterm stress.

When to use it:

• When you’re feeling stuck in your own healing journey
• When you’re ready to start reconnecting to your inner world
• When you’ve been through some level of trauma (make sure you have support before engaging in this practice)
• As part of a routine to keep yourself healthy and happy mentally and physically.

How long it takes:

This one has a bigger time investment-up to 30 minutes twice a day.

T.A.M.E

Another exercise from Russ Harris’ book The Happiness Trap, this practice helps you make space for difficult or big emotions that may arise when you start connecting with your inner world through the first two practices mentioned here.

What it is:

A four step process that helps you TAME big emotions.

• Take note-notice and name what’s showing up in your body.
• Allow– give your feelings permission to be there, let it be.
• Make room– open up to the feeling and let if freely flow through you. I like to play with giving it more or less space and allowing it to have as much space as it needs.
• Expand awareness– broaden your focus to include the world around you.

What it does:

Helps you to stop fighting against (resisting) your emotions and instead be with them without being taken in by them. Creates space for new perspective and insight to come through.

When to use it:

• Any time you come across sensations in your body that feel big or scary or anytime you want to connect more deeply with your inner landscape.
• With practice, this can be done quickly throughout your day. But until it becomes second nature, schedule specific times through your day to check in with yourself and practice TAME-ing any emotions you come across.
• Use in conjunction with Mindful Body Scanning to help process any buried emotions you find in your body.

How long it takes:

This process can be done rapidly as you get used to it. To start, plan on at least 3-5 minutes to engage with yourself and deepen your noticing and naming into TAME-ing.

The Stress & Burnout Busters

Dr. Barbara Fredrickson has done substantial research in the power positive emotions have in negating the physiological toll of stress in our lives. The following are a few ways you can start to build and measure what she calls your Positivity Ratio. The goal is not to be happy and positive all the time, but to experience at least a 3:1 ratio of positive emotions to negative in our day to day lives. As she discusses in her Broaden and Build Theory, the more we take notice of and invite positive emotions into our lives, the more the benefits of positivity builds in our health and lives.

The Positivity Portfolio

What it is:

The brain child of Dr. Fredrickson, this is a list of things that elicit positive/renewing emotions like love, kindness, happiness, gratitude, compassion or joy. Some examples include:

• A positive playlist that you play in the office or car everyday (think upbeat, feel good, makes non dancers want to dance and everyone sing along)
• Artwork or pictures where you see it regularly through the day that make you feel happy–a vacation spot, vision board, family, pets etc
• Activities that always bring a smile to your face.
• Inspiring quotes or sayings.
• Anything else you can think of.

What it does:

It creates intentional moments through your day where you are actively eliciting positive emotions for yourself (and ideally others).

When to use it:

Anywhere and everywhere it will be noticed throughout your day. Put intention into it.

How long it takes:

The only real time investment is in creating your portfolio. Pace yourself and add to it over time. Start with whatever is easiest!

Loving Kindness Meditation

What it is: a short meditation that inspires compassion, love and kindness towards yourself and others.

How to do it:

• Begin by closing your eyes, or lowering your gaze and connecting with your heart. Place your hand over your heart and slow your breathing down, imagining the air is flowing in and out of your heart.
• Turn your attention towards yourself and send yourself kind and loving thoughts. Some examples: “May I be happy and healthy. May I be safe and secure. May I live with ease.”
• Next expand your focus outward to include your close family and friends. Send them similar kind and loving thoughts. “May you be happy and healthy. May you feel safe and secure. May you live with ease.”
• Expand your focus further to include your practice members, your community, your state/country/world. You can go as large as you want. Again sending love, kindness and compassion to this group.
• Radiate the feeling of love and compassion towards yourself and others for as long as you have time and space to do it.

*Note, if there are certain people or groups you feel resistant to sending compassion and kindness towards, simply take note of that and utilize some of the other tools in this handbook to work through whatever is coming up for you.

What it does:

Improves your vagal tone by increasing positive emotions, thereby negating the effects of stress.

When to use it:

Anytime you want, but with intention. Some recommendations:

• Upon first waking up or going to sleep
• As part of a morning huddle with your team.
• At the beginning or end of your shift or day.
• Anywhere else you see being able to have consistency in practicing it.

How long it takes:

This can be a relatively short meditation but spending at least 10 minutes practicing it is recommended.

Positivity Ratio Tracker

What it is:

A 2 minute self test created by Dr. Barbara Fredrickson that allows you to track your positivity ratio each day.

What it does:

gives you an objective view of how you’re doing in noticing and experience positive emotions throughout your day.

When to use it:

• Daily for a week or two to measure your progress
• As a check in whenever you want to have objective input into your emotional states
• For an office challenge with your practice members and staff over a designated time period.
• Any other times you see it being useful.

How long it takes:

2 minutes or less per day.

I hope these practices serve you in the ever ending journey to find balance and our own state of healing and flourishing in both our personal and professional lives. Need some accountability or more guidance? As a next step, check out the 7 Day Burnout Reset that will come right to your inbox and guide you through a gentle reset over seven days.

References

• Ackerman, C. E., MA. (2024, November 6). What is flourishing in positive psychology? (+8 tips & PDF). PositivePsychology.com. https://positivepsychology.com/flourishing/
• Cayoun, B. A. (2011). Mindfulness-Integrated CBT: Principles and practice. http://doi.wiley.com/10.1002/9781119993162
• HeartMath Institute. (2022, November 18). Heart-Focused Breathing – HeartMath Institute. https://www.heartmath.org/articles-of-the-heart/the-math-of-heartmath/heart-focused-breathing/
• Happiness Practice #1: Three Good Things | Week 1: Introduction to the Science of Happiness | The Science of Happiness | EDX. (n.d.). https://learning.edx.org/course/course-v1:BerkeleyX+GG101x+3T2023/block-v1:BerkeleyX+GG101x+3T2023+type@sequential+block@0fb987e3d7224fa9b8d241273b88c6e1/block-v1:BerkeleyX+GG101x+3T2023+type@vertical+block@a31d0c47091b42a4977301be59a989cf
• Harris, R. (2022). The Happiness Trap (Second Edition): How to Stop Struggling and Start Living. Shambhala Publications.
• Positive Psychology – Positive Emotions: The Tiny Engines of Positive Psychology – Week 1 | Coursera. (n.d.). Coursera. https://www.coursera.org/learn/positive-psychology/home/module/1
• Williams, S., Zipp, G. P., Cahill, T., & Parasher, R. K. (2013). Prevalence of burnout among doctors of chiropractic in the northeastern United States. Journal of Manipulative and Physiological Therapeutics, 36(6), 376–384. https://doi.org/10.1016/j.jmpt.2013.05.025