Why Physicians Would Benefit From Being More Vulnerable with Dr. Manizeh Mirza-Gruber

Dr. Manizeh Mirza-Gruber talks with Jill Farmer about why physicians would benefit from being more vulnerable.

“Part of the journey for me is about permission. Can I give myself permission to feel both the discomfort in feeling afraid to be vulnerable as well as the courage to be vulnerable?”

– Dr. Manizeh Mirza-Gruber, MD, is a licensed, Board-certified Psychiatrist, Certified Yoga Teacher, Certified Mind-Body Medicine Skills Facilitator (CMBM)

Today’s episode reveals the benefits of physician mindfulness with Dr. Manizeh Mirza-Gruber, MD, licensed board-certified psychiatrist. Master Certified Life Coach and cohost of of the podcast Jill Farmer welcomes Dr. Mirza-Gruber to have a conversation about why and how physicians should be encouraged to show vulnerability. As Dr. Mirza-Gruber shares in the episode, she has found that by being vulnerable with her patients, she is able to understand and help them better, and to ultimately find more joy in practicing medicine. By allowing yourself to be vulnerable and acknowledge your personal worries or doubts, Dr. Mirza-Gruber has found that physicians are able to better show compassion for themselves, so that they are then more suited to care for others. Today’s episode works to normalize these physician experiences. 

Manizeh Mirza-Gruber, MD, is a licensed, board-certified psychiatrist (ABPN), Certified Yoga Teacher (NACYT), and Certified Mind-Body Medicine Skills Facilitator (CMBM). She leads meditation groups, and is currently in a two-year Mindfulness Meditation Teacher Certification Program, Class of February 2023. 

Manizeh was born and raised in Karachi, Pakistan and moved to Houston, Texas in 1988 for her post-graduate training in Psychiatry. She worked in community mental health for almost sixteen years providing psychiatric emergency services to a culturally diverse, underserved community. 

In May 2017, she founded her own private practice, Manizeh Mirza-Gruber, M.D., PLLC – DBA Mindful in Practice™, to follow her lifelong passion of helping individuals become their true and authentic selves.

As an individual, parent, and psychiatrist, Manizeh follows a holistic approach to life. She believes in connecting mind, body, heart, and spirit for healing. 

She has been facilitating Mind-Body Skills Groups and workshops since January 2018 to bring healing in the aftermath of Hurricane Harvey, and now during the Coronavirus pandemic. 

Manizeh is happily married to her husband and has two adult children and a dog. She has a daily practice of running, yoga, and meditation. She has run several marathons, and since 2014 has been “fundracing” for a nonprofit organization, Back on My Feet. She is now one of their lead volunteers for the morning circle runs in the Houston Chapter. She believes in giving hope to the homeless one mile at a time.

Manizeh loves to read, cook, spend time with family and friends, and volunteer. She is a forever learner. Her purpose is to continue to make a meaningful impact for others by sharing her own journey with its struggles, challenges, beauty, and triumphs, and in knowing we each have the potential to find our own inner goodness.

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Please enjoy the transcript below

 

Manizeh: Part of the journey for me is about permission. Can I give myself permission to feel both the discomfort in feeling afraid to be vulnerable, as well as the courage to be vulnerable?

[DocWorking theme]

Jill: Hi everyone and welcome to DocWorking: The Whole Physician Podcast. I’m Jill Farmer, one of your cohosts of the podcast, as well as the lead coach at DocWorking. And as always, this is brought to you by DocWorking Thrive. So, go to docworking.com for more information on that today. 

I am really excited about today’s conversation. We have Dr. Manizeh Mirza-Gruber, who is a licensed board-certified psychiatrist in private practice in Houston. She is a certified yoga teacher, a certified mind-body medicine skills facilitator, and, as an individual parent and psychiatrist, Manizeh follows a holistic approach to life. She believes in connecting mind, body, heart, and spirit for healing. And we had the privilege of meeting in person not too long ago at a symposium on burnout, on physician burnout, in New York City.

Manizeh, you and I had what I considered a very rich conversation about the topic of physicians and vulnerability, and how challenging it can be for physicians to express vulnerability, and what a roadblock that can be sometimes for processing challenging situations. Thank you so much for being with me here today, so we can have a little bit more of a conversation. Hopefully, it helps people to understand where vulnerability can be meaningful in their life.

Manizeh: Thank you, Jill. Thank you for this warm and welcoming introduction. I’m just very grateful and honored to be sharing this space with you.

Jill: Let’s talk a little bit about your own story. You went through medical education, MD, and a practicing psychiatrist. In your own experience, what were the signs for you that vulnerability was something that was going to be hard to be part of your life as a practicing physician?

Manizeh: First and foremost, I was not born and raised here in the United States. I was born and raised in Karachi, Pakistan, and that’s where I went through my medical education, and then I came here to the United States almost 34 years ago, this September. I think I realized right then that it would be so much harder to be in a residency as what was then called a ‘foreign medical graduate’. They’ve changed it to ‘international medical graduate’ now. I know that even from the beginning, even when I was interviewing for residency positions, I found that rehearsing anything, a script doesn’t work for me. I function, I resonate best with where I am in this present moment. If that means putting me on the spot, if that means owning my truth, if that means really being with who I am, that’s the person you’re going to see and that’s who I want to bring to the table with some limits, obviously.

But even at that time, I realized, in order to best heal someone else, it’s almost as if I have to show them more than just empathy. I have to show them compassion, which I have to understand really where they’re coming from. This is just one example that I will always remember. Houston flooded during Hurricane Harvey and we flooded as well. This was a few weeks after the flood. I was covering at a community mental health clinic. I was covering for another physician, and one of the patients came in and she was angry, and she was upset, she wasn’t seeing her doctor, who is this person sitting in her place she’s not going to understand, and she came in and she was loud, and she said, “You’re not going to understand anything. What do you know about what it’s like to be in a flood and how can you understand where I’m coming from and now, I don’t have my doctor?” So, I just allowed her to speak. 

Then I said, “Would it be all right if I came and sat next to you?” She said, “Yes, you can come and sit next to me.” “Would it be all right if I showed you a few photographs?” I opened my phone and I showed her photographs of our home that had flooded. And she said, “Where are those from?” I said, “That’s my home. My entire neighborhood.” She just burst into tears and said, “You flooded? Doctor, you flooded?” I said, “Yes, we flooded.” We spent a long time sharing our experience. And then I said to her, “Would it be all right if we now took care of you for your appointment?”

Jill: Wow. Why do you think that just you sharing that simple shared experience was helpful to your patient in their healing in that situation?

Manizeh: Because she knew I was human, like her. I’m just not a doctor, right? I’m not just this person of this hierarchical doctor patient. We’re people, we’re humans. We’re interconnected. We all are. We are interdependent. Reverend Martin Luther King said, “Right, we are in the same fabric of destiny.” We’re bound together. We are an interconnected community. We connected out of the blue at the symposium, but we were all there for a common reason.

Jill: Mm-hmm.

Manizeh: I think what it allowed me to share with her is that your pain can be my pain. I do understand and I’m here with you. I think people need that. People need to know that we’re not just taking care of– This is where the whole psychiatry thing for me. It is not neck up. I want to take care of the whole person and I would want someone to take care of me that way. If I can attend to others by that real listening and as I even said, “Listening to me begins, obviously, with the ears and the eyes.” But I have to listen from my heart. I have to be present with them in the same space and just notice and be. That’s that sharing space like we are now.

Jill: Yeah, it’s really beautiful. I’ve heard from many, many physicians that I’ve worked with both in coaching practice, as well as listening to people on the podcast. In medical education, there’s often an emphasis put on the opposite of that, which is to not be vulnerable. And in the process of both in competitive environments, all the way from medical school and into residency, and in other ways, often doctors are saying, “We’re being taught the opposite of that.” So, let’s talk a little bit about A, why that is and B, why it potentially needs to change?

Manizeh: I can only guess why that is. I feel my culture already puts me in a different position. I didn’t grow up not being vulnerable. I have not felt that in order to be better or compete against someone else that I can’t show my softer, more vulnerable side. Maybe I’m not answering your question, but that’s never been a part of who I am. It’s not like I wear my feelings on my sleeve or I’m not professional, but I’ve always felt a little bit, maybe the outlier in that case, because I don’t feel that, that I can’t be vulnerable. I’m okay with it. I’m okay with sharing, I’m okay with connecting, I’m okay with sometimes just being in that space and just listening. I don’t know why here in the United States it’s not considered okay or we have to get ahead by not being vulnerable. To me, vulnerability is actually one of my strengths. I find it something that is an attribute that I honor and I’m grateful for.

Jill: It is an attribute. It’s a pathway towards something extremely meaningful. And so, I think to that point, I think you bring up something really valuable for us to all take in, that if vulnerability is something that’s uncomfortable for us, it is something that can be cultivated. It’s not something that’s fixed. And so, as a professional and as somebody who lives in this space very comfortably, how would you invite somebody else to be able to cultivate more vulnerability in their life and to experience what you see as a more open-hearted way of living and healing as a physician?

Manizeh: May I share something I wrote? I wrote this poem and I actually shared it in a course that I was teaching. At the end of it, it was the feedback that I received. So, I’ll read it to you first and then you tell me. It’s a poem titled Fear that I wrote on December 29th, 2021. “What I fear most seems to be fear itself. Fear of making a mistake. Fear of not being good enough. Fear, I will not be accepted for who I am. Fear, I will not give myself the chance to have my voice heard. Fear, I will leave this world with all the gifts I have inside me to share. This terrifies for I know I can continue to add value and worth to this world. I can make someone else’s world better. I can make someone else’s world easier. There are so many more fears. We all have them, don’t we? So, as I walk into today, tomorrow, and the next day, I will say to my fears, “You are my friend. It is all right if you never leave me. You can walk hand in hand beside me for you are my friend and I am not afraid.” I wonder if that answers your question.

Jill: It does. It’s so beautiful. And I just want to say, your open-hearted way of communicating helps open my heart, right? So, when people are wondering, “What’s the benefit of being more vulnerable?” or, “Isn’t it going to be risky?” there is, of course, some risk in opening our hearts to each other that sometimes, we hurt each other’s feelings or sometimes, somebody doesn’t receive it in that way. But then when you close off that, you also close off the benefit of the most beautiful way of being in communicating, connecting to each other in the human experience. And that’s what I hope people are feeling as they’re listening to this way that you’re showing us what we’ll call vulnerability, but really to me, it just feels an open-hearted way of living and being is.

Manizeh: You are right, Jill. It is scary. For some people, it might be very difficult. I think what I would share with them is, “That’s okay. That’s all right. If it’s feeling difficult for you in this moment, maybe offering even that difficult space within you that, all right, all right, my dear. This is difficult right now. But I’m here with you. Let’s walk through this together.” It’s not dismissing that. Because we have to acknowledge all those parts of us. Maybe I’m calling vulnerability or this disability that I can share as a strength for someone else that they may have some other strengths, which are beautiful and to be honored, as much as it is to honor what they are uncomfortable with.

I think we have to know where we are uncomfortable and honor that discomfort as well. Create that space. Create that space. When I lead a meditation, it’s always coming into the space with my own aspirations, and intentions, and allowing others to come into their space. There are no set rules. Everyone has to be where they are. It’s a journey and we’re all on it together but at different parts of that journey. There have been times in my life where I have noted my heart to close, and I found clearly that was one of the most difficult times in my life. I remember just asking for guidance, and one of the things I did I was, I just went into extended child’s pose, which if people practicing yoga know what I’m talking about. But mainly, I just extended my arms on to the ground below, I knew Mother Earth would hold me. I surrendered to whatever that pain was and said, “I need help. Show me the way.” I ultimately found it within myself, but I had to go from a closed heart to the willingness to be heard again, to find strength, and I know that’s where my courage comes from.

Jill: For somebody who’s listening to this and says, “That sounds beautiful when I listen to the way that Manizeh expresses herself. I can feel that it’s coming from her heart and that’s great. But gosh, I have no idea where to start. I don’t know how I’m supposed to do that. If being vulnerable helps me connect people or gosh, at best, it does what I really want to do most in life, which is better serve my patients and help them heal on their own journey, how do I start, how do I do that?”

Manizeh: I would say, be kind to yourself. I would say, begin with the compassion and kindness to yourself. Acknowledge that that is hard for you and ask yourself, “What am I feeling right now and where am I feeling this?” Maybe allow yourself to breathe into that space and soften if possible. Maybe just even take cycles of breath and see with each inbreath if you can guide your breath to that place that is asking, “How do I do this?” And then with each outbreath, maybe give yourself permission to let go. And I think part of the journey for me is about permission. Can I give myself permission to feel both the discomfort in feeling afraid to be vulnerable, as well as the courage to be vulnerable?

Jill: That is so important. I just want to re-emphasize that, because I think so much of work for physicians is other focused, how do I take care of the needs of those who I’m caring for? The internal dialogue can be so self-critical that it’s very understandable why it’s hard to show vulnerability to somebody else, because you don’t show it to yourself. You don’t show that compassion, that kindness, that open-heartedness to yourself. So, I love how you reminded us that when we start with that love in our heart for ourself, that vulnerability of being open about where we feel uncomfortable, where we’re hurting, giving that space, it just makes us so much more capable to be able to serve others in that more open-hearted and impactful way.

Manizeh: Yes. Through my mindfulness meditation practice through yoga, I have to say, through my running – I’m a marathoner – one of the things that I value is, I am in it for the long haul. I’m an endurance runner. I know, there is a term used in running called DNF, which is a did not finish. We use it when you don’t cross the finish line. I haven’t had that title yet. I have to admit there’s a while where I said, “Oh, gosh, I’m not going to be a DNF.” During 2020 right before the pandemic started and my training was not what it should have been. I was at the start line and I said to myself, “Manizeh, if you don’t finish today, you are here now, you showed up and that’s all that matters.” We are going one mile at a time. That’s all that matters.

I did finish, I did finish. But one of the things I remind myself is that, A, I have all these things that I wear that remind myself that I can do it, but I’ve given myself permission now that if I got a did not finish, that’s even okay, because it all belongs. 

Jill: Wow, you have really helped open my heart. This conversation was just lovely, and healing, and such an inspiration to me to think about communicating and listening from the heart. And for people who want to learn more about what you do, how can they reach you?

Manizeh: I have a website, www.mindfulinpractice.com. It’s also on Instagram @mindfulinpractice.com. Contact me through the website. They can sign up for a newsletter. They can join me on Mondays from 12 to 12:30 Central Time for what I call Mindful Mondays. It’s a free 30-minute guided meditation. Just drop me a line, and there are workshops, and there are many different things that I do, and I would love to share and make a difference. And thank you for making such a difference in my life when we met. 

One of the things that I really would like to say is to all us physicians and people out there, be kind. Be kind to yourselves and be kind to others. In the words of the poet, Rumi, “Your acts of kindness are iridescent wings of divine love which linger and continue to uplift others long after your sharing.” Thank you for your kindness, thank you for the invitation, thank you for allowing me to share. If even one person feels that they can connect and be kind to themselves, you’ve made me a happier person.

Jill: Dr. Manizeh Mirza-Gruber, you are wonderful. It was just great to be with you today. Thanks for being here. And thank you to all of you who joined us for this conversation today. We appreciate you. Tell your friends, share with them and go to docworking.com today to find out more about how we can support you in your life and in your work to thrive. Until next time, I’m Jill Farmer on DocWorking: The Whole Physician Podcast.

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