When Everything Hurts, What Do You Do?

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 NotesLink to Vincent’s book “How We Break” https://www.penguin.co.uk/books/273528/how-we-break-by-deary-vincent/9780141979793Book Review by The Guardianhttps://www.theguardian.com/books/2024/feb/01/how-we-break-by-vincent-deary-review-look-after-yourselfStudies 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 UniversityLink: https://researchportal.northumbria.ac.uk/ws/portalfiles/portal/179099797/HelenCartnerThesisUNN.pdfAckah, 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/10.1080/09638288.2025.2512587Content note: This episode discusses burnout, depression, anxiety, chronic illness, and relationship breakdown.