Crisis doesn't always show up with sirens. It's often quieter than that. You're still showing up to work, still answering emails, still functioning. But inside, you're slowly coming apart. Maybe, without knowing.

Vincent Deary calls this "the trembling state." After a decade running an NHS fatigue clinic, he's identified patterns: the most capable people often break hardest. Rest becomes impossible. And telling exhausted teams to be more resilient makes things worse.

We discuss allostatic load, what happens when demand never lets up, why convalescence matters, and the ethics of staying with people in crisis. This isn't about optimization. It's about what breaks us and what it takes to rebuild.

Vincent Deary is a Professor of Applied Health Psychology at Northumbria University and author of the books 'How We Break' and 'How We Are'.

Episode Notes

Link to Vincent’s book “How We Break”

https://www.penguin.co.uk/books/273528/how-we-break-by-deary-vincent/9780141979793

Book Review by The Guardian

https://www.theguardian.com/books/2024/feb/01/how-we-break-by-vincent-deary-review-look-after-yourself

Studies mentioned in the episode (for full sources from Vincents work, see the book ‘How We Break’):

• Cartner, Helen (2024). “'A taste of my life' ... altered eating and Sjӧgren’s syndrome: a participant-led exploration of eating experience using application of a novel methodology, 'food play', Doctoral Thesis, Northumbria University

Link: https://researchportal.northumbria.ac.uk/ws/portalfiles/portal/179099797/HelenCartnerThesisUNN.pdf

• Ackah, M., Deary, V., Abonie, U. S., Hettinga, F. J., & Hackett, K. L. (2025). “Rest recharges my energy”; experiences and perceptions of rest in adults with long-term conditions and fatigue in rehabilitation: a qualitative study.” Disability and Rehabilitation, 1-12. Advance online publication.

Link: https://doi.org/10.1080/09638288.2025.2512587

Content note: This episode discusses burnout, depression, anxiety, chronic illness, and relationship breakdown.

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What happens when crisis hits? How does it move through your life? Through work, relationships and identity?

This is is When Everything Hurts, What Do You Do?

In every episode, I explore crisis through those three dimensions, because when one part breaks, the rest moves.

I sit down with psychologists, doctors, business leaders, and people living through disruption right now.

Episode 1 drops next week with Vincent Deary, Professor of Applied Health Psychology and author of the books "How We Break" and "How We Are"

Because at the end of the day, we’re all faced with the same question: when everything hurts, what do you do?

Hosted on Acast. See acast.com/privacy for more information.