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 experiences 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-fire 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.

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.

An Out-of-Balance Seesaw: Physician Burnout and the ABIM Apology

An Out-of-Balance Seesaw: Physician Burnout and the ABIM Apology

On February 3, 2015, the American Board of Internal Medicine (ABIM) issued an apology to American physicians for subjecting them to an out-of-date and burdensome board recertification exam.

The importance of this step cannot be overestimated. Of the ~850,000 active physicians in the U.S., over 200,000 currently hold ABIM certification, which is required of internists and most medical subspecialists. Starting in 1990 (the year I was unfortunate enough to complete Internal Medicine residency!), physicians have been required to take the exam every ten years to maintain their board certification.

While the ABIM cites data suggesting that the exam improves quality of care, this has not been definitively established, and questions have arisen from a number of quarters about appropriateness of content, the expense, and whether the exam is contributing to early retirement, a major concern in terms of the growing physician shortage.  The ABIM apology focuses on making the exam more relevant to the practice of medicine, allowing CME credits to be used in place of the esoteric MOC (maintenance of certification) modules, and eliminating the onerous practice assessment and patient survey requirements.

Board recertification is expensive, time consuming, and requires intensive preparation. In the setting of increased demands to see more patients in less time, decreased reimbursement, increased scrutiny, increased role definition by non-physicians, and the burdens of the EMR, board recertification is yet one more factor contributing to physician burnout.

Physician burnout is a complex phenomenon and yet it can also be summed up with a very simple equation.

X = all the things that buoy a physician up

X equates to things like positive patient encounters, good relationships with support staff and colleagues, intellectual challenge, or picking up a tricky diagnosis.  X also includes meaningful personal relationships, adequate sleep, and personal health, in addition to a sense of meaning and accomplishment.

Y = all the things that drag a physician down

Y includes an EMR that is frustrating to use and eats away at precious time, unrealistic patient loads, having more and more administrative hoops to jump through, inadequate staffing, or not having time to just focus on the care of your patients.

The math is simple:

When Y outweighs  X, you get imbalance and physician burnout, almost like two sides of a seesaw.

And board recertification is in the Y category big time. My own experience is telling. When I recertified in 2010, as a hospice physician out of touch with general practice, I prepared for over a year and a half, studying 3 hours a day for 3 months. I spent most “free” moments studying, I was completely drained, and my family was angry and alienated. Prior to that recert, my 13-year-old son had always proudly called himself Dr. Gazelle Junior. By the end of the experience, he said you couldn’t pay him enough to become a doctor. Now, at age 18, he’s planning on a career in engineering.

Many things can be done to decrease physician burnout. Not having to spend time that you don’t have studying for an irrelevant test is one important one, but it is still just one factor. Part two of this blog series will discuss the growing body of knowledge on other interventions.

The Impostor Syndrome Part II: What’s the Treatment?

The Impostor Syndrome Part II: What’s the Treatment?

Part I of this post explained this common disorder, which strikes physicians in their primes, leads to chronic low self-esteem, and contributes to the epidemic of physician burnout. What else do we know about it?

Many physicians have some form of the Impostor Syndrome (IS) but almost all suffer in silence and isolation. This isolation actually feeds into the syndrome, making physicians focus more on the belief that others are more competent than they are. And the vicious cycle repeats or even intensifies.

Furthermore, IS erodes confidence and sense of accomplishment. There are so many pressures on physicians, so many things that weigh you down. Given this, in order to survive you need to limit or eliminate anything that can contribute to the weight of these pressures. Walking around waiting to be “found out” is definitely in this category.

Here are a few ways to manage IS:

  1. Realize that many of your peers also suffer from IS. You can derive comfort from the knowledge that IS comes with the territory of being a physician. It is an occupational hazard, unrelated to your actual skill or expertise.
  2. Try not to expect yourself to be perfect! No physician is, so stop berating yourself for being human. We would have been much better served if we had been taught this in medical school.
  3. Remind yourself that you’re selling yourself short by comparing yourself to others. You bring unique strengths to your work.
  4. When symptoms hit, consciously shift your focus to at least one specific way you excel professionally.
  5. Regularly acknowledge that there is so much new information out there, you cannot possibly keep up with it all.

Like many treatments, this prescription will not take effect immediately. It must be practiced consistently. Old thought patterns are difficult to change. Take care of yourself in this way and you will promote your well-being over your entire career.

This week, if you experience symptoms of IS, try the methods above. Do they relieve your suffering?