Exit Rich | Dr. Cindy Tsai | Stress Management


Every business owner or entrepreneur is a go-getter. They want to achieve so much in life that they often forget to take care of their health and resort to poor stress management just to achieve their goals. Stressful thoughts and burnout can sneak up on you if you’re not careful. You must act on them as soon as possible because the longer you wait, the worse they could get.

Join Michelle Seiler Tucker as she talks to author and award-winning physician Dr. Cindy Tsai about her fierce battle against chronic illness. Discover how stress impacts the body negatively and the inflammation that comes with it. Find out some breathing exercises that can help you manage stress and why you should take a pause and check-in with yourself every now and then.

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The CEO’s Guide To Stress Management And Well-Being With Dr. Cindy Tsai

For my very special guest, I’m so excited to have her on the show. You’re going to learn some innovative concepts, strategies, techniques, and a toolbox of stress relievers. You’re going to learn how to manage anxiety, be in touch with your body, and decrease chronic illnesses. I can’t even say how important this is for all business owners and all entrepreneurs because they are the leaders in getting chronic illnesses and diseases. What’s a disease? It’s a body not at ease.

Our very special Dr. Cindy Tsai is joining us. I’m so excited to have her. She is an award-winning physician, bestselling author, TEDx speaker, mindfulness teacher, and wellness life coach who is on a mission to redefine self-care. Dr. Cindy has earned her Bachelor’s and Master’s degrees from John Hopkins University and her MD degree from Dartmouth. As a leader, physician, and patient herself, Dr. Tsai saw and experienced the impact of chronic illness and chronic stress on the body. She was compelled to do more than just prescribe medications as a band-aid that treats the symptoms rather than treating the problem.

Dr. Cindy is the author of the bestselling self-help book called So Much Better. Everybody should rush on and get it now. Don’t we all want to be so much better? So Much Better: Life-Changing Strategies to Develop Calm, Confidence, and the Curiosity to Become Your Own Inspiring Success Story.

FYE 46 | Stress Management

So Much Better: Life-Changing Strategies to Develop Calm, Confidence & Curiosity to Become Your Own Inspiring Success Story By Dr. Cindy Tsai

Dr. Tsai has been naturally recognized, featured, and published in a range of media focused on wellness and healthy living. She’s so excited to share her expertise and passion, and wishes to guide as many entrepreneurs and business owners as possible in this journey of self-discovery to recognize the importance of self-care and alleviating chronic illness. It’s not just for us entrepreneurs and business owners, it’s also for people in everyday jobs, women, mothers, and everybody. Is that right, Dr. Cindy?

Yes. We live in a very stressful world these days. This is an important conversation to be having. Thank you for having me.

Let’s get started there. Walk us through your journey of how you truly first experienced chronic disease. Of course, you’ve seen hundreds of patients for chronic disease, maybe thousands. Walk us through your journey of healing and leading a successful career as a physician with a big organization in alternative medicine along with your coaching and mentorship programs. You don’t see often someone that goes to school to be a physician. It takes a lot to become a physician, especially a good one. Walk us through that journey.

I want you to imagine waking up one day and not being able to see. That’s what happened to me.

Everyone, close your eyes and imagine yourself waking up. Your eyes are closed and you can’t see a thing. Go ahead, Dr. Cindy. I’m closing my eyes.

You wake up one morning. You open your eyes and everything is blurry and dark. This is exactly what happened to me at the end of my medical training. It was terrifying because I had no idea what was going on. I talked about this in my TEDx Talk. I was trying to stay calm and running through different diagnoses in my head, and trying to diagnose myself, “Is this cancer? Is this diabetes? What’s going on?” I’m confused about what happened overnight. I went to see an optometrist. They said that my prescription increased threefold overnight.

I would be petrified.

I went to see an ophthalmologist who did some labs, hoping that they had an answer. Everything looked fine. I remember being in the office and the doctor saying, “This is interesting.”

That’s not a word you want to hear when you can’t see or you’re experiencing chronic illness.

You don’t want to be interesting to a doctor. You want them to be straightforward.

You don't want to be interesting to a doctor. You want to be straightforward and textbook-like to them. Click To Tweet

You want the answers.

It was confusing and unsettling. I got a new pair of glasses so I could finally see again, but I was confused with being this medical mystery. A couple of days later or a week later, some more symptoms came up, and we finally did get a diagnosis that I had an autoimmune condition. It was an autoimmune Uveitis that was impacting my eyes that could have led to full blindness. It was one of those rare conditions, like one in a million type of cases. I started on serious medications like steroids and immunosuppressants so that it wouldn’t worsen and we could control the inflammation. At the same time, I also wanted to understand what was going on. I didn’t just want to take the medications as a band-aid.

You’re treating the symptom, not fixing it. That’s what so many doctors prescribe. It’s treating the symptoms and not getting down to what’s causing this in the first place.

Especially in acute situations, you want that band-aid or that quick fix. You want to be stabilized. I also recognize that I didn’t want to be on medication for the rest of my life if I could help it. I took the time to pause and pay attention to what was going on. Why was there so much information? What was my body trying to tell me? It started me on this journey to exploring integrative medicine and all these other wellness and healing modalities, and to understand that everyone is different, and that the things you need are different.

There are so many great tools, resources, and things out there that can help you be well. It was a process. I learned to advocate for myself and to assemble my team of practitioners who truly listened, who are focused on treating the root cause, and who looked at all aspects of my life. I was working overnight, super hard, and doing all the right things. I was doing all the shoulds and checking off all the boxes.

All the shoulds and the right things for your career, but not necessarily for your body’s condition. You got to take care of yourself before you can take care of your patients.

I see this in business owners and leaders. A lot of times, as high achievers, we want to do many things. We end up looking externally for all of the accolades, the approval, and the accomplishments. Along the way, we lose connection with who we are. That is stressful on our system.

FYE 46 | Stress Management

Stress Management: Business owners and leaders only want to do as many things as they can for accolades and approvals. But along the way, they lose connection with who they are, and that is stressful to their system.


People don’t even know who they are.

We’re no longer aligned and connected to who we are. We’re just doing all the things and I see this over time. What this ends up being is it results in chronic stress and inflammation. We know that from a physiological perspective, inflammation is at the core of many chronic diseases. It starts with inflammation. I’m grateful to have gone through the journey to have been able to take the time to learn to heal. On the other end and coming out on the other side, being able to take all these learnings to be able to share this with others, patients, and clients to know that you don’t have to wait until that point of burnout, exhaustion, some significant trauma, or disease to finally take care of yourself. It starts now.

Explain inflammation because it is the root cause of all illnesses. As I said earlier, what does disease mean? It’s a body not at ease. What is inflammation? What causes inflammation? How can we prevent inflammation?

The important thing to note is that inflammation is a normal response. It’s how the body deals with different triggers and traumas. It’s part of the healing process.

Inflammation is normal and a part of the stress-healing process. It is how the body deals with triggers and traumas. Click To Tweet

It can be caused by the food you eat. Sugar causes inflammation. Processed food causes inflammation.

Something happens, whether it’s a trigger, something we eat or experience, or some input that comes into the body. Input can be something we perceive through our senses, something we see, feel, or whatever. It can also be our thoughts or something internal.

It’s also the negative self-talk and all the childhood baggage. Everything that we think that we moved forward and dump our baggage, but that baggage is still with us until we dispose of it.

We’re carrying it with us. It’s like a heavy backpack.

I always say, no matter where you go, there you are.

What it is basically is our system, brain, and body getting activated. It leads to a series of chemical reactions in the body which releases different hormones, chemicals, and things like that. Inflammation is part of this process where it gets the signal to attract different cells and chemicals to help either calm it down or get rid of it. Maybe if you ate something that was bad and there’s a virus. Inflammation is part of that process to help with the healing to bring in the cells to get rid of the virus.

The problem is a lot of times, our triggers nowadays are constant. We’re under chronic stress. We’re eating a ton of junk food, processed foods, and all the things. There’s this ongoing onslaught.

Food is not grown and created nowadays the way it was decades ago. Inflammation, leaky guts, and autoimmune diseases, you didn’t hear that terminology in the medical field way back then.

Our food nowadays is so much more processed than it was before with industrialization and all of these things. The concern is that because there’s an ongoing need for inflammation, it also leads to the creation of these cells and chemicals that are causing damage to the body. We never get a chance to calm down and heal, that’s why it’s important to recognize your triggers. What’s causing your stress? What are you doing in terms of your diet or lifestyle? It’s all of these things together. Learn how to turn off that stress pathway so that you can activate the relaxation response and get into a place of common ease.

Before we dive into your toolbox, how was that transition for you going from an award-winning physician to your private practice of mentoring, coaching, speaking, and helping people from all walks of life, and I assume all around the world? Also, you have to tell me this. Is being a physician in a hospital in real life similar to Grey’s Anatomy? You’re the first physician I had on the show so I had to ask.

It was a transition. I was always interested in and focused on becoming a physician ever since I was young. I was always interested in wellness and being healthy. I studied hard and did all the things. I was always focused on being a doctor. When I got sick and I experienced this, it helped me see that there are so many other ways I could help people. It wasn’t until the pandemic hit that I was focused on wanting to do more than just prescribe medications as a band-aid. It’s important to start early to focus on prevention and wellness.

We are addressing the things upstream as opposed to when there’s already chronic disease and illness. It’s not to say you can’t take care of things at that point too but it’s more extended. There are more things going on at that point. I didn’t have any background or training in entrepreneurship, business, marketing or sales, like none of that. I was always studying biology, doing my research, and all those other sciences.

Always address things upstream instead of waiting around for a chronic disease and illness to come up. Click To Tweet

They don’t teach you prevention in medical school.

We have many great advancements in Western medicine now in dealing with acute diseases, whether it be pharmaceuticals or surgeries. A big component is recognizing that there are other tools out there that can keep you healthy and well. This transition was very different, but it’s been exciting and fun. I feel in the business world, you get to use a different part of your brain. You get to be creative. You’re meeting people. There’s a level of freedom that comes that’s a little a bit different from a structured path in becoming a physician or any of the professional degrees.

That’s why I always teach my clients that it is important to engage the left brain and right brain, and change up their habits like brushing their teeth with their left hand if they’re a right-hander or throwing a ball with their left hand, and focusing on becoming ambidextrous because we use a small percentage of our brain. Grey’s Anatomy, yes or no? My husband spent years and years in the hospital. He said, “It’s not like that, but a little bit.”

I’m sure there are some bits and pieces that reflect what it’s like. I went to training programs that were on the smaller side. I feel there wasn’t as much going on. There are plenty of large programs and people. It’s stressful going through medical training. When you’re under stress, it can either bring out the best or the worst in you.

here are many entrepreneurs and business owners that have chronic illnesses, some die young. Many times, for entrepreneurs but not as much as employees, that work-life balance is not there. It’s so crucial for business owners and entrepreneurs to understand the mind-body connection and how to tune in, which is why I had you on the show. I’m sure you would agree to that.

What are some steps? You can’t just go from A to Z in zero time. What are some easy steps that you recommend that busy entrepreneurs and business owners to buy in and take a few minutes to practice strategies and methodologies on a daily basis? Why do you recommend that? I know you recommend it because of chronic illnesses and what you’ve seen as a physician.

The first thing to recognize is that the mind and the body are not separate. It’s very much connected, but a lot of times we forget that. An example of the mind-body connection is thinking about something that comes up in your mind. Let’s say you’re about to give this big speech or you’re about to go on a stage and you don’t like public speaking. You’re feeling these butterflies in your stomach.

FYE 46 | Stress Management

Stress Management: People forget that the body and mind are not separate but very much connected. That is why you get butterflies in your stomach when you’re about to give a big speech.


You’re feeling like you’re going to pass out, which is what I would do if I’m going to be speaking in front of a thousand people.

This is the mind-body connection at work. You’re having these thoughts like, “I got to give a speech in front of a thousand people. Am I going to be able to do it? Am I going to mess up? I’m not going to remember what I’m going to say.” That connects to your body and your internal organs in the systems. That results in this innate visceral body experience.

It could be that flight or fight syndrome too.

Our brain communicates with the various systems using the system called the autonomic nervous system. The autonomic nervous system is separated into different sides. There’s the sympathetic nervous system and then the parasympathetic nervous system. You mentioned fight or flight, which is essentially another name for the sympathetic system.

There’s also this other side, the parasympathetic, which is about creating relaxation in the body. Both systems are connected to all of our organs. Think of the sympathetic as pressing on the gas pedal to activate these organs. It’s helping the heart beat faster and helps your muscles tense up to help prepare you in times of stress to fight or flight. There’s also the parasympathetic system, which is the brake pedal to calm things down, slow your heart rate down, slow your breathing, and relax your muscles and tension.

Oftentimes we don’t recognize it until hours later, and we’re like, “My neck is sore.” At the end of the day, I feel like my shoulders are up to here. We’re not taking care. We’re not taking pauses and paying attention to what’s going on. Part of it is recognizing and having ways to connect to your body throughout your day so that you can check in and actively turn off that stress response and shift into a more relaxed state.

Back to the tips that you give entrepreneurs to start with quick easy tips. Let’s go ahead and dive into that real quick, and demonstrate how we can do that anywhere in a car, at our desk, or in a bathroom.

I can share a couple of tips. One of the easiest ways is to engage your breath and be mindful about breathing.

I forget to breathe a lot of times. My trainer tells me, “Michelle, you have to breathe. You’re going to pass out there on the set.”

A very simple breathing technique is called the cleansing breath, and this is where you take an inhale through your nose and then exhale through an open mouth. This is a very simple technique. A lot of times we go through our days without even remembering to breathe, and this takes two seconds.

When I do it, it does calm me down.

That’s why breathing is one of the easiest and most effective techniques to help with stress management. When we are taking those deep breaths, we’re expanding our chest. As I mentioned, there are the sympathetic and parasympathetic systems. The parasympathetic relaxation system is regulated by a nerve called the vagus nerve. It’s a nerve that runs through our chest cavity and it’s connected to various organs. When we’re taking a deep breath, what we’re doing is we’re stimulating that vagus nerve that’s in our chest. It helps to prompt this relaxation response. That’s why taking a deep breath and you’re inhaling and expanding your chest increases the likelihood of activating that nerve to help you feel calm and relaxed.

Breathing is one of the easiest and most effective techniques to help with stress management. Click To Tweet

What’s another step? What’s another quick tip that we can all do and all these entrepreneurs can do?

Another simple technique, especially if you’re in a place where you can’t take a bunch of breaths, is when you’re sitting down, take a moment and feel all five toes. Feel your feet on the ground and feel the ground beneath you. Feel your toes.

That’s called grounding. You go outside and walk on the grass.

I always refer to the human body as a computer. When we have a lot open of apps on our computer or our phone, our cell phone, computer, or iPad slows down and then shuts down. That’s how human is. We have too many things open if we’re trying to do things at once or we’re completely overwhelmed. That’s where burnout comes from. That’s when we begin to shut down and that’s where chronic disease comes from. You got to focus on results instead of busy work and the to-do list, “What are 3 to 5 activities I can do today that will gain the most results for my company?”

It’s important to take a moment, especially first thing in the morning, to set these intentions, and to set the tone for your day. I know for a lot of people, it’s tempting when you wake up to grab your phone. You’re checking and scrolling your emails and responding. At that point, you’re already no longer present. You’re already subject to all the busyness that’s going on in the world.

FYE 46 | Stress Management

Stress Management: Take a moment for yourself every morning instead of waking up and grabbing your phone to check emails. At that point, you’re already no longer present and are subject to the busyness of the world.


Highly successful people don’t start their day by checking their phones. Highly successful people start by working out, reading, connecting with family, and then starting to work.

We need to be in a good place ourselves first so that we can show up as the best version of ourselves in our business, professionally and personally. If you don’t even know and you don’t have that strong support and grounding of who you are, you’re going to be off-balance and off-kilter. Something will come up and you’re going to be distracted. You’re not going to be able to stay focused.

That’s why it’s important to plan your day the day before instead of the day up. You gave us two good tips, grounding and breathing. Any other tips?

I like this exercise. It’s called the five senses Exercise. It is a simple mindfulness practice, which helps you be in the present moment without judgment. This is fine because it engages all of your senses. I’ll lead you through this and we can do this together. I want you to first take a breath. Get into the moment, and then I want you to tell me the five things that you see. We’re going to look at five things.

Me, you, my Exit Rich banner, and the comment section where nobody comments yet. What else do I see? Maybe my computer screen. If I am alone, I see my headset and my coffee cup.

Counting down to four, tell me four things you feel right now.

I love doing this show because I love educating business owners and entrepreneurs in every aspect of their life.

Physically feel.

I physically feel happy, motivated, and inspired.

It’s also feeling the seat beneath you.

Before we started, I felt a bit of distress and anxiety because I know you’re on a time clock. When you use these different platforms, there are always technical difficulties. It seems on their end. I feel the chair beneath me. I do have my toes on the ground. I am grounding as we speak. I felt Princess Coco Chanel’s bed next to my feet.

Your hair and the temperature getting into the body, and then three things you hear.

I hear the air conditioning. Everybody can hear it because we forgot to turn it off. I hear you and myself. It’s pretty quiet in my office.

Two things you smell.

Princess Coco Chanel’s little pad over there her training pad, and my perfume.

One thing you taste.

I guess I still taste the protein bar that I ate an hour ago.

There you have it. It’s a very simple countdown 5, 4, 3, 2, 1. It’s a mindfulness exercise to help you get into the present moment. It’s helpful because it takes you out of the busyness in your mind when you’re worrying to be like, “Let me pause and look at five things I see, four things I feel, three things I hear, two things I can smell, and one thing I can taste. It’s a way to engage your senses in the present moment to get you out of whatever thing that was spiraling that was going on.

If I look down at my desk, I see piles of paper and folders that need my attention, and I feel anxious.

It’s essentially important to help you take yourself out of whatever spiral thing that was going on. Talking about the mind-body connection of getting into that place of relaxation and being present. This is another helpful exercise that’s simple and easy for people to try out.

I know you’re on limited time. We talked about the toolbox. Is there anything we left out of the toolbox? I’m sure we did.

There are more tools and resources that I share in my book. It’s called So Much Better. Check it out. It’s a self-help book based on mindfulness. It’s available on Amazon and Barnes & Noble. It provides a lot of different strategies. I break it down into three key pillars of calm, confidence, and curiosity. It’s important to understand calm is about regulating your nervous system. We talked a lot about that earlier.

This will regulate your cortisol level.

Cortisol is essentially the stress hormone. An important thing to note with stress though is that stress in and of itself is not a bad thing. It’s important to be able to activate that stress response when we need it. If we’re out in the wild and a bear comes, we want to be able to notice that stress and activate our fight or flight response so that we can run, flee, and survive. The problem is when the stress is chronic and then we can’t turn it off. That’s when it leads to that ongoing inflammation and cycle that triggers chronic diseases and all those pathways like hormone imbalances.

FYE 46 | Stress Management

Stress Management: Stress in and of itself is not a bad thing. If you’re out in the wild and a bear comes, you want to be able to activate your fight-flight response so you can run.


The number one cause of a heart attack is stress, isn’t it?

It’s way up there for sure. We’re seeing more research and data coming out about how inflammation contributes to the buildup of plaque in the heart walls. All of that is part of this whole process. Calm is about regulating the nervous system. Confidence is about working with your mind and developing that strong sense of belief in yourself. Part of that is rewiring your brain. I’m sure as with entrepreneurship and business, you have to be open to growth and to do things differently. What worked in the past may not work for you now or in the future. If you keep doing the same things, you’re not going to necessarily get better results. It’s important to have those tools and techniques to rework that and to rewire your brain so that you’re set up for success.

Everything that Dr. Cindy is talking about is something that we should be teaching our children. Especially when it comes to calmness and confidence. Curiosity, they already have. Let’s get into curiosity real quick.

Curiosity is about bringing in the fun and joy, and connecting to your inner wisdom and purpose.

That’s your happy self or what makes you happy.

As we continue to go through life as we grow older, we lose that connection. We’re focused on doing, the work, the serious stuff, and we forget that play. It’s important to continue to cultivate that joy and wonder, and stay connected to who you are. It’s that sense of deep fulfillment and purpose. You can continue to shine your light and do what you’re meant to do here.

Before you go, a couple of things. This is important. The mind-body connection. They are not separate. I want to talk about your success story or the success method.

The inspiring success story formula is the three key pillars. It’s comprised of the three key pillars of calm, confidence, and curiosity.

You have that trademarked.

I break that down in my book and I shared a little about it. It comes down to awareness. You have to know where you are and be open to changing things. Know that this is a process and it looks different for everyone. Give permission to yourself to do that or to do it your way.

Any final tips, words of wisdom, or golden nuggets you can leave? I know you’ve already dropped so many.

It’s important to take the moment each and every day to pause and check in with yourself. You do have the wisdom and the answers within. When there’s much going on, and we live in a busy noisy world right now, we can’t hear that. Have ways to ground yourself, not just through breathing or whatever. Exercise is a great way, when you’re out on a run. Know that everyone is different and you find your own ways and tools that work for you so that you can stay connected to who you are and who you’re meant to be.

Take a moment each and every day to pause and check in with yourself. Click To Tweet

That’s important. I always say when you’re in your fog, it’s foggy. One thing that entrepreneurs don’t do, and I’m sure stay-at-home moms do because they got children running around like crazy, is take that time to take care of themselves, whether it’s meditation or not. I’m not calm enough to meditate. I’ve tried it many times. Get in that quiet space and try to clear your mind.

Try to focus on one thing or one problem that you’re having to come up with those solutions. It’s in the quiet where we find the answers and where we can thrive. We get so busy. I call entrepreneurs firefighters because we’re putting out fires more than we’re creating and building a sustainable, scalable, and sellable business. It is important to do these different breathing exercises and all the tips that she gave, the breathing and the grounding. Make sure you put calm, confidence, and curiosity. Get in touch with your inner self and always spend that time. I appreciate you coming to the show. How can they find you?

I’m available on social media with my handle @CindyTsaiMD. Please follow and connect with me. I share content regularly. My website is CindyTsaiMD.com. I have a bunch of free resources on there, including a free guide to creating your calm. I have a course, Self-Care 101, and also some guided meditations for those who are interested and curious to try.

I had another question for you. Do you still treat or see patients with chronic illnesses, not just with a preventive approach but an integrated approach?

Currently, I’m focused on my coaching and speaking practice. Integrative medicine is still important to me. There are some thoughts on how to blend all of it to bring that integrative wellness to people.

That’s what I always seek out as an integrated physician. You’ve been a tremendous wealth of wisdom and guidance. I hope all entrepreneurs and our audience take this to the heart and take care of your heart, mind, and body. Seek that quiet time and become calm, confident, and curious. Thank you, everybody, for tuning in. Thank you for your patience. I can’t wait to see you in the next episode for another special guest. Thank you so much, Dr. Cindy Tsai. You’ve been an amazing guest.

Thank you.


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About Dr. Cindy Tsai

FYE 46 | Stress ManagementDr. Cindy Tsai is an award-winning physician, bestselling author, TEDx speaker, mindfulness teacher and wellness/life coach who is on a mission to redefine self-care. She loves helping leaders and healers transform their stress into strength so they can feel so much better. Dr. Tsai earned BA and MS degrees from Johns Hopkins University and MD degree from Dartmouth. As a leader, physician, and patient herself, Dr. Tsai saw and experienced the impact of chronic stress on the body and was compelled to do more than prescribe medications as a bandaid. Through her own healing journey, she explored and trained in a wide range of solution-oriented therapeutic modalities and now emphasizes taking an integrative approach to wellness. As author of the bestselling self-help book, So Much Better: Life-Changing Strategies to Develop Calm, Confidence, and Curiosity to Become an Inspiring Success Story, she introduces a radical path to well-being, through creating the Inspiring Success Story MethodTM. This method offers clients a diverse range of mind-body-spirit techniques to expand the possibilities of achieving their dreams. Dr. Tsai has been nationally recognized, featured, and published in a range of media focused on wellness and healthy living. She is excited to share her expertise and passion to guide as many as possible in the journey of self-discovery to recognize the importance of self-care as a wellness practice to lead and enjoy a life of ease.


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