Episode #85: Acupuncture Marketing School Podcast: Selling a 7-Figure Practice and Recovering from Burnout with Gabrielle Juliano-Villani

Join me and Gabrielle Juliano-Villani, a business consultant and former therapist who helps business owners scale sustainably without burning out.

Gabrielle shares how she rapidly scaled her therapy practice to 15 employees in just four years, as well as how burnout played a role in deciding to sell the practice.

In recovering from burnout, she discovered polyvagal therapy, a way to regulate the nervous  system. We discuss acupuncture and other polyvagal therapies, and Gabrielle shares how gratitude fits into the picture of burnout recovery.

Plus we discuss tips for selling a practice (including one big thing to avoid), as well as facing your fears as a business owner in order to make progress, and more.

I hope you enjoy this episode with Gabrielle!

Announcement! I’m thrilled to share the launch of Acupuncture Marketing School Live, a six-week Zoom course where I show you how to set up strong, effective marketing for your acupuncture practice.

Learn how to increase the visibility of your practice, attract more patients, and build your marketing confidence.

Classes will be held on Friday mornings from 10am to 12pm Eastern Time starting this week, Oct. 25th, and running through Friday, Dec. 6th. We’ll be skipping the week of US thanksgiving.

Learn more about the live class here.

This live class includes all the same content as the self-paced, video-based version of Acupuncture Marketing School, and I’m excited to teach it live so that we can work through your marketing together.

You’ll have the opportunity to get your questions answered in real time during classes, as well as support, accountability, and motivation.

Prefer self-paced classes that you can complete on your own schedule?

The self-paced version of Acupuncture Marketing School is on sale this week for $200 off with the code AUTUMN200. Click here to learn more.

Show Notes: 

🎙️ Listen to Episode #85: Selling a 15-Person Therapy Practice and Recovering from Burnout with Gabrielle Juliano-Villani

Subscribe to the Acupuncture Marketing School podcast on Apple Podcasts or Spotify

 💖 Love the podcast? Help other acupuncturists find the podcast by leaving a review here.

Transcript:

[MICHELLE GRASEK] (00:00):

Welcome to the Acupuncture Marketing School podcast. I’m your host, Michelle Grasek, and I’m here to help you get visible in your community, take marketing action with confidence, and get more patients in your practice and more money in your pocket every week. We both know you’re a talented, passionate acupuncturist and that acupuncture has the power to change lives. So let’s dive right into this episode and talk about how you can reach more patients.

(00:33):

Welcome back. Today I’m talking with Gabrielle Juliano-Villani, a therapist and business coach who grew her counseling business to employ 15 clinicians in just four years. Her business grew so fast that she experienced massive burnout, which eventually played a role in selling that business. Today, she helps fellow entrepreneurs grow their businesses in ways that are sustainable and support their values, as well as supporting a calm nervous system. So in this episode, we talk about facing your fears as a business owner, tips for selling a practice, why your online presence matters in selling your practice, and it might not be exactly what you’re thinking of, how to avoid burnout and using the polyvagal theory of nervous system regulation to heal and recover from burnout. Plus much more.

[AMS COURSE] (01:23):

Before we get started today, this episode is sponsored by Acupuncture Marketing School. I am thrilled to share the launch of Acupuncture Marketing School live; a six-week zoom course where I show you how to set up strong, effective marketing for your acupuncture practice. You’ll learn how to increase the visibility of your practice, attract more patients, and build your marketing confidence. Classes will be on Friday mornings from 10:00 AM to 12:00 PM Eastern time, starting October 25th and running through Friday December 6th. We’ll be skipping the week of US Thanksgiving. This live class includes all the same content as the self-paced video-based version of acupuncture marketing school. And I’m excited to teach it live so that we can work through your marketing together. You’ll have the opportunity to get your questions answered in real time during classes, as well as the support, accountability, and motivation that comes, not only from working together with your instructor, but also from your fellow classmates who are going through the material with you. It’s an incredible learning opportunity, and I’m so excited to do this with you.

(02:34):

It’s time to quit feeling stressed about marketing and about your patient numbers. Marketing is just a tool that we can use to reach more people, and I can’t wait to show you how to do just that. Plus, every student who signs up this week gets a special bonus worth $247, a free 60-minute one-on-one marketing strategy session with me. The link is in the show notes. If you’d like to join me, feel free to email me at michelle@michellegrasek.com with any questions at all. I am more than happy to chat with you to make sure this class is a good fit for your needs. And if you prefer self-paced classes that you can complete on your own schedule, that is no problem. The self-paced version of Acupuncture Marketing School is on sale this week for $200 off with the code [AUTUMUN200]. I’ll put the link for that in the show notes as well.

[MICHELLE] (03:25):

All right, let’s get into this episode with Gabrielle. Hi, Gabrielle, how are you today?

[GABRIELLE JULIANO-VILLANI] (03:32):

I am doing well. Thank you so much for having me.

[MICHELLE] (03:35):

My pleasure. I am really looking forward to talking with you today. You have a Master’s of Social Work, and you scaled and then sold this incredible practice, and now you teach other practitioners. You’re a business coach. I feel like you wear many hats, so if you want to introduce yourself to the audience, that would be super.

[GABRIELLE] (03:56):

I do wear many hats so it is a lot to capture, but I think you did a pretty good job. I am a Licensed Clinical Social Worker, and yes, I had a private practice that really specialized in the Medicare and Medicaid community and then due to my own burnout, I sold it. I scaled it to seven figures and 15 people working for me, which I never thought would ever happen and then I ended up selling it in 2021. And so since then I’ve pivoted and I do business consulting to help other people scale sustainably without burning out. I help consult people on how to sell. I also consult on Medicare and Medicaid compliance. I also run retreats on burnout prevention for healers and helpers and entrepreneurs with a big focus on nervous system regulation, A.K.A polyvagal theory. So I think that covers all of it. And in my free time I teach Zumba.

[MICHELLE] (04:59):

So cool. I love it. I’m so curious to learn, first of all how you went about scaling to have 15 people working for you. That’s incredible.

[GABRIELLE] (05:10):

Thank you. It still feels like weird to say sometimes because I know when I started my practice, I just never ever, ever thought that that’s how it would end up, which is I guess why you should never say never. But I had a really strong niche that was needed. I actually started my practice doing home visits with Medicare population, and so we did in-home counseling with them. And because there’s such a lack of Medicare providers and people who work with that population, I got really full really fast. And I told myself when I started my practice, oh, I’m just going to see 15 clients a week and then that turned to 18 and then it was 20, and then somehow, I was seeing 30 people, which is insane, especially for therapy. And actually, one of my Zumba students who was an occupational therapist, was in home health. She was like, “Oh, the next thing to do is to just hire somebody and I know a social worker who works with me and she would love to do this.” So that was great that that relationship just happened to open the door to my first hire who stayed with me through the whole thing, by the way. And so I hired her and I asked her to be flexible with me because I was building the plane while I was flying it. I was like, “I don’t have forms and I don’t know what I’m doing.” And she was great. And then that went well and we kept getting more phone calls so I hired somebody else and that went well. And then it just snowballed and before I knew it, I had 15 people working for me.

[MICHELLE] (06:51):

I wish I could tell people all the time what a great idea is and that it’s actually safe to build the plane as you’re flying it. I think that really prevents people from taking the next step in their business. And it’s because, and I have felt this as well as an acupuncturist, I want to hire someone, but I don’t know how. And so you just sit on it and sit on it and sit on it until you do burn out, because you’re continuing to work by yourself or whatever the thing is that you’re afraid of. But I think that for people who regularly build businesses, like the classic entrepreneur that we might think of, it’s totally normal for them to just dive in head first and exactly as you said, build the plane as they’re flying it, and just trust that as they need the answers, they will do what’s required to find them and it will all work out. But that’s scary if, I don’t know about therapists, but acupuncturists are not really taught business education in school. And so we have no context for taking that risk as business owners.

[GABRIELLE] (08:07):

Same thing for us, especially with social work. I think in some other therapy disciplines, like for counselors and maybe even marriage and family therapists and psychologists, they talk about even just opening a private practice, but nobody ever talked to me about that. I didn’t even know that that was a thing. The way that I found out about it actually was that during grad school and my bachelor’s also, I worked at Chase Bank as a teller, and one of our clients was a social worker in private practice, and she was coming in to deposit the checks for her client’s copays and she was like, “You should get your license and you should start a practice and you can take insurance.” And I was like, “Oh, really?” I didn’t know that.

[MICHELLE] (08:52):

Crazy.

[GABRIELLE] (08:55):

So same thing, we have no business experience, and it’s true, you have to lean into the fear. That’s what I’ve really learned throughout, like starting that business and then a second business, you have to use it as a motivator because nothing changes. If nothing changes, you’re never going to know everything. You just have to take the leap blindly sometimes. And you might it up and that’s okay too. We’ll figure it out.

[MICHELLE] (09:24):

Yeah. And I find that the mistakes that we make when we take those risks end up being so much smaller than the disasters that we’re anticipating. And I guess if you’re investing your whole life savings in something that’s like a different story, that’s a different risk, but mostly what I see small business owners doing are things that are not going to break their business if they give it a try, like hiring someone and not having all of the forms immediately ready is like, generally it’s going to be fine. It’ll turn out well. So I hope that people really take that to heart and think about what is the thing that I am afraid of doing in my business and what would happen if I just started?

[GABRIELLE] (10:14):

Yeah. I mean, that’s the difference. I even know, like when I first started getting more into business coaching and consulting and offering digital products and things that I do, I felt really stuck. And I also noticed that I was definitely just being vulnerable and transparent. I was definitely judging other people in this space who were doing that, oh, they’re so shameless and they’re always posting and blah, blah, blah. Yeah, they are and they’re the ones doing it and like, making money doing it so I have to do the same thing.

[MICHELLE] (10:51):

I have had that experience where I’m like, oh, now that I’m in it, I understand their perspective and they’re doing it just right. So it’s okay to be visible, but it is so super scary at first.

[GABRIELLE] (11:02):

It is, it is. And again, you have to lean into the fear a little bit.

[MICHELLE] (11:08):

Okay. So you had these 15 employees who were going into people’s homes. I don’t think I realized that. When I read in-home, for some reason I was imagining like Covid Zoom therapy session, but this is visiting people in their homes. Was this really before Zoom was a thing or this was a population that at that time was not going to be using Zoom?

[GABRIELLE] (11:33):

It was in the beginning. So when I first started my practice at the very, very end of 2017, I just did in-home because I had actually done that with my previous job. I used to work for Humana as an in-home care manager and so that’s what I did. I was like, oh, this is easy. I don’t need to pay for an office. I don’t really mind driving. At that time I didn’t mind driving, I wouldn’t do that now. But then I was like, whatever, it’s fine. And it gave people more access to care and so throughout 2019, and partially the beginning of 2020, that’s what we did. And then of course, 2020 happened and Covid and we completely shifted to virtual. And from then on we were almost entirely virtual. I still had maybe two clinicians who were seeing people in their homes, but it was hard.

(12:27):

I mean, the landscape had changed and clinicians didn’t want to do that anymore, which I totally understood. But we took Medicare, we took Medicaid, we took commercial insurance, we started growing and seeing different populations a little bit too, but our Medicare clients were still able to do Zoom or we could do phone sessions with them. But there was, I think people really preferred in home. But that was like, part of what was burning me out, was like I couldn’t find people who wanted to do that.

[MICHELLE] (12:56):

Oh, got you.

[GABRIELLE] (12:58):

So we had to make do with Zoom and virtual therapy.

[MICHELLE] (13:02):

Yes. Can we just talk about how pristine clean my house would be if my therapist actually came here? I think I would have to tell her like, no, we have to do Zoom. You can’t come into my house today, it’s a disaster.

[GABRIELLE] (13:18):

You know what, I would probably be the same, but a lot of these clients did not feel that way, I will say that.

[MICHELLE] (13:24):

Well, good for them. It’s like, “You wanted to come here, this is it.”

[GABRIELLE] (13:28):

Yep, this is how it is. But it is like a different layer of connection, I think, to see people in their homes, which I did really enjoy. And because again, like not everybody on Medicare is elderly, but a lot of our clients, of course, that we were doing in-home with were. And so they just, they really appreciated it and they were more open and they felt more comfortable and they would make me coffee and tea and it was like, like these little rituals that were nice too.

[MICHELLE] (13:59):

Oh, that is so nice. I very briefly did in-home acupuncture before I had an office right after graduation and felt like for me, the not knowing what to expect in someone’s home, will I have space to set up this table? Is their cat going to try to dump on the table while they are getting acupuncture? That first treatment was always a little stressful, but then, like you said, you sort of figure out the flow of this person’s house and they know that they need to put the cat in the spare bedroom or whatever the situation is. But yes, it was a nice experience in a different way to see them in their element like that.

[GABRIELLE] (14:43):

Yeah.

[MICHELLE] (14:44):

Okay, so now you’ve got these 15 people, gosh, who are working for you. And I am pretty sure I read on your website that that was about 200 sessions a week between all of your employees.

[GABRIELLE] (14:58):

Yeah, it probably, some weeks was even more. I think Medicare for sure, it was 200 sessions a week. And then of course, like if we’re thinking about the other insurances we took, it might have been more some weeks. It was a lot.

[MICHELLE] (15:12):

So were you mostly doing the admin and the billing at that point or were you also seeing clients still?

[GABRIELLE] (15:18):

Well, that’s what contributed partially to my burnout. And what I have learned and what I teach other people when I am coaching them to not do is, I was for a long time still seeing 20 clients a week. And I was doing all the billing, which I actually liked doing the billing because it was tedious, and I didn’t mind. I’m like it has a beginning and an end, like just clicking the buttons. And that was definitely a huge mistake and I started to realize that mid or beginning of 2021, I think, and I started telling my clinicians, I am going to be pairing down my caseload and giving, hopefully transitioning some of these people to you because it was way too much. And I think it was fear-based. I was afraid if I stopped seeing clients, then that’s like less money that I get to keep. And I was afraid of that. So I had to do some mindset shifts around that. And eventually I got down to I think probably 10 to 12, which was much more manageable, but still a lot. I mean, that’s 12 hours of the week where I’m just with someone and I’m not doing anything else. So that was a big chunk, but yeah, don’t do that. It’s the moral of that story. You can’t do both. You can’t. It’s too much, so don’t try.

[MICHELLE] (16:47):

And I would imagine that fear of scaling back because of losing income is pretty common. I would guess that lots of people that you talk to who need to scale back have that same concern. So what do you tell them?

[GABRIELLE] (17:03):

It is. And I even recently have had a few coaching clients who are group practice owners with practices as big as mine was, or bigger who are still seeing 25 clients a week. And I’m like, that is way too much. And so I tell them, you know why. We need to figure out the why. Is it because you’re afraid? Is it because you like doing it? There’s nothing wrong with that, but if you like seeing clients, you can’t have a full caseload and try and run this business. So if you’re going to see a full caseload, then you need more leadership because you need to delegate out more. So I just try and help them lean into the why and figure that out and oftentimes it is scarcity of yeah, losing that income, but we have to reframe that as that’s more hours for you to work on the business instead of in the business and to create maybe other streams of income. Or maybe it’s because you want to go to your own acupuncture on Friday morning instead of being in meetings or with clients. And that’s important too.

[MICHELLE] (18:11):

It’s so interesting that you mentioned maybe people do want to keep their caseload, but that means they need to hire someone else to do the admin and the running of the business that they’re doing like an operations manager or something like that. I find that one of the biggest struggles for any wellness business owner as we grow is learning to delegate. And that can just be so scary. You feel like you’re giving your power, your decision-making ability away to someone else, but I think we forget that if we own the business, we can teach the person, here are the values of the business and here are the guidelines for making decisions. And then you can find someone who will faithfully carry that out. It’s not like you are going to hire someone and then they’re going to do insane things, hopefully. But I think it’s almost like a, it’s fear-based, like you’ve been saying. It’s like a visceral thing where you’re like, “Gosh, if I give this away to someone, what will happen?”

[GABRIELLE] (19:13):

It is really common for us in the wellness space. We’re helpers and we’re healers and we just think that we should or need to do it all. And I always think about it from a CEO mindset. They don’t do everything. The first example that came was not good, but like, Jeff Bezos, do you think that he is the one dealing with the water delivery in the offices? No, he’s not. And obviously we don’t need to be like him to delegate. I’m just saying. But people who run their businesses successfully, they know that, that they can’t and they shouldn’t do everything. And that’s why other people exist, virtual assistants or admin assistants or an operations manager, even a fractional COO or a fractional CFO. That’s why these people exist so that they can help you be successful so you can be the visionary and do the things that you’re good at doing.

[MICHELLE] (20:15):

Okay. So we just lost connection, but we’re back. Yay. I shouldn’t say we, it was me. It was all me. My Wi-Fi stopped.

[GABRIELLE] (20:23):

It’s all good. We’re back now.

[MICHELLE] (20:26):

After you experienced the burnout in your practice, you scaled back to 10 or 12 patients, but then what did you do after that?

[GABRIELLE] (20:36):

So what I tried to do was delegate more to, I’ve made somebody, I promoted him to assistant clinical director in my practice, and so tried to give him more of the stuff that I didn’t want to do, but then he ended up not wanting to do a lot of that stuff either. So that wasn’t super helpful, but a little bit because I was able to delegate somewhat. And then probably spring 2021, a friend of mine who’s in a totally different field but also an entrepreneur, she was like, “Why don’t you just sell your business?” And I was like, “Do people buy mental health counseling practices? I didn’t think people bought that.” And she was like, “Yeah, sure, why not?” I’m like, “Oh, okay. Yes, that’s true.” So we just ran some preliminary numbers and I was like, this is not, it’s not enough money because that’s what you always think, it’s not enough money.

(21:31):

And I was like, “Okay, I’m just going to have to suck it up and keep pushing through.” But it was really rough. I was losing more people and the landscape for mental health had changed. So we had like a lot of bigger venture capitalists coming in, trying to cash in and so a lot of clinicians were leaving to work on their own because they had made it a lot easier and they were going to get paid more. So there was a lot of attrition and just, it was so hard to hire. And I was like, okay, I don’t really know what I’m going to do here. And I do remember feeling very lost because the selling isn’t going to be enough. Somebody who I tried to delegate to, it’s not working. I can’t find anyone to hire. We have more clients than we know what to do with. People are calling multiple times a day to get services. And then I went on vacation and I got a phone call, I was on vacation and they said, “We represent a company that’s interested in acquiring your practice. Give us a call back.”

[MICHELLE] (22:35):

Wow.

[GABRIELLE] (22:36):

It’s like, that’s totally spam. That’s fake. I’m not going to do that. And my friend was like, “No, that’s how these deals happen. I mean, Google it first and meet them and make sure.” And I did and they were legit. So I met them and that’s who ended up buying my practice six months later.

[MICHELLE] (22:56):

Wow. Did they know that you were thinking of selling or they just reached out to you out of the blue?

[GABRIELLE] (23:02):

They did not know. Maybe on like a universal energetic level, they knew, but they did not know. I had not put it out there to anybody except for this friend. And so that’s just how it ended up happening.

[MICHELLE] (23:17):

Wow. So do you have any advice for people who are considering selling their practices? It’s funny, because in acupuncture, I think we assume everything is unique to our industry. Like every industry thinks it’s unique, but because we’re in our own silo and then we finally get to talk to other people and we’re like, “Wow. Oh gosh, everybody’s dealing with this.” But the perception that I’m familiar with for most acupuncturists is that you can’t sell your practice, nobody’s buying, you’re not going to get a good price for it, that thing. So if you have any advice or thoughts for someone who’s trying to do that, I think people would find it really helpful.

[GABRIELLE] (23:58):

Yeah, of course, we all have those thoughts in every industry. So that’s true. And I think some things to think about if you’re selling a business, first of all, I mean, you could sell to somebody privately if it’s maybe just you, but that doesn’t happen as often. So that’s something to think about, is, because I do get a lot of therapists, even who it’s just their practice and it’s their clients and it’s just them. And that’s not really sellable because the business is tied to you. So you want to start to, and that’s the importance of delegating also, like, you don’t want to be the sole pillar. All the business shouldn’t be dependent on you. So like my practice, I still, like I said, mistake, seeing too many clients still, but there was still people in my practice who they were bringing in more than I was because it wasn’t just me. So if I go away, then there is still income in revenue coming in. So I think that’s very important. And also just being very organized. So you think that, yeah, you started your business 10 years ago and you got some letter in the mail and you got something from the IRS about your EIN, like you need to keep all those things.

[MICHELLE] (25:14):

Yeah.

[GABRIELLE] (25:14):

So if you accept insurance and you have contracts, you need those. So you want to have basically anything that’s related to your business, any documents, all that stuff you need to keep. And it needs to be organized. You want to be tracking those things. I mean, even for, if it’s mental health or acupuncture, they’re going to want to know how many clients did you see last year versus this year? How much money did you make last year versus this year? If you accept insurance, were you billing this plan or this plan? They’re going to want to see all of those KPIs. They’re going to want to know where your clients come from. The thing that I was actually surprised about, because I asked them, I was like, how did you find me? Because like I said, I didn’t put it out there to anybody. And they were like, “Well, we wanted to buy a Medicare practice because of what they did and you were had the best SEO on Google, like you were the first one that came up and you had the most reviews.” So your online presence and your reputation is also important.

[MICHELLE] (26:22):

It is definitely sellable. I have seen a successful sale of individual acupuncture practices to another individual, but it requires a lot of patient education and massaging because it is, like you said, you are the business, you are the income, the clients are yours, and they are very attached to you as an individual. And so to transfer the entirety of it to someone else, you really have to bring that person on, introduce them to everyone, have them in your clinic, have them shadowing you, endorse them in front of current patients in multiple ways, like in-person. And then send out your email newsletters and be like, “I’m bringing on this lovely person. They have the same practice style.” So I have seen that happen and I think it’s normal to expect a certain amount of attrition even with all of that effort, but the person purchasing the practice is aware of that’s going to happen. They know that. So I think that can be sort of calculated into their buying price. But I do think, and I have never sold a practice, but the people that I’ve talked to, it seems helpful to have a brand that is, as you said, like at least a little bit independent of you. And so if that’s something that people want in the future, maybe they could think about rebranding in a way that doesn’t necessarily use their name or is something that people would want to buy that they feel like could fit them as well.

[GABRIELLE] (28:03):

Yes.

[MICHELLE] (28:03):

Yeah, I think it’s doable, but I agree with you. You’ve got to have, it’s got to be specific. Maybe have this planned in motion for a little bit before you try to sell it.

[GABRIELLE] (28:13):

Which also made me think of when you were talking about this, I had forgotten, but I remember now my old chiropractor, well, I went through three chiropractors and they just, it was like this one practice that had been sold and I just called one day to make an appointment and the guy I was seeing wasn’t there anymore. And they’re like, “Yeah, this is Mel now.” I’m like, “Okay.’

[MICHELLE] (28:34):

“Okay, Mel.”

[GABRIELLE] (28:36):

Well, thank you. I mean, and I was like, “Do you have the same style as the guy I was seeing?” Because he was a little, he’s very gentle and I liked that. And then it happened again, same thing, like I stopped going for a while and then I called to make an appointment and it was a different dude. And I’m like, “Okay.” So they didn’t even tell me and I got their emails.

[MICHELLE] (28:58):

Really interesting.

[GABRIELLE] (28:58):

Nobody made an announcement. Now it’s just different dudes going through the same chiropractor’s office. So yeah, it is doable.

[MICHELLE] (29:07):

It’s doable. I hate to think about the number of patients that they lost in every transition because they didn’t make an effort to connect the dots for their patients, “Hey, this person’s taking over. I think they’re great. Their practice style is similar and different in this way. Here’s how you make this decision.” Maybe come and meet them at an open house. I don’t know, maybe, I feel like if I were managing that transition as a marketing obsessed person, I would treat it as a marketing campaign and be like, okay, this campaign is about getting these patients to love this new person. Because you know that they’re talented and they’re warm and wonderful, but the patients, the audience, they don’t know that yet.

[GABRIELLE] (29:51):

I’m the same way. And I’m also very big on relationships because that’s what’s really helped me build both of my businesses and everything that I’ve done has really been through relationships. I mean, that’s how I met you, was my relationship with Jane. So I feel the same way that I would just want to explain and have that piece of it. And that’s important I think on both sides. Even as a patient with my chiropractor, I would’ve liked to know that some new dude was going to answer the phone and be touching me. And on the other end, I would want our clients to know that as well. And that’s what I did. When we sold, we had to have that conversation with all of them. And we did send emails and we made an announcement, but everybody also with each individual client had that conversation with them that your care is not changing. I’m staying, all of those types of things.

[MICHELLE] (30:53):

Yeah. And I mean, it is a lot of work, but I do think that selling a practice is a project on its own. It’s not like you just collect money and walk away. I’m sure no one anticipates it will be that simple, but there’s a lot of layers.

[GABRIELLE] (31:12):

Yes. I think a lot of people come to me because they’re burnt out and they’re like, you sold your practice. I want to sell my practice. And I have to tell you that going through the sale and staying on, because you often have to stay on, at least in our field, that could be negotiable, but the selling was so stressful. It was during the holiday season, my family was visiting me and I was on the beach trying to watch the sunset on Christmas Eve, and I’m on the phone with my attorney negotiating terms of this deal. It’s not that easy. So I don’t regret it, but still it was really stressful.

[MICHELLE] (31:54):

So how did you recover from the burnout that you were experiencing? So you sold your practice and then things got better, or how did you approach that?

[GABRIELLE] (32:04):

I think I expected them to. There’s this, I don’t really know how to explain what I’m trying to say, but there’s like this phenomenon, that’s the word I was looking for, where when you are doing something really big and then it happens, you feel numb. And my friend actually sent me an article about this in the Atlantic about this New York bestseller and everyone’s like, “Oh my God, you’re on the bestsellers list,” and like, “How do you feel?” And she was like, “I feel nothing.” That’s how I felt. I think there was all of this buildup. And I also had to stay on for a year to help with the transition so it didn’t quite feel done yet. And I felt very lost. Okay, now what? I thought I wanted to do something, but I wasn’t really sure. And so what really helped me looking back on that journey were a couple of things. First, I just really needed deep rest because I had been in fight or flight for so long.

(33:06):

So that was helpful to where I wasn’t seeing as many clients. I wasn’t taking on so much, there wasn’t so much stress. I had more space. I really needed more space. And I got into sound healing and I became a sound healer, which really helped me. I found my own spirituality through that, which helped me. And I also started noticing, well, there was two things. One, I also got diagnosed with ADHD, which also helped explain some of the things I was struggling with. And I really leaned into polyvagal theory and nervous system regulation and really paying attention to this is what my system needs and I am privileged to work for myself and I need to create a business and a life that supports my system through that. And those are the things that really made big changes. And also, I did a lot of work about my own values and my own purpose and making sure that everything that I do every day is really in alignment with that too.

[MICHELLE] (34:10):

I love that. Can you tell us about polyvagal theory?

[GABRIELLE] (34:15):

I could talk about this for 12 hours, so I’m going to try and make it short.

[MICHELLE] (34:21):

Perfect. We have time.

[GABRIELLE] (34:21):

My favorite time thing to talk about. Polyvagal theory was developed by a psychiatrist named Steven Porges. We already knew about the vagus nerve and all the fun, amazing things it does for our body, but Dr. Porges rediscovered these other two pathways. And so it’s basically responsible for our stress response, our emotional regulation, and also what happens physically that we don’t have control over. So he says that there’s three stages. There’s our ventral vagal, which is probably what we’re both at right now because we’re calm and connected and we’re making eye contact with each other, which listeners won’t see, but maybe they can feel it. That’s our baseline, but then we have stress, everybody has stress, and we go into fight or flight. Everybody knows what that feels like, probably. And then after fight or flight, when our system is too overwhelmed, we go into freeze. And so that’s our third phase there, and then we cycle back through them. So Dr. Porges says this is a better way to understand how we connect to ourselves and the environment and the responses that we have. So that’s like a very high-level response. But I love that you’re an acupuncturist because that’s super helpful to get you into your ventral vagal and help maybe release some trauma or stress that you might be holding onto that could be keeping you in fight or flight or freeze.

[MICHELLE] (35:56):

I love it. I was just going to say, acupuncture is so good for regulating the vagus nerve and, I think we’re just beginning to understand what it does and how it does that, but there are other ways to access that as well, right?

[GABRIELLE] (36:12):

Yeah. And a lot of them, like sound healing is a really easy way. Acupuncture, for me, also works really well. I usually fall asleep because I’m so relaxed. I mean, but it doesn’t have to be super zen and meditating. You could dance, you could go for a walk, you could pet your dog, you could notice the sunset every day. Or one of my glimmers is what we call them, which are micro moments of joy that gets you into that ventral vagal place, one of mine is the way that the sun comes in my bedroom window at night right before the sun sets. It’s really beautiful. And I always try every day to intentionally watch that, even if it’s just for a couple of seconds.

[MICHELLE] (36:56):

I love the idea of the searching for that glimmer and having it be intentional and recognizing it, because I do think when you are paying attention at that level, it makes your life better in so many different ways. And it really builds gratitude.

[GABRIELLE] (37:13):

Those are all extremely important things that regulate our nervous system. And we think it’s so small, like, oh, gratitude, whatever, every wellness person does to be grateful. But it’s really true. Those small things make huge changes in your nervous system. And it’s like a muscle because the more you do the things that feel good and keep you anchored in that ventral vagal energy, the more glimmers that you notice, that window gets a lot bigger and the fight flight and freeze windows gets a lot smaller and you’ll have more resilience when you’re in those places too.

[MICHELLE] (37:54):

Is it correct to assume that meditation also enhances the ventral vagal stage?

[GABRIELLE] (38:00):

It does. And I will also just say the caveat with meditating is that it doesn’t work for everybody. And it also from a trauma informed perspective, if you’re somebody who has experienced trauma, it might not feel safe for you. So yes, for some people, but not for others. Or, again, you want to like titrate it and start small.

[MICHELLE] (38:24):

Yeah. And I know often people have this perception of meditation where they have to have a quiet mind. I don’t think I’ve had a quiet mind for like a moment in my life.

[GABRIELLE] (38:34):

Same.

[MICHELLE] (38:35):

But as I understand meditation, and I’m really just a beginner that seems not necessary for success. And so I think that is helpful to know on the front end. But yes, really good to know that if people have a history of trauma, maybe it’s not the best choice for them, or not to dive in face first at least.

[GABRIELLE] (38:56):

Yes, exactly.

[MICHELLE] (38:58):

And is that something that you work with your business clients on?

[GABRIELLE] (39:03):

I do. And so, because to me it’s really, it’s the foundation for everything and for everyone, and if you are burnt out, you’re in freeze, and if you’re stressed, you’re in fight or flight. And when you are in those places, your prefrontal cortex is also not online. And that is the part of our brain that makes rational decisions and executive functioning and all of those things. And so if you’re running a business from your amygdala, which is fear then the…

[MICHELLE] (39:32):

That’s your lizard brain, the amygdala>

[GABRIELLE] (39:35):

That’s your lizard brain. And you don’t want to live from there and you don’t want to make choices from there. So it’s the basis for everything. So it really comes down to every decision that we make. So yes, I do this work and I do teach, I do something called mapping our nervous systems where we go through each stage and I teach you to understand yourself and what it looks like for you and if you need help, to put a plan into place to build upon more of that ventral vagal energy.

[MICHELLE] (40:05):

I don’t know if we talk enough about how being a stressed-out business owner or, I think a lot of people operate in burnout for a long time before they simply cannot anymore. But just the idea that you aren’t making the best decisions in that place. And I have had multiple business coaches on here, and so many people will say, pause and go on vacation. Take a week off and do a staycation, and then have like a little business pow-wow with yourself, but wait until your nervous system has come down a notch and then do your self-assessment. Although it probably takes more than a week to really come down out of burnout. But it really is important to advocate for taking good care of yourself as much as you can all the time so that you are not in any of those heightened stages so you can make good business decisions so that you never have to feel like, I just want to quit. Because I think that sounds like the freeze stage where you are just like, forget it, I want to sell this business. I’m going to hire Gabrielle and she can help me sell this business.

[GABRIELLE] (41:17):

That’s it. Exactly. The pause is so important. And I also even think about, sometimes I don’t know, I’ve gotten an email that piss me off and I just want to like start pounding the keyboard back. I’m going to say things that are not compassionate because I can’t access compassion when I’m angry and when I’m triggered. And so I just let that email sit there for a day or two, it’s not urgent, and then when I come back, I can look at it with more compassion. And I have experienced that many times, even when I was burnt out with my staff, sometimes they would text me at 8:00 PM and I would get so and then I’m like, well, first of all, this is a me problem because I shouldn’t be allowing anybody to text me at eight o’clock. We’re not an emergency service here. Nobody is in crisis. And also, I don’t need to respond right away and I need to set better boundaries. And when I set better boundaries, then I’m not going to be pushed into fight or flight and the whole thing. So it’s important and yes, a week vacation isn’t going to solve the burnout or all of your business problems, but I think, and that’s actually where retreats come in. It can be a good vacuum to just reset and then start to put a plan into place that supports you long-term because that’s the real true self-care.

[MICHELLE] (42:40):

Yes. I’ll definitely have to have you back because clearly, I just think all of these topics are fascinating and really important for longevity as entrepreneurs. I know lots of entrepreneurs who say that they really have no intention of fully retiring ever. But I think in order for that to be a reality, to still have your hand in some capacity when you’re 70 or 80, it starts now learning the skills to take care of yourself and support yourself so that you can be active in some business capacity later on. Anyway, I have one last question for you that I ask everybody, and that is, what is your definition of success?

[GABRIELLE] (43:22):

I love this question so much because five years ago I would’ve had a very different answer, would’ve been like more money hustle, harder grind, or this big business. And now my definition of success is freedom. And that to me is freedom to travel, freedom to do whatever I want during the day. And I have, I’m pretty close to like having that 100% of the time. And to me that is success, is having the freedom to live your life on your terms however you want to.

[MICHELLE] (44:01):

Well, thank you so, so much for being here today. Where can people get in touch with you? I’m sure some people are interested in your coaching and going through the vasovagal training with you.

[GABRIELLE] (44:13):

Yes. Well, I’m easy to find because of my name. My website is just gabriellejulianovillani.com and you can find me on Instagram at GJV Consulting. My Medicare website is medicareconsultingfortherapist.com and then LinkedIn, TikTok, YouTube, Facebook, all just my full name.

[MICHELLE] (44:38):

Perfect. And Juliano is spelled with a J, right?

[MICHELLE] (44:42):

Yes.

[MICHELLE] (44:43):

In case people are Googling you.

[GABRIELLE] (44:44):

Yes

[MICHELLE] (44:45):

Awesome. And we’ll put all the links in the show notes. Thank you again so much for being here. This has been such a fun conversation.

[GABRIELLE] (44:51):

Thank you for having me. It was great

[MICHELLE] (44:56):

As always, thank you for being here. I hope you’ll consider joining me for Acupuncture Marketing School live on Friday morning, starting October 25th. This six-week class will be jam-packed with essential marketing lessons to help you grow your practice and your marketing confidence. Seats are limited to 20 students, so reserve your spot while you can. I’ll put the link in the show notes and please don’t hesitate to email me at michelle@michellegrasek.com with questions. If you prefer working through classes at your own pace, don’t forget Acupuncture Marketing School SELF-PACED is on sale this week for $200 off with the code [AUTUMN200]. The link for that is in the show notes as well. Have a fabulous week.