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How to Stop Spiralling When Massively Stressed with Scott Weingart

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Jul 7, 2025

Scott Weingart, an emergency department intensivist and physician coach, shares invaluable insights on managing stress in high-stakes medical environments. He introduces the 'Beat the Stress Fool' technique, emphasizing breath control and mental rehearsal as essential tools. Weingart highlights gratitude practices and loving-kindness meditation as antidotes to burnout. He also discusses the Stoic method of negative visualization to enhance emotional preparedness. These strategies offer a roadmap to resilience and emotional integrity under pressure, making them vital for healthcare professionals.

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ADVICE

Breathe to Calm Stress Physiology

Use slow, controlled breathing to calm your nervous system in stress moments.
Focus on extending your exhalation to twice the duration of your inhalation, ideally through the nose.

ADVICE

Use Positive Self-Talk or Noting

Counter negative self-talk with realistic, positive affirmations about your skills.
Alternatively, practice noting and labeling thoughts to create psychological distance and reduce emotional impact.

ADVICE

Mental Rehearsal Ends with Success

Visualize the full successful completion of a high-stakes task, including the emotional win.
This activates task-focused thinking and reduces catastrophic rumination.

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Stressful events can hijack cognition, cloud judgment, and leave emotional residue that can fuel long-term burnout. For acute care clinicians, those moments of emotional overwhelm, when heart rate spikes and the thinking brain goes offline, can have consequences that last far beyond the shift. While long-term resilience is essential, it’s often the just-in-time strategies that determine whether we break down or rise to the moment. In this episode, we explore the physiology and psychology of real-time emotional regulation with Scott Weingart, MD, co-creator of the Beat the Stress Fool protocol. Finally, we uncover how practices like gratitude flooding and negative visualization can inoculate against burnout and offer emotional integrity in the most harrowing moments of care.

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Scott Weingart, MD, is an emergency department intensivist and physician coach based in New York. He completed fellowships in Trauma, Surgical Critical Care, and ECMO, and is internationally recognized for his expertise in resuscitation and critical care. As the creator of the EMCrit podcast, with over 40 million downloads, he has shaped how clinicians think and perform under pressure. Together, Scott and I co-founded Guidewire Coaching, where we create and teach tailored courses to address the real-world pain points of acute care medicine.

We Discuss:

Rapid stress reset with “Beat the Stress Fool”
Breathing techniques that calm the nervous system
Self-talk under pressure
Mental rehearsal that ends in success
Trigger words for fast de-escalation
Gratitudinal flooding as a shield during emotional overload
Real-time tools for grief resilience
The quiet strength of negative visualization
Teaching stress tools to trainees without pushback

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As physician coaches, my partner, Scott Weingart, and I have noticed a pattern: some doctors are thoroughly burned out, and some are on the path to burnout. Almost all were shortchanged in their medical training, having been molded into excellent clinicians but given virtually no tools for retaining joy and equanimity throughout their careers. This course will teach you the hidden anti-burnout curriculum.

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