Payman goes live this week from the busy launch event of Mahrukh Khwaja’s new book, Resilience and Well-being for Dental Professionals.

He was lucky enough to catch Mahrukh for a whistlestop chat on the process of writing the book, the importance of factoring well-being into work and team culture, and it matters now more than ever.   


In This Episode

01.42 – Writing and pitching

04.53 – The value of therapy

06.36 – Work culture and mental wellbeing

15.44 – Suicide rates in dentistry


About Mahrukh Khwaja 

Dr. Mahrukh Khwaja is a dentist, positive psychologist and mindfulness teacher. She founded Mind Ninja—a wellness startup dedicated to improving mental health and resilience among dental professionals. 

Her book Resilience and Well-being for Dental Professionals is published by Wiley Blackwell and available from major book retailers.

Having to almost like suppress certain emotions and thoughts because we’re being professional, we’re looking after someone else, and we’re constantly in that caregiver role, and that takes its toll. And beyond that, like, we want to be happy and we want to be thriving. We want to get, like you were saying, we want to get beyond baseline to optimal states. And how do we do that?

This is Dental Leaders the podcast where you get to go one on one with emerging leaders in dentistry. Your hosts Payman, Langroudi and Prav Solanki.

A special episode of the podcast from the Brooklyn book launch of Mark’s Mark Wojo’s book, which is called Resilience and Wellbeing and Well-Being for Dental Professionals. I was surprised at the name of the book, Mark, because all the other names of your brands are so cool and and zippy. Mind flossing. Mind Ninja, was it? Brain flossing. Yeah. Mindfulness. Yeah.

Absolutely. Yeah. I appreciate that question. So I actually desperately wanted this to be a really fun, cool, catchy kind of name. But I’m working with publisher Wiley-blackwell and they were not having any of it. So for them, it was really important that it was a searchable title. And so and people were able to find it. And so it made sense for them to put those. That’s the. So there was no way around it. They weren’t they didn’t even want me to have a subtitle. And so I would have loved to have a little, little something in there.

So tell me, from the moment that you decided I am going to write a book to the moment that a week ago it came out, how long was that process?

It’s been a really long process, actually. I think I started talking about this 2019 and then I actually got around to pitching the concept to Wiley in 2020.

And how did you even know that’s what you had to do? Like pitching to Wiley, Did you research? Did you Google? How do you publish a book?

No, actually, I have, um, so I have a dental coach. I’ve got quite a few coaches, actually. And Dr. Janine Brooks has written quite a few books for Wiley. Okay. And I was in a coaching session with her and I was just talking about publishing a book and creating something. And actually I thought you had to write the book and then you pitch it to the publisher. Actually, that’s not the other way around at all. Yes. So you pitch a proposal. So Dr. Brooks was being kind in kind of introducing me to Wiley in the first place, because actually, what you would otherwise do is have an agent. You can’t just approach a publisher and you have an agent, and then they help you with creating a proposal and putting that together. So yeah, I wrote a proposal and also attached this really fun, um, little kind of teaser of the book. So I had actually been creating kind of worksheets whilst I’d been teaching like the year before. So I’d done lots of kind of workshops and created loads of worksheets around that. So that was always going to be integral to the book. It needed to be practical.

So it’s full of worksheets and exercises and colours and just a lot going on in that book. 300 pages, yes. What was your process for researching and then writing that?

I mean, honestly, it was a complete joy to write. So the way I did my writing was I sort of a skeleton and what I wanted it to look like. And for me, it was important that it was a journey. So exploring and spotlighting the evidence based tools and coming up with some sort of resilience framework and then actually thinking about how to make those habits that stick. So that kind of that really spotlighted the whole journey. So firstly, like learning about the tools and how do you make them sustainable and, and so then, yeah, it wasn’t actually too, too bad at all. So it was a matter of sitting down, working on it chapter by chapter and getting on with the first draft. So putting pen to paper as you will, and just writing, um, looking at the evidence base, incorporating that thinking of creative ways to, to do that. But firstly, you’ve just got to get the words on paper and then you can start having fun in the editing process. So yeah, it was really honestly joyful and not as hard as what people make it out to be.

It seems like you, it feeds you, it feeds you. You seem so, so energised by by this process. And it’s so lovely to see that because I remember the beginning of this process. Four years, 4 or 5 years, three, four, five years ago when you initially started talking to me about just just getting into this space, when you when you pitched this sort of stuff to not only publishers, but when you when you talk to dentists and and it’s such a big area mental health. And just when we were sitting there, you were making the comparison to, you know, going to the gym and and really nice thing that you’re saying, you know, it’s not only for when you’re in trouble, it’s for optimisation and other other tools you use for someone who’s in trouble. Similar to the tools used for someone who wants to optimise mentally. It’s a lovely thing. It’s almost like, do I have a therapist because I need a therapist or do I have a therapist because I want a therapist kind of thing. What are your thoughts around that?

Yeah, I think it’s it’s a really, really important kind of question. I think it’s really important to think of training your mind as you would train your physical body. And so these tools, you can use them in so many different ways. So whether you’re unwell. So it would certainly be applying those same kind of tools, but in a slightly different way because you don’t want to overwhelm the self when you’re experiencing illness. So it would be a slightly different approach, but certainly you can apply a lot of the things no matter what, where you are on that spectrum. Yeah, absolutely. It’s just delivering it in a way that’s engaging and also truly experimenting with the tools and seeing what fits the person best. That’s like really, really crucial.

And then the work that you’ve done where you go into organisations and try and change the culture for sort of positive, positive culture. Explain that to me. If I know you’re going to bigger, bigger and better organisations than Dental practices only, right? But, but from the dental practice perspective, if you were going to come into a dental practice and try and improve the culture of that practice, let’s say, let’s say it’s a bit of a we’ve all worked in a practice where there’s a bit of a toxic culture. Yeah. And not only, you know, I know you had some examples where you had a boss boss associate nightmare and that happens a lot. But, but we see it a lot in dental practice just within teams, there’s toxicity. How do you start to, first of all, even assess what is the culture of this place that I’ve walked into? And then secondly, change that culture in what how I mean, it must take more than one visit to change culture in a place.

Yeah, absolutely. I’ve got a whole chapter on this very topic where I delve into creating positive work cultures. I think it’s absolutely massive and crucial when it comes to our sense of well-being and also the team’s productivity and stability is all linked. And so there are many kind of roots to this. But I mean, firstly it is talking to your team and finding out more about their needs as well and creating a culture of psychological safety. So when we use this term, we’re talking about a environment where your colleagues feel safe to share concerns without reprimand. You can actually, um, yeah. Just be your general concerns. Yeah.

General mental health concerns, general counsel.

General, like things you’re unhappy about in.

Terms of be able to talk openly.

Be able to talk openly and to create that culture. That’s open door policy. Not every practice is okay with that, certainly not that embedding psychological safety is really underpins wellbeing. And as I was saying, it all leads to positive outcomes anyway. So creating that culture which is open, you’re, you’re saying that you’re comfortable for feedback. I want to know it and I want to know your thoughts and, and to not be defensive at that point. It does take a lot of work, I think, from management side of things. Yeah, really, really important. And then another aspect that’s absolutely crucial is thinking about mental health first aid and having this available for the whole team. So go on a course on mental health first aid. It’s very accessible. Two days, brilliant time. What do you.

Mean, What does it.

Mean? So you learn the tools and you learn the early signs and symptoms of mental illness.

In yourself and in others.

Exactly. So now you can as a team, start recognising when your team member needs support and then you can have the conversations with them around mental health, ill health, I’m talking about. So, so we’re talking about things like depression, anxiety, suicidal thoughts, and you can signpost them appropriately because there are things at crisis point for us. So if you have, say.

Throw out a couple of those, what are they? Irritability, sleeplessness? What is it?

Yeah. So it’s it’s when someone is appearing to act differently to how they were before. Yeah. So it’s about maybe eating more or eating less, not sleeping well and you might notice them physically look different and they might be more aggressive. They might be withdrawn. Yeah. But just start starting to recognise those signs is really, really important. And then you’ll actually be taught how to talk about mental illness in a way that’s kind, loving, non-judgmental, compassionate and you’re going to start creating that culture that’s more accepting and open. So that’s one aspect. Another massive aspect I believe obviously is um, resilience and wellbeing education and have psychological tools accessible for everyone. So it’s not just about reducing burnout. Team, but it’s equally as important to get your team members to feel more engaged at work and living a life of meaning and purpose. And there are routes to this. So with the way when I’m teaching my programs and workshops, I’m talking about finding your strengths and bringing them to work. And there’s different ways we can do this as well. So in positive psychology, there’s a lot of research to support. If you’re using your strengths in challenges as well as outside of challenges, you’re going to feel better, you’re going to be happier, and you’re going to be more profitable.

There’s an acronym, isn’t there, for the five, six things you bring to that?

I don’t know. The acronym. Yeah, you said it.

You said it yourself. Maybe it’s a different thing. I don’t know. I heard you speak. I heard you speak. Speaking on some other podcast on Qadis.

Okay. I don’t remember an acronym, but but strengths is really, really massive. Then you’ve got values. So bringing those into work and understanding your values, gratitude. So creating a culture of gratitude and there’s so many cool ways you can do this. So in your team meetings, playing ping pong, so sharing compliments back and throw like wins in your day, like small moments, big moments, actually sharing it with your team amplifies positive emotions. And that is amazing. You’ve you’ve we’ve all understand that experientially we’ve we’ve talked to others cheered our wins and we’ve noticed an increase in our feelings of you know feeling more inspired, more grateful, more um, feelings of compassion, fulfilment and meaning all of these beautiful emotions. So what positive emotions do when a team is they help broaden their perspective and to increase psychological resources. So that’s really, really important. And so that’s a great way. So creating a culture of gratitude, it could be as simple as spotlighting someone who’s a really well in your team. You could have a gratitude board at work, you could have a gratitude WhatsApp. But actually honing into what’s going well in your team is really, really worth celebrating because you’re going to create a culture where people feel recognised and supported and and and it’s joyful. So yeah, finding ways that you can integrate that could be a great way of changing culture. But yes, it does take time. This isn’t something that happens overnight. It takes conversations really getting to know your team and their their unique needs. But there is there is wellbeing education out there that’s evidence based. There are frameworks that are useful.

You know, get resistance when you when you go into a place from individuals.


So the stigma is still there, right? And some people some people feel like, I don’t need this conversation.

Yeah, absolutely. And you can’t bring everyone on to the table. You can only just share. Look, we’ve got a course on if you’d like to be part of it. This is you might be that it’s compulsory, but I’d like you to engage in it like it’s fine if you can’t engage in the way that I want you. That’s absolutely fine. You just. You’ve got to just make those choices available and not force things on people. But I think normally when people start to understand what this can do for them, then normally they’re quite receptive actually, because, you know, people want to speak openly and be free and talk about things that truly matter to them. And this is where wellbeing truly shines because you can share what’s really going on, right? And often as Dental professionals, we’re having to almost like suppress certain emotions and thoughts because we’re being professional, we’re looking after someone else and we’re constantly in that caregiver role and that takes its toll. And beyond that, like we want to be happy and we want to be thriving. We want to get like you were saying, we want to get beyond baseline to optimal states.

How do we do that? So even if, like the illness side of things doesn’t resonate, like because you’re like, okay, well, I’ve never experienced depression like that just doesn’t I wouldn’t that doesn’t impact me, right? That’s okay if you feel like that and you can certainly benefit from just understanding mental health better and you can help, you know, maybe your family or your kids or you can also just learn to be more resilient or happier or more optimistic. So there’s always something you can learn because actually the brain is wired for negativity bias. It’s full of automatic negative thoughts that are unhelpful. And so actually, just even learning about thought patterns better and mindset is going to be really beneficial to you in terms of thriving. So I think anyone can get a benefit from this. It’s fine if if that person’s resistant. We don’t want to push anything on anyone, but it’s just. About hopefully them being curious and having an open mind. And who knows, they might discover something really useful and beneficial.

So one final question. Yes. And it’s a serious one. Suicide and dentistry. Now, you’ve looked at so much research. Is there research that says, number one, it’s real, that dentists do commit suicide more than other professionals? Or is that sort of urban myth sort of thing? And number two, what’s your opinion on why dentists, you know, why not brain surgeons? Why not some other type of professional?

Yeah. So the rates of suicide are higher in dental professionals in other sectors, of course, like healthcare professionals are all in a similar pool. So if you even look pre-pandemic. So there’s going to be a bunch of research, obviously post pandemic, but pre pandemic Toon and colleagues in 2019 did a study on UK general dental practitioners and found that 10% experienced suicidal thoughts. So yes, they didn’t commit suicide, but the general public is 5%. So this is higher in our population. And so what the research spotlights into why, like why is this happening? Why particularly us and lots of different reasons. It’s multifactorial. Some of the factors are because of organisational issues. So things like contract targets, admin issues, staffing, all of those aspects, work culture, obviously all feeds into it. Then you’ve got the risk of litigation.

But I read 50 years ago in Kansas, yeah, dentists had a higher chance of suicide than other professionals, you know what I mean? There was no there was no contract. There wasn’t. So. So what is it about the job itself? Yeah.

So it doesn’t so it may not be Udas, but it’s the organisation kind of framework that so like I said, staffing issues, that’s not practices. Yeah, Yeah. So that’s like almost like many, many practices can relate to that. But kind of beyond that, let’s just take the patient factors. Simply us working with patients who are in distress, awake, awake, but anxious, they might be going through trauma. You know, we see them regularly, like three monthly sometimes and we’re actually with them in their journey. They’re going through a divorce and they might be raped. There’s so much stuff that we deal with and and a patient comes in and we’re looking after them. We’re the caregiver. So simply being around that much trauma can feed into ourselves and we can simply take on a patient’s pain. That’s called compassion fatigue when you take it to its extreme. Yeah, but then why not, you know.

Psychologists or GP’s? I mean there’s something about dentistry. Yeah. I mean the, the loneliness of the room.

Yeah. So is it. Yeah. So, so then you’ve got other factors such as individual factors. So in our niche we’ve got high levels of perfectionism and that can lead to things like burnout and psychological distress. We’ve got imposter syndrome. It’s quite high in our profession as well, and we might not have the self-care tools. There’s loneliness as well, and loneliness actually increases our levels of stress. As we know, chronic stress states are really harmful for mentally and physically. So there’s all of those aspects.

And it’s such an unfair question to ask you, isn’t it, at this moment to say why? But I have to know what you thought about that.

It’s so multifactorial. There isn’t one aspect. And the other aspect I haven’t spotlighted was just the risk of litigation and the stress of regulation. So our bodies are regulating us. It’s not that they’re regulating us. It’s more like when there is a fitness to practice case. It takes so long for that case to go through and there’s so much anguish in that period. So there’s that aspect. And that’s not just UK based, that’s, you know, that’s everywhere globally. So there’s that as a factor as well. And so there’s a range there really. And then obviously you’ve got things that aren’t in the research yet. There’s social media and we’re making constant upwards social comparisons and dentistry, so visual. So you know, you’ve got that aspect as well. Yeah. And then on top of that, we’re not taught the tools, the psychological tools early on. Like I think it’s madness.

It should be in the undergrad, what you said, what you said, it needs to be in there, but much, a whole lot of stuff needs to be in the underground, right. And a whole lot of stuff that shouldn’t be in the underground. Yeah. We spend hours and hours and hours doing things that most dentists never do. Yes. And then things like this. Things like how do you get a loan for a business? You know, simple stuff like that.

Simple stuff like that.

Covered at all?

Yeah. No, absolutely. We could definitely shift that. But then even beyond that postgraduate, we need more of an emphasis on this. Sure. And not just anecdotal advice, but more evidence based. I think it would be great to move towards that. So I think that’s the way of the future.

Where it’s such a pleasure to see you doing this, to bring out the book one more time, say the title and where they can get it.

Oh, thank you so much. Hey, it’s been a pleasure. It’s resilience and well-being for dental professionals and you can get it in Amazon. It’s also available in Waterstones and spirits and all sorts of places. But yeah, yeah, it’s absolutely everywhere and it’s global, so which is wicked. But Amazon probably the cheapest space you can get it amazing. It’s a really good deal right now.

And such a lot of resource in that book. So check that book out. I certainly will be getting a few copies right now. Thank you so much.

Yeah, Thank you. So proud of.

You. Hey.

This is Dental Leaders, the podcast where you get to go one on one with emerging leaders in dentistry. Your hosts. Payman, Langroudi and Prav. Solanki.

Thanks for listening, guys. Hope you enjoyed today’s episode. Make sure you tune in for future episodes. Hit subscribe in iTunes or Google Play or whatever platform it is. And you know, we really, really appreciate it. If you would give us a.

Six star rating.

Six star rating. That’s what always leave my Uber driver.

Thanks a lot, guys. Bye.

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