Reader''s Group Guide Discussion Questions: 1. HOW DO YOU FEEL? begins with Gold sharing an uncomfortable moment during a session with a patient. How does this set the tone for the rest of the book? Why do you think she chose this scene to open the book with? (For people in healthcare: If something similar happened to you, do you think you would have reacted the same?) 2. Gold struggles with the fact that, during the pandemic, she is considered a "non-essential" worker. How does this impact her sense of identity as a healthcare worker and her job of taking care of healthcare workers who are on the frontlines? Discuss the moment where she struggles to go into the hospital when she''s on call. What do you think about her decision to include this, and why do you think she did even though it might not be something most people not have admitted? (For people in healthcare: Thinking back to that time for you, did you ever question your identity or role? How did you feel about it?) Knowing what we know now post-pandemic, do you think healthcare workers in psychiatry would be treated the same way if another pandemic hit? 3. Throughout the book, Gold talks about the idea that healthcare workers, starting from their early days in school and prepping for the MCAT, define themselves by their career path. Why do you think this is the case, particularly in healthcare, and what toll does this take on them? How is this different from other industries and career trajectories? 4.
Gold shares that she was an "overachiever" growing up and always strove to accomplish many goals and wear many hats. How do you think this affected her as she went through the pre-medical journey and started work in psychiatry? Do you think being an "overachiever" is something that has impacted you in your field, whether you work in healthcare or not? How so? 5. Gold writes that there are two types of perfectionism: adaptive and maladaptive. What did that discussion make you think of your own behaviors? Knowing this, would you still want your doctor to be one? 6. Presenteeism is the opposite of absenteeism and is very common in our workplaces. Gold tells a few stories about what she has heard and seen in medicine about this. What is it like in your own field? Do you feel like you can really take time off when you are sick, or if you need a mental health day? Why or why not? 7. Throughout the book, Gold''s relationship with her own therapist, Dr.
Miller, is discussed. How does Gold''s relationship with Dr. Miller help her to uncover truths about herself? How does the discussion of their relationship, parallel to Gold''s discussion of what she is going through as a healthcare provider, impact the reader''s experience? 8. Self-disclosing (when a therapist shares information about themself to a patient) is talked about many times throughout the book. Gold discusses how, although it''s often not encouraged, she has found it to be sometimes helpful in building trust with a patient. What do you think about this? How much self-disclosing do you think is appropriate by a doctor, but especially a mental health provider? Do you think it would (or, has it) affected your relationship with a therapist? What do you think about Gold choosing to write a memoir, given these conversations? 9. Gold chose to feature the stories of four "patients" in the book to help share her story. Do you think this choice was helpful in your reading of the book? Why might Gold have decided to include patient examples rather than strictly outline her own experiences? Did one of these patients stand out to you in particular? Why? 10.
On page 234, Megan shares with Dr. Gold the story of one of her patients commending her for crying when her husband had passed, sharing that it helped her deeply. In response, Gold wonders if it''s "okay to be a psychiatrist who cries in front of colleagues or patients." What do you think? Is there a difference between a hospital doctor and a psychiatrist showing this type of emotional vulnerability? Why or why not? Do you think it is appropriate to show emotions in any workplace? What kind of messages have you received, explicit or otherwise, in your own field about sharing your feelings? 11. Gold discusses the toll that the Covid pandemic takes on her, and specifically on her telehealth appointments. On the patient end, how do you feel about telehealth? Do you agree that it can lead to a less personal, connected experience between the healthcare worker and the patient? What are the pros and cons of telehealth, especially as it seems to be a more permanent fixture in post-Covid healthcare? 10. If you work in healthcare: do you relate to any of Gold''s story? Have you felt that you need to suppress human emotion in order to serve your patients? What messages did you get in school and training about them? How do you think this has impacted you and your patient care? Does reading Gold''s story make you think any differently about your experience or your own mental health? If you don''t work in healthcare, do you feel you understand healthcare workers better after reading HOW DO YOU FEEL? 11. Gold discusses that many of the issues she has with healthcare culture are large, systemic ones, which might feel overwhelming to think about.
What are some ways, on a day-to-day level, that you think individuals can help to combat the stigmas that Gold outlines throughout the book? What kinds of skills that Gold describes trying herself or discusses with her patients resonate with you or have worked for you in the past? 13. If you have been or currently are in therapy or psychiatry: What did you appreciate about Gold''s vulnerability in sharing her struggles as a therapist? Does this affect the way you might think about your own treatment? Do you think there is a different stigma associated with medications vs. therapy? Why? 14. If you have not been in therapy or psychiatry: Do you have a different perspective of therapy now? Do you think the ideas Gold discussed can apply at all to your life or your line of work? 14. Why do you think Gold chose HOW DO YOU FEEL? as the title? What is its significance in the book as a whole? Activities 1. Pick a scene or "patient" described in the book and act out what a conversation between them and their therapist might be. Try to really embody) the characters and imagine how they might be feeling. Then, debrief and discuss how you felt, or what insights you might have gained, acting this out.
2. Take a few moments to self-reflect or journal, individually, about how you related (or didn''t relate) to the book. This can include how you cope with your emotions at work, or how the Covid pandemic affected you emotionally. Share and discuss as a group. 3. Pick a study that Dr. Gold referenced in the book which piqued your interest and read further about it. Then, present your findings to the group.
4. Dr. Gold shares a lot about the role of poetry and music in her own mental health and how sometimes she chooses other people''s words to better describe her own. Pick a song or poem or meme that helps you express your mental health, and explain why. Author Q&A HOW DO YOU FEEL? begins with you hitting what you describe as a "breaking point." How did you get there? What did the lead-up to that moment look like? Sometimes you don''t know you''re off until you''re REALLY off. Like so many of my patients, I blow past early warning signs (for me, extreme anger at my inbox, for example), and attribute them to work or, really, medicine just being hard. I think "I''m fine" and just "a little tired," and push through nearly falling asleep, and ignore my emotions, and just keep going.
I learned to do that in medical school, because we''re always needed, and not supposed to come first, and all of those thoughts were only compounded in the pandemic. I felt pulled and needed so much as a psychiatrist who saw healthcare workers and an administrator in charge of our staff and faculty support during such a challenging time, but I also felt guilty because I was not an "actual frontline worker" and that only made me want to do more and more. What feels like a sudden break is never really sudden, but is often just bad enough for you to finally recognize yourself in the equation. This book discusses not only the challenges healthcare workers face but also the complexities of caring for others in general. What implications do your findings have for readers who are outside of the medical field but are nonetheless struggling with the difficulties of care work in their personal lives? Not everyone is in healthcare, but healthcare is just one example of putting others before yourself. Take motherhood, instead: I hear over and over from women that they care for their kids, and sometimes also their parents, and after that, there is no time for them. The truth is, we are all better caregivers when we recognize and take care of our own needs. I think seeing me and the patients in the book struggle with this balance is not only validating but enlightening.
I hope people who struggle with the same universal themes (overwork, perfectionism, empathy, burnout) feel less alone, but also learn some tips and tricks to try in their own lives. It isn''t a self-help book, but readers will see me suggest interventions to my patients and my therapist do the same to me, and can decide if they want to incorporate any of those ideas into their lives. Plus, if a healthcare worker who studies mental health topics like burnout (or, in the case of me, specializes in it!) can fail to notice symptoms in themselv.