Demystifying Mindfulness: Overwhelm

Demystifying Mindfulness: Overwhelm

Does Mindfulness In Your Medical Practice Seem Unachievable?

For many of my readers, the concept of mindfulness may seem out of reach. The term evokes imagery of tranquil monks and mountain tops, existing miles away, both literally and metaphorically. I created this series to bridge this distance, and to introduce mindfulness to practicing physicians as an accessible tool to combat burnout.

Each post in this series will examine the relationship between mindfulness and a specific area of a physician’s day-to-day life. They each include a physician’s story, and how the rigors of practice hamper their ability to fully enjoy that part of their life. After detailing their situation, I provide guidance for how the physician can utilize mindfulness to gain fulfillment and mastery in that area.

With each post, I’ll give you an actionable step that will help you integrate the post topic into your daily life. I’ll also provide an exercise that you can practice in your free time that will help strengthen your resilience, calm, and fulfillment. My goal is to transform mindfulness from a daunting, unapproachable ideal into a broad toolkit that you have easy access to. Simply put, I want to help you be a happier, more productive version of yourself, at the workplace and at home.

Without further ado, the inaugural installment of Demystifying Mindfulness!


Today’s topic: Overwhelm

Our physician: Dr. P, is a cardiologist in a large Midwestern practice: 
“I don’t know what to do. I feel like I’m drowning in my work. Every day of my practice feels like a battle, and when I’m with patients all I can think about is getting to the end of my day. I used to be in love with my practice and I don’t know what happened. Now, my work feels meaningless, and I’m completely overwhelmed.  What can I do?”

Dear Dr. P, 
You’ve already won half the battle. You’ve noticed that you’re locked in an ineffective pattern at work, and you’re interested in strategies to improve your situation. This realization is no small thing! What I want you to start doing is focusing on your physical experience. You’ve just wrapped up with your last patient of the day, you’re late to make it home for dinner with your family, you still have a half dozen charts to complete – what does your body feel like? Is your heart rate elevated? Are your hands tense? Are you sweating? Get in tune with the physical sensations that accompany the feeling of overwhelm, and you’re well on your way to combatting it, and feeling more in control. 
 
Physical sensations often precede feelings of overwhelm; in some ways they’re an early warning system that can help you break the vicious cycle. Once you notice these physical precursors, take a brief pause. If you can take 5 seconds in between patients to take deep breaths and ground yourself, that’s a victory. See how many of these pauses you can give yourself in a workday. While this may seem trivial, overtime, mindful pauses will begin to weave together into a calmer day, and a calmer and happier life. 

In addition to your feelings of burnout, you wrote that you no longer feel connected to your work. Overwhelm and lack of passion and fulfillment often go hand in hand. Of course, it’s challenging to stay connected to work when it’s so demanding. Reducing feelings of overwhelm by mindfully pausing throughout the day will help you feel more authentically connected to your work, and may revive some of the enthusiasm you’ve experienced in the past. Reciprocally, mindfully nourishing your commitment to patients will shrink feelings of overwhelm.

At the end of every day, I encourage you to write down things that went well in your day. Focusing on what went well can reconnect you to your strengths and your sense of meaning. As doctors, we are trained to focus on what is going wrong. Give yourself structured time to focus on what is going right.

Give this mindful strategy a shot and look forward to being more present and fulfilled in your practice.

To your resilience,
Dr. Gail Gazelle


Have an idea for a future Demystifying Mindfulness post? Want Dr. Gazelle to help you tackle your problem? Write in at drgazelle@mdcanhelp.com or contact us on the website.

Stress Strengths, don’t Strengthen Stress: Combat Physician Burnout

Stress Strengths, don’t Strengthen Stress: Combat Physician Burnout

Focusing on Your Weaknesses Won’t Make You Stronger

In this week’s post, I break down why physicians should Stress Strengths rather than Strengthen Stress in order to combat physician burnout.

Last week, I was speaking with a medical director at a large practice who was telling me that he couldn’t understand why the physicians in his group were having trouble getting their charts done on time. I asked him what sorts of strategies he’d employed to try and make the situation better, and he told me he had 1) Issued email warnings, 2) told physicians that their pay would be docked if they didn’t do better, and 3) posted comparison charts of members of the group. He could not fathom why performance wasn’t improving.

I also recently sat in on a meeting with a client of mine (an internist) and her non-physician supervisor. To my disappointment, the entire meeting was focused on patient wait times, an area where the supervisor determined she was not meeting targets. Not one word was spoken about the internist’s improved Press Ganey scores, the gains she’d made in consistently starting her day on time, and the positive comments staff had made about her performance. At the end of the meeting, my client broke down in tears.

How can anyone expect me to succeed when all they do is point out my shortcomings?”

Physicians are hyper-focused on their own flaws; we don’t need a supervisor to point them out for us. Negative reinforcement is an old and outdated leadership approach. A person’s path to growth and improvement lies in mobilizing their areas of strength.

Meeting with “the big bully” and seeing the “wall of shame” erode self-esteem and don’t lead to improvement. If you’ve been on the receiving end, you have no difficulty understanding how damaging these strategies can be.

What Research Shows About Negative Reinforcement

Gallup conducted a study when they analyzed over one million work teams. They found that only 9% of employees who are forced to work in an area of weakness are engaged, while 74% of their counterparts who are allowed to work in an area that uses their strengths are engaged. This isn’t a minor difference either; the gap is staggering.

Engaged employees tend to be more productive and happier at their work. One of the easiest ways to increase employee engagement is to help them align with their strengths.

Let’s try a simple exercise:

Think of a task you’ve been putting off completing. Imagine that you’re sitting down to do it right now. For 60 seconds, think about all the ways you believe you’re inadequate to get this task done:

  • I’m not smart enough
  • I’ll never get this all done
  • I’m not as disciplined as others
  • I’m a great procrastinator

Don’t hold back, pick your poison!

Now, mindfully, check-in with yourself. Rate your level of motivation to do the task on a scale of 1 to 10, where 1 = no motivation at all and 10 = let me at it!

Next, switch your focus to all the ways you’re more than adequate:

  • I’ve gotten this type of thing before
  • I am accomplished and well-regarded
  • I’m good at this type of task
  • Even when I procrastinate, I always cross the finish line

Sweeten the pot a little more by giving yourself an extra 30 seconds to think how good you’ll feel once the task is off your list.

Now check-in with yourself again.

Want to combat physician burnout but not sure what your strengths are?

While you may be used to focusing on your weaknesses, in your roles of physician and family member I can assure you that you have many. You simply could not have made it this far without them.

An easy way to find your strengths is to complete a basic personality traits test like the one provided by the University of Pennsylvania Department of Psychology.

How this relates to physician burnout

I’ve written about physician leadership and burnout in the past, and it’s clear that a deficit, weakness-based focus, and burnout go hand in hand.

If we want to avoid burnout or find out how to combat physician burnout, the strategies I mention in this article are key:

  • Stop focusing on what went wrong and start focusing on what went right
  • Help others see their strengths

Want to learn how you can reduce physician burnout and promote healthy physician leadership?

Get my Anti-Burnout Physician Leadership checklist for further FREE tips on how to combat physician burnout.

Physician Mindfulness Retreat Helps Physician Burnout

Physician Mindfulness Retreat Helps Physician Burnout

For the first ever Mindfulness-based Physician Resilience retreat, 20 physicians came from across the US to learn during the Martin Luther King holiday in January. There were a wide range of medical specialties represented, from Psychiatry to Family Medicine, Palliative Care to Radiology, General Internal Medicine to Obstetrics. Physicians trudged bravely to Massachusetts in the dead of winter from such points as California, Washington state, Wisconsin, Louisiana, Michigan, North Carolina, and Florida. The commonality was a desire to develop tools to manage the many stressors of practice.

What Physicians Had to Say about the Physician Mindfulness Retreat

The learning was completely experiential from interactive exercises to journaling to yoga. Mornings began with morning meditation and yoga. Dr. Paula Gardiner and I gave talks but there was no boring powerpoint!

Topics included:

  • How training sets us up for burnout and doesn’t give us the skills we need to manage it
  • Ways to work with your judging mind to decrease suffering
  • Building self-compassion as a way to manage self-doubt and the Imposter Syndrome
  • Strategies to manage challenging emotions and cultivate positive ones
  • Tips for spending more time being and less time doing

From a walking meditation to the ocean, to the hot tub (with suits!), to delicious chef-prepared meals, and time with new colleagues, in addition to all the learning, this physician resilience retreat provided many opportunities to relax and renew.

A Second Physician Resilience Retreat is Coming October 2018!

Feedback was so positive that we’re offering a second retreat October 26-28, 2018. For more information, contact us today.

5 Benefits of Mindfulness in the Present Moment

5 Benefits of Mindfulness in the Present Moment

Modern conversation is dominated by discussion of mindfulness. The implication is that “being in the present moment” will magically help us but, unfortunately, we are constantly distracted by email, Facebook, and the most recent text message, or, just as easily, by our own thoughts. Let’s look at 5 benefits of being in the now:

Mindfulness brings Calm

Often our minds spin wildly, jumping from thought to thought. The swirl of thoughts can be like the torrent of a waterfall. We try to focus on a task and our mind goes to an argument we had that morning, a recent text, or how guilty we feel for eating those 3 scoops of ice cream last night. When we aren’t ruminating about the past, we fixate on a concern about the future, and anxieties and worries take hold. Even if there are no current stressors, our thoughts can take us into a downward spiral driving fear, rumination, and distress.

Mindfulness helps us realize that thoughts are simply thoughts, not reality.

Instead of being swept away by the waterfall, we learn to watch it from the comfort of the water bank. Creating some distance from our thoughts frees us from being trapped by them and allows us to access a natural calm and ease.

Improved Relationships

Despite being physically present with loved ones, it’s easy for our minds to be elsewhere. Often we stew about a meeting we have to plan for or replay a tense conversation with our boss, missing what’s in front of us. Mentally living in another moment, we can see our partner or children as the annoying distraction. We find ourselves impatient and short-tempered.

When we’re in the present moment, we detach from past experience and future worries, and give our full attention to those we’re interacting with. Drifting from the now is inevitable, but we can note this and gently return to the present. We all know how good it feels to interact with someone fully invested in us in that moment, and others immediately sense when we’re fully there with them. Staying in the present, we often find that it’s easier for others to join us there.

The Present Allows Broader Perspective

When we’re in mindless mode, we develop tunnel vision. We become stuck in a fixed reality that we have assumed to be true. Watching the world through this clouded lens, we have difficulty simply seeing and appreciating what is. Often times the way we see a problem can in fact be our problem, and part of being mindful is being open to challenging our own assumptions. One of the cornerstones of mindfulness is a quality of open awareness and curiosity. When we become inquisitive about a problem and question our assumptions, we see options that were previously outside of our field of view.

In addition, by shifting our focus to the present moment the magnitude of our problems begin to shrink. Right here, right now, it’s likely that our needs are being met, our health is manageable, and we can meet the challenges we face.

Be More Resourceful

What if you could focus on what is rather than how you think things should be? Releasing expectations about your situation allows you to take action from where you actually stand. If you know what you’re facing, as opposed to an altered version of it, it’s likely that you’ll have more clarity. You’ll be able to see what the real constraints are and where there are openings for change. And all that energy that you’re putting into wishing things were different can be harnessed to take action with what actually is.

When you stay in the present moment, there is more available to you to come to a solution. You can then respond wisely and in a fully informed manner, rather than reacting blindly. You develop the superpower of conscious clarity. Watch this light animation of Dan Harris explaining how practicing mindfulness can be a superpower.

A Mind in the Now Fosters Confidence and creativity

When we focus on what’s actually going on right now, we shed comparisons with others, harsh judgments about ourselves, and our analysis of our circumstances. All of these thoughts sap our natural creativity, and besides being overly-critical, they are rarely accurate.

When we live in the present moment, our attention is focused on what we’re experiencing and instead of getting caught up in negative self-talk, we can simply note it and move on. We leave rigid ways of understanding our experience behind. This flexibility clears room for new thoughts and ideas, and the results are often a rush of creativity.

Integrating mindfulness practices into our lives provides a multitude of benefits: we spend more time in the here and now, we experience less anxiety and more calm, and we enjoy deeper and more meaningful relationships. We reduce the tendency toward tunnel vision and see more options and choices, and this helps us feel less trapped by our circumstances. And we remove barriers that stifle our creativity and confidence.

It’s easy to get absorbed in our email, phones, and the most recent text message. Just as easily we get lost in our own internal thoughts. When you find yourself distracted, worried, or anxious, take a few minutes to bring your attention to your breath. It’s a sure-fired way to access the present moment.

Learn How to Be Mindful Within the Present

Through her experience as a physician coach, Dr. Gail Gazelle improves the lives of doctors throughout the United States. If you would like to learn how to become more aware and mindful, reduce stress, and decrease burnout, contact Dr. Gazelle today.

How to Respond to Physician Burnout in a Colleague

How to Respond to Physician Burnout in a Colleague

Two hours of administrative tasks for every hour with patients. A proliferation of non-physician administrators deciding how the day is going to run. Little in our training about how to cope with uncertainty and change. It’s no surprise that physician burnout rates are approaching 60%. Despite being so common, when we see a colleague struggling with physician burnout, we may not know what to say. Responding appropriately can bring someone back from burnout and may even save a life. Here are some tips:

Approach the situation with compassion

Burnout is often referred to as erosion of the soul, and for good reason. With it comes a great sense of despair, hopelessness, and isolation. We lose our perspective.

Often there is no better remedy than the kindness of a colleague, someone who has walked in our shoes and knows what we’re experiencing. Approach the colleague with the empathetic aim of letting them know that you care about them, you’ve noticed that they are struggling, and you’re there for them. Afraid of saying the wrong thing? Here are some ways to convey your concern.

“I can see you’ve had a rough week.”
“I’m concerned about you.”
“I get why you’re feeling this way.”
“I don’t have answers but I want you to know I’m here and I care about you.”
“You deserve to feel better.”
“I know these feelings will pass.”

Normalize the experience

With burnout comes a sense of personal inadequacy. Everyone else seems to be coping with all the stress. What’s wrong with me? Tell your colleague that what they’re experiencing is normal and that many physicians are having the same feelings. Let them know there’s nothing wrong with them. Make it clear that these harsh feelings do not mean that they are a failure. And, no matter what they’re thinking, that experiencing physician burnout is a normal response to the stressors of modern practice and doesn’t mean they’re in the wrong career.

Don’t problem solve or give advice

As physicians, we’re conditioned to fix whatever problem the person in front of us has. It is quite literally what we are trained to do. But with burnout, we need to suspend our desire to problem-solve. Instead of doing something, we need to focus on simply being present with a colleague’s suffering.

On that same note, we also need to avoid giving advice. Giving advice sends an implicit message that the person doesn’t have the inner resources to solve their problem. Not only that, but the last thing someone wants to hear when they’re low on energy, overwhelmed by demands, and disconnected from any sense of meaning is “I know how to solve your problem, here’s what you should do.”  Simply listening without suggesting any action can help someone in burnout begin the critical step of gaining perspective on their situation.

Help them connect with their accomplishments

When we’re in burnout, we’re focused on everything that’s wrong, with the workplace and with ourselves. We’re disconnected from meaning and purpose. Positives slide off us like Teflon and negatives stick as if attached by Velcro. Whatever our strengths and accomplishments may be, we believe we have none. It’s critical to find a way to reconnect with the things we are accomplishing.

Ask your colleague if they’d consider keeping a running list of three things they accomplish every day. This simple exercise can provide ballast against the pull to inadequacy and negativity, and potentially help relive some of the symptoms of physician burnout.

Let them know seeking help is not a sign of weakness

We learn early in training that seeking help is a sign of weakness. We’re the head of the team and we’re supposed to have all the answers. Yet, we can’t solve every problem by ourselves (no one can.) Reassure your colleague that asking for help is a sign of health, not weakness. Recommend that they speak to loved ones and other colleagues. Encourage them to seek coaching or other professional help.
While you can’t change the external landscape, know that applying these tips can make a big difference in a colleague’s ability to see a way forward.

In summary, remind yourself to listen compassionately. Normalize their experience. Avoid the temptation to give advice or problem-solve. Help them see their strengths and accomplishments.  Let them know that seeking help is often vital and is not a sign of weakness. Reassure that they can find a way to meet the intense demands of practice with much less anguish.

Get more resources on physician burnout.

If you’d like to be in touch or schedule a coaching session, contact me today.

Please share your own tips below.

Physician Leadership: The Missing Piece in the Physician Burnout Puzzle

Physician Leadership: The Missing Piece in the Physician Burnout Puzzle

Data confirms high rates of physician burnout, but it doesn’t tell us how burnout can be avoided. In fact, data on preventing physician burnout is almost nonexistent. One thing we do know, however, is that physician leadership is a key variable. Physician leaders can make or break a workable culture. A 2015 study from the Mayo Clinic found that qualities of physicians’ leadership accounted for 47% of the variation in physician satisfaction and 11% of the variation in physician burnout. Looking at their study, a number of leadership attributes stand out that can be helpful in avoiding physician burnout.

If you’re a Physician Leader or Executive looking to bolster their management skills, learn more about my Physician Leaders and Executive Coaching services.

Treating physicians with compassion

Compassion is a core value for most physicians but is increasingly bypassed in medical practices. Recently, I coached a 47-year-old Internal Medicine medical director who oversaw 80 primary care physicians. Much of the stress of his job was conveying edicts from the administration to the physicians he supervised. At the end of a particularly terse medical director meeting, the Chief Medical Officer bluntly told the medical directors that, in addition to recent cuts, they would need to inform their physicians of a further 10% pay cut. There was no discussion of the impact this would have and the news was delivered in a cut and dry fashion. My coaching client felt morose, defeated, like a cog in the wheel of the healthcare factory. The communication had flown completely in the face of compassion, a core value for him. He wondered how much longer he could go on in his position. He noted that if the same news had been delivered with concern for the impact it would have, while the consequences would still be painful, he would have experienced a greater sense of hopefulness and community. I coached him around maintaining his values by learning from this experience and never repeating this type of conduct. We continued to focus on making sure that each and every one of his communications conveyed the compassion he knew first-hand was vital in maintaining morale and avoiding physician burnout.

Facilitating engagement

Employee engagement has been hailed as the single most important factor in determining levels of satisfaction with work. In a 2012 meta-analysis of research studies, Gallup found that compared with the bottom quartile, companies in the top quartile for engaged employees had 22% higher profitability, 10% higher customer ratings, and 48% fewer safety incidents.

Engagement is the antithesis of burnout. The many administrative burdens physicians face make it difficult for physicians to engage fully with their most important task: caring for patients. Physician leadership makes a pivotal difference. Given the many metrics coming down the pike, leaders need to constantly orient their approach around such questions as: “While metrics need to be pursued, how can I focus on how hard my physicians are trying rather than whether they’re meeting each specific target?” “What actions can I take today to help my physicians feel more energized and engaged.” “How can I facilitate my physicians performing at their best?” Sometimes small actions go a long way to facilitating engagement.

Recognizing a job well done

Everyone wants to feel valued and recognized for their contribution, yet in the current healthcare environment, too often the emphasis is on areas of deficiency rather than successes. A Chief Medical Officer I coached worked with her team to achieve large improvements in productivity. To remain competitive, however, metrics revealed that further improvement was needed. While her tendency was to focus on the gap between where clinicians were and where she wanted them to be, I coached her to focus on the gains rather than the deficits. She worked to ground each communication with her physicians on the strides they had made, identifying what strengths and skills they had used to make improvements, and assisting them in utilizing similar approaches to glean greater success. In a subsequent satisfaction survey, her physicians gave her the highest scores.

Communicating with positivity

We spend most of our waking hours communicating with others, but very often the rush keeps us from doing so in a respectful and positive manner. In a 2004 study of 60 top management teams engaged in annual strategic planning, the single most important factor in predicting organizational performance was the ratio of positive to negative communications. The research revealed that in high-performing organizations, the ratio of positive to negative communications in their top management teams was 5.6 to 1. By contrast, in low-performing organizations the ratio was 0.36 to 1. In a recent physician resilience retreat I led, I asked the audience how their risk of burnout would improve if their leaders focused more on the positive. The responses were instructive: “It would be infectious,” “I’d be more productive,” “I’d be less irritable,” “There would be less spill-over with my family.” Anecdotally and empirically, the evidence for positive communication is high.

Open listening

A principle of effective leadership is listening affirmatively and supportively, being open to the input of others, and not jumping in with one’s own opinion and advice. Leaders who inspire dedication, sacrifice, and grit are ones who listen openly. As noted by Stephen Covey, effective leaders communicate with the goal of seeking understanding. A key skill is to ask open-ended questions.  Open-ended questions communicate a deeper interest in the person’s response, increasing their sense of being heard. By shifting from questions that suggest a right and wrong answer, open-ended questions encourage others to respond more fully, contributing to greater engagement.

If you’re a physician leader, take heart in knowing that your actions can have a significant impact in mitigating physician burnout. Even if you’re suffering from physician burnout yourself, you can help motivate physicians to overcome the challenges they face. If you are a front-line clinician, please feel free to forward this post to your physician leadership. Many physician leaders are excellent clinicians or researchers and bemoan the fact that their leadership skills are limited. Most are happy to learn ways that they can improve.

If you’re suspecting a colleague may be suffering, here’s how to respond to physician burnout in a colleague.

 

Managing the Vortex of Fear

Managing the Vortex of Fear

Uncertainty can elicit a deep sense of fear and ill ease. Fear, like all emotions, has its place. We need to recognize this feeling and take time to tend to it. When fear becomes the major driver, however, it can take us to a dark place. Fight or flight is vital when we need to take rapid and immediate action for safety or for survival. When we don’t, fear can be paralyzing, leaving us feeling powerless, hopeless, and stuck. Fear breeds hostility, rigidity, and takes us to a place of reactivity as opposed to one of thoughtful and mindful activity. When we’re in fear, we move out of compassion for ourselves and for others.

To stay grounded and focused, we need to assess. What’s being triggered? Is it my safety and security? My sense of well-being? In this moment, am I facing a real threat? Or is my fear related to something that hasn’t even occurred, and may or may not occur in the future? This discernment is critical so that you can mobilize resources to cope with whatever it is that’s right in front of you, and build reserve to face future challenges as they unfold.

Check in with yourself right now. How resourceful are you when you’re in a place of fear? When you look back on decisions you’ve made based on fear, do you believe that you’ve made the best decision? Have you seen others make wise decisions? Now ask yourself the following question: when you’re at your best, are you letting fear steer your course or are you able to notice your fear, center yourself, and move forward from a constructive place? What would be different if your focus shifted from fear to calm and equanimity?

Once you’ve righted yourself, you can decide what action is the right next step. In the face of fear, small actions are best. You can set a daily intention to tune in to yourself and notice when fear is nipping at your heels.

Gandhi said “The enemy is fear. We think it is hate; but, it is fear.” His words ring true in the current political environment. Managing one’s fear could never be more important. Like anything, this requires practice. It’s well worth it, though, so that we can live with a sense of peace and contentment. So we can make decisions that we don’t later regret. So we can mobilize resources to be our best with all people we meet.

Please leave your comments and suggestions below so others can learn from your experience.

Retooling New Year’s Resolutions to Set Yourself Up  For Success

Retooling New Year’s Resolutions to Set Yourself Up For Success

It’s that time of year again when many people are already feeling a sense of inadequacy around their New Year’s resolutions. While yearly resolutions help some, the tradition is often unsuccessful. The goal may be too big, it can be challenging to maintain motivation by oneself, and the tendency toward self-criticism are but a few of the factors that combine to make realization of one’s goals a daunting task. The good news is that simple strategies can help you reach your goals. Try these 10 tips:

  1. Start small.
    Taking on a large goal is tempting, but it’s also the most sure-fired way to fail. If the goal is too much of a stretch, it can fuel a downward cycle: lack of achievement, decreased motivation, and self-criticism. By starting small, you increase the likelihood of taking the vital action steps, and each “win” helps build your belief that you can achieve your goals. This creates an upward spiral of confidence, motivation, optimism, and competence: all key ingredients of self-efficacy and success. Gary Hamel, author of the 2007 Amazon best business book of the year, The Future of Management, defines the key to success as “win small, win early, win often.”
  2. Envision success.
    Envision a day in the future where you’ve accomplished your resolution. Close your eyes and sit for a few minutes, letting yourself bask in the experience of having reached your goal. Experiencing this wonderful state is much more motivating than berating yourself over something you weren’t able to accomplish. It can help you shift your focus to self-motivating questions such as “what small step can I take TODAY to help me get to this feeling?” and “what is a new way of thinking about my goal that will help me experience more of this feeling?”
  3. Let go of old goals.
    If you haven’t moved forward on a goal year after year, it’s time to think about what’s holding you back. Putting something on the list after years of not succeeding can start the year off with a sense of shame and disappointment. One option is to include a resolution to forgive yourself for things you didn’t accomplish and start taking credit for all that you do achieve.
  4. Keep your list short.
    Would you rather succeed at three out of three resolutions or one out of ten? It’s much easier to focus on a small number of goals than a long list. And think of the satisfaction you’ll have checking each one off!
  5. Focus on “wants” instead of “shoulds.”
    Focus on what you truly want to achieve, rather than on things you believe you “should” be achieving. To be successful at any life change, you have to really want it. It pays to take the time to consider what it is that you truly want, teasing out the things others have said you should do or stop doing. Similarly, Ryan and Deci’s theory of self-determination tells us that intrinsic motivation is much more powerful than that generated by external forces.
  6. Resolve to “be” instead of “do.”
    Make sure to include resolutions that involve “being” and not just ones that require “doing.” For example, a resolution could be: “This year, I will have more moments of being present with my family, times where I’m not focusing on all the work I have to get done.” “Being” resolutions are ones that you can achieve at any time. Even if you stray on a “being” resolution, you can accomplish it the next day… or even in the next hour.
  7. Plan.
    Start every day off by planning one small step you’ll take to get closer to your goal. This method of breaking down the larger goal into more feasible parts is a great way to make incremental change. It also reminds you that you, truly, are in charge of your fate.
  8. Find an accountability partner.
    Whether it’s your spouse, a friend, a coworker, or a coach, it’s much easier to follow through on goals if you have a buddy. In the best-case scenario, you’ll hold one another accountable. Tell your partner to go big on the cheerleading and championing as it’s much easier to succeed when there’s someone rooting for you and shouting, “I know you can do it!”
  9. Don’t use your resolutions as a means to beat yourself up.
    This is an area where many people falter. If you’re like most people, you probably have plenty of inner critics badgering you as it is. New Year’s resolutions provide fodder for these pernicious and ever-present gremlins. It’s much easier to move forward from a place of competency and strength rather than one of deficit and inadequacy.  Try to keep your focus on what you are accomplishing instead of what you are not.
  10. Don’t let a sense of failure stop you.
    It’s all too easy to swing from the high of “this is the year I’ll accomplish X” to the low of “I just did the opposite of X; I’ll never achieve my goal.” In reality, every day represents a new opportunity to move toward your goals, so go ahead and be sure to seize an opportunity. This is true for New Year’s resolutions and true for any goal in your life. If failure presents a major hurdle for you, you can always think back to #6 and try to “be” instead of “do.” You might be surprised at how a change in perspective—viewing failure as a platform for growth instead of for sinking—can help you achieve different aspects of your goals.

Go forth and decide what steps you’ll take today. Even if you falter from your path, every moment of your life can be used to institute change. Remember, self-improvement is always within your reach.

Comparison:  The Thief of Joy

Comparison: The Thief of Joy

How much time do you spend on mental comparisons? Looking on Facebook and thinking everyone else has better relationships and is much happier than you?  Thinking that everyone in your peer group is smarter than you? Or fretting about how much fitter, thinner, smarter, or more successful you were at a different point in your life? Much of our stress, frustration, disappointment, guilt, and regret is the result of comparing ourselves to preconceived ideas about how we should be acting, how we should be looking, and how our personal successes are perceived by others. Theodore Roosevelt once said that comparison is the thief of joy. Indeed, comparisons often keep us in a mental hamster wheel of self-doubt and lack of confidence. To combat physician burnout, it is critical to decrease the tendency toward comparisons.

But comparison allows me to improve my performance

You may believe that comparisons keep you on your toes. Let’s test this out. Think about any times you’ve compared yourself to someone else in the past week. Did the comparison help you feel good about yourself and your circumstances or did it send you into a spiral of self-critical thoughts? Did you feel energized and optimistic about your circumstances or did you feel defeated, inadequate, and that your life would be forever deficient?

Like advertisements, comparisons hold us in the belief that if we only had product or service X, we’d be happier, feel and look younger, and be the king or queen of our world. While it’s always good to work toward life improvement, comparisons typically leave you unable to focus on the satisfaction inherent in your current circumstances. Comparisons push your focus onto either the past or the future, or simply what’s wrong with the present. Comparisons keep you from being content and perhaps more able to accept what is. Right now.

How to stop comparing yourself to others

As a physician coach, here are four steps I teach to overcome the pull to comparisons:

  1. Start tuning in to your own thought processes. Simply begin noticing when you are going into comparison-oriented thinking. Try not to judge yourself. Jot these instances down so you can begin to see how often this occurs.
  2. Once you’ve noticed that you’re making a comparison, name it to yourself. Say to yourself “there I go comparing myself again.” Doing this begins to create a distance between the comparison you’re focusing on and the reality of the situation. Having that distance and separation is vital in having choice and control over your own thoughts.
  3. Now ask yourself: What is the cost of this thought process? What would I gain if I spent less time on these mental comparisons? Journal about these questions.
  4. Now for the challenge. When you find yourself making a comparison and coming up short, push yourself to think of at least three ways you, your circumstances, your thoughts, and your actions are right and adequate just as they are. Your mind will call you back to the land of comparison and self-criticism. Your job in this step is to exert equal and opposite force in the other direction! Definitely take notes here.

These steps take a lot of practice. What you will gain, though, is the ability to see your own strengths and accomplishments. You’ll find yourself experiencing more calm and a stronger sense of your own self-worth. Harkening the words of Theodore Roosevelt, you may even find yourself experiencing more joy.

Holidays and the Science Behind Sadness

Holidays and the Science Behind Sadness

The holidays are upon us and it’s the time of year that is supposed to bring cheer. Being with loved ones and celebrating together. Returning to places that bear fond memories. Exchanging love and gifts. The oft-romanticized season brings the belief that we’re supposed to be happy, and a sense of wanting if we are not.

Societal expectations surrounding the holidays can leave many feeling a sense of insufficiency and isolation. There may be deep frustration and disappointment, and sadness aplenty. We may experience the loss of family and love, wish our lives were different, or hope for things that might have been. We receive little modeling about how to manage sadness, and many people work hard to push this emotion away. As we navigate the internal conflicts that come with events like the holidays, there’s an important question to consider: is it better to avoid sadness or does sadness have an important role in our emotional well-being?

Pixar’s recent movie, Inside Out, sheds light on this question. Populating the mind of a teenage girl named Riley, the movie has five main characters: Joy, Sadness, Anger, Fear, and Disgust. While Joy, voiced by Amy Poehler, tries to push Sadness as far away from Riley’s consciousness as possible, Sadness comes forth as Riley’s family move across the country, she loses long-time friends, and has trouble fitting in with the new crowd. Joy’s attempts to quell Sadness contribute to Riley feeling confused and angry, and becoming isolated from her family. We witness how difficulty managing emotions can lead teens to make impulsive and dangerous choices. As Riley’s external world becomes more and more impacted by her volatile emotions, Joy finally realizes that it’s critical for Riley to experience sadness as part of her path to happiness.

The movie, and its exploration of emotions, is based on well-founded research. Dr. Dacher Keltner, a psychology researcher at UC Berkeley, worked as the scientific advisor to the movie as did Paul Ekman, whose research on a multitude of cultures initially identified these universal emotions.

Movies like Inside Out use popular culture to help show how to normalize emotions. Meanwhile, research, like that from the Greater Good Science Center and on emotional intelligence, provides evidence that sadness can help people improve attention to external details, reduce the bias formed by inaccurate judgments, increase perseverance, and promote generosity and learning. It may even promote the formation of new memories. And being more comfortable with a wider array of emotions decreases stress, and increases one’s ability to face and manage conflict and change.

However difficult it is, experiencing sadness is a crucial part of life. Don’t be hard on yourself if you feel it during the holiday season.  In fact, increasing your comfort with emotions that you once tried to avoid leads to heightened confidence and balance.  So, if you find yourself feigning a smile or grabbing another slice of apple pie to dull your sadness, try to remind yourself that your body and mind are feeling this for a reason. It might just make you happier in the long run. While our sadness most likely has different roots than that of a young teen, we can learn from Disney and perhaps get to know our own emotions a little bit better.