Dipti Chrastka has spent a life dedicated to behavioral health and wellbeing and believes a prevention (wellness) approach can prevent or mitigate illness when an individual looks at their whole being.
In this month's Rungs of Learning, Dipti shares the concept of a "pizza pie" approach to wellness including her own as a lifelong learner within the construct of her ethnic heritage.
Tell us a little bit about your background and your role at the University of Washington.
I got my Master’s degree in clinical psychology and have done a bit of everything in mental health including working with kids and school systems and from a diagnostic point of view.
From there, I got into crisis work which is a level up because you are dealing with intense issues like suicide prevention and very intense medical mental health crises. I was the Senior Director of Clinical Operations of the biggest crisis provider in the area and that put me in a firefighting mode. It took a toll on me, and I realized I needed to do something more upstream in prevention work which got me interested in my current role as the Director of wellness for the University of Washington’s graduate medical education program.
We serve medical students who are now doing their residency or fellowship. The UW is the sixth largest graduate medical education program in the country and my job is to foster wellness in our trainees.
Working in healthcare is a very stressful profession and doctors sometimes put others before they take care of themselves. We encourage them to prioritize their wellness and normalize that it’s okay to get support. It’s a cultural change as we orient toward a wellness model, not an illness model.
This doesn’t mean that some of the doctors I work with today don’t have mental health diagnoses but the message we like to send is to connect and talk with someone and take care of yourself. It’s more of a proactive prevention model
What is in the scope of wellness?
Wellness is a broad definition about your wellbeing and encompasses so many elements of your life. I describe it to my clients that it’s like a pizza pie. Each domain of your life is like a slice of pizza: work, family, social, spiritual, spiritual, physical health and more. Often, we find we are not in balance because we are lopsided in one or two of these slices so our relationships or self-care might not be where they need to be.
Wellness is about taking a step back and evaluating where in your life can use some more attention and what is realistic. It could look like reconnecting with your relationships, spending time in nature exercising or doing something what is important to you and your values. It is a wide spectrum, but it looks beyond the just the symptoms and what is contributing to your wellness.
What have you learned about your own pizza pie and setting boundaries for your wellness?
That relates directly to my decision to step down from the Sound board.
I was juggling all these balls and our culture glorifies working hard, multitasking and being superwoman. I recognized that is not what I wanted to be doing or what was important to me at this time. I needed to look at where I could say “no”. I wasn’t doing justice to all my interests so I had to be honest and make sense of it for myself. It was hard because I felt it was letting someone down (and I’m not a quitter) and I felt obligated to honor my responsibilities. But I had to look at it not as I was giving up but recognizing where I needed to be with my energy.
I had to be kind to myself and hold myself accountable to whether I could keep it all up and do a good enough job. I came to the answer that I could not.
When I made the decision to quit the board, everyone was so supportive and compassionate and that helped a lot because it was counter to my fears.
How do you help your clients overcome their own overwhelm?
The people I currently work with are a unique population. They are very type A, driven, intelligent and they’re not used to failure. Some of them are overly responsible and, in their profession, they’re not really allowed to make mistakes. For example, if you’re a surgeon, you better be precise so they pride themselves on being right and this can lead to perfectionism or an ‘all or nothing’ mentality.
I noticed they use the word “should” a lot and there’s high criticism for themselves. A lot of times it’s helpful to point that out and understand the values that brought them into their profession can also have this other side to them. For example, someone who is overly responsible may feel like they can’t leave and are the only person who can do it. So, if we help them take a look at what brought them to their field and made them successful might now also be a hurdle for them or hampering them from showing up in other ways.
A metaphor I use with my clients is to think about a dimmer switch that can go brighter or lighter. If you have it up high all the time, you can burn out so where are the times you can dim it a little bit? You need to be in charge of yourself and ask what’s really needed right now. So it means being self-aware and then having more self-compassion, which can be hard. We can be very punitive to ourselves so I ask them to imagine if a friend came to us with this problem and how would we respond to them? That’s how we can respond to ourselves.
Do you see any differences in your ethnic minority clients?
First off, the value that is placed on certain things that originate from your culture can be a big difference. For example, the value that is placed on things in my culture is a high focus on academic achievement, excellence and being the best. In contrast, it’s almost discouraged to have emotional intelligence.
With a pizza pie like mine, there's an ease of telling you everything about their field, but they don’t have the ability to talk about how their feeling because it’s never been encouraged. Instead, they want to people please a lot because it’s rude and individual expression is not valued. This makes it harder to set boundaries because this reflects on your whole family. You also aren’t encouraged to make decisions on your own because you don’t want to screw up and be judged.
There’s a lot of shame about emotions and people can have a hard time setting boundaries and learning that it’s okay to say “no”. I teach clients that it’s okay to be firm and to be kind.
I encourage clients to try doing small things that have low stakes when working on different behaviors. You can rewrite your story so that it works better for you and don’t need to live a lie that is not authentic and genuine to yourself.
On another topic, how did social justice become important to you? How has it been part of your learning journey?
Growing up in India, I grew up in a sheltered privileged background. I started noticing when I entered the workforce that others didn’t have the privileges I had. I was working with under resourced and impoverished communities and realized and they have the same needs and desires in the end.
When I came to the U.S., I worked with a lot of different people and realized the world is big and small at the same time and how structures can keep people down (in India, it’s the caste system and here it’s about race but the same concept). I wanted to be an agent of change and work in this field.
Growing up, my mom was a very accomplished person and very smart and then she became blind in both eyes so I could actually see how hard it was for someone who didn’t have that faculty. It made me think about what people don’t have what I do. I was my mom’s helper and guide since she was missing so much, and I wanted to help her have an improved quality of life.
What are you focusing your learning on these days?
I’m neck deep in the medical graduate education and there’s so much that I need to learn about. One of the things I’m learning is how to expand my network and make connections in service to expand our program and the system.
I’m also growing by checking my own stuff and how I’m working with my team. Asking myself what are my triggers and how are my buttons getting pushed? How can I show up and practice what I’m talking about? This also applies to my adult children.
When Dipti isn't advancing wellness, you can find her on tour - she's an elite level table tennis champion.