Last week, I read a blog post written by a women physician leader. It caught my attention because she was talking about the benefits of being a physician-the ability to save a life, pay her mortgage and have respect in the community. That’s not what most physicians are thinking or talking about in their overwhelmingly busy workday. Yet many don’t realize that when you practice gratitude, it is guaranteed to increase your happiness and work fulfillment.
The Power of Gratitude
Long-term studies support gratitude’s effectiveness, suggesting that a positive, appreciative attitude contributes to greater success in work, greater health, and a higher sense of well-being.
But while we may acknowledge gratitude’s many benefits, it still can be difficult to sustain. Physicians are trained to notice what is broken, undone or lacking in our lives. And for gratitude to meet its full healing potential in our lives, it needs to become more than just a Thanksgiving word. We have to learn a new way of looking at things, a new habit. And that can take some time.
That’s why we need to practice gratitude. When we practice giving thanks for all we have, instead of complaining about what we lack, we give ourselves the chance to see all of life as an opportunity and a blessing.
Gratitude isn’t a blindly optimistic approach in which the bad things in life are whitewashed or ignored. It’s more a matter of where we put our focus and attention. Pain and injustice exist, but when we focus on the gifts of life, we gain a feeling of well-being. Gratitude balances us and gives us hope.
There are many things to be grateful for: colorful autumn leaves, friends who listen and really hear, warm jackets, the ability to read, roses, our health. What’s on your list?
Some Ways to Practice Gratitude
- Keep a gratitude journal to list things you are thankful for. You can make daily, weekly or monthly lists. Or use your creativity and draw or paste pictures. Greater frequency will be better for creating a new habit, but just keeping that journal where you can see it will remind you to think in a grateful way.
- Practice gratitude around the dinner table or make it part of your nighttime routine.
- Make a game of finding the hidden blessing in a challenging situation.
As you practice gratitude, an inner shift begins to occur, and you may be delighted to discover how content and hopeful you are feeling. That sense of fulfillment is gratitude at work.
Last week, I had a one-hour meeting over coffee with a busy and typically emotionally stable, positive, and strong physician. She apologized to me at least three times, saying, “Next time, I won’t be so negative.” Like many women I work with, she is especially stressed due to the election results. Women are reluctantly admitting to each other that they’re not sleeping well, feel shocked, and are fearful about the state of our country. The strong feelings and negative thoughts are taking a physical and emotional toll on physician well-being.
What can you do to reduce stress?
1. Address your stress by sharing your feelings and supporting each other.
Stress is chronic in medical practice. Even a temporary increase in stress can result in lack of focus and limited perspective. Getting less done or making mistakes surely would raise your level of stress.
I was surprised how much better I felt, when shortly after the election, I shared my reactions with women I trusted. Actually, we really were in no shape to do much work before we shared the truth of our emotional states. Our interaction was cathartic. I hold monthly Women Circles for physicians. Even after a long day, the physicians show up, because they feel so supported and energized sharing stories and being together.
It sounds simple, but how often do we speak to one another about how we are feeling?
Tips to Reduce Stress:
- Band together for mutual support.
- By seeking and creating positive relationships to help counteract existing relationships that drain you, you will feel more togetherness and motivation.
2. Focus on what you can do, and do more.
It is common to feel helpless in response to an outcome you don’t support. Rather than concentrate on what is wrong, focus on what you can do to make things better. My sense of shock has motivated me to protect and nurture what I value.
Doing more to feel less stressed sounds like a paradox. However, when you are more engaged in constructive interactions, you can break out of the sensation of being stuck and feeling overwhelmed and cynical.
Constructive steps to consider to reduce stress:
- Find a cause you feel passionate about and get involved. Your contribution matters, and you will feel less helpless.
- Feeling ineffective? Engage in some professional development or coaching, and get the skills and network you need to have more influence.
And even if what is stressing you isn’t an election, other outcomes in medicine can stop you in your tracks. So, start now to expand your supply of constructive relationships and activities. Enjoy the lower stress and your more productive, fulfilling life.
Like you, I have a lot of roles and relationships I care a lot about; family, work, mentor, community member- oh, don’t forget myself! All too often I am focusing on what I need to do next in all these domains. My anxiety levels go up and my self-confidence goes down. Usually not soon enough, I renew the search for my lost sense of peace, calm, and life balance.
The truth is amazing results require focused time and attention. Doesn’t matter if we are referring to becoming a physician or learning to play the violin. Other important priorities, like your health and relationships, become “second fiddle”.
The antidote to feeling like “I have no life”, while pursing something important in life, is counterbalance. Gary Keller, in his amazing book The One Thing: The surprisingly simple truth behind extraordinary results, recommends we get used to being “out of balance”; just not to stay there too long. Counterbalancing is moving back and forth between your priorities so you can focus on your big goal and not stay away too long from the other priorities that bring you quality of life.
Think of the priorities in your life as juggling 5 balls: work, family, health, friends and integrity.
James Patterson, in his novel, Suzanne’s Diary for Nicholas, wrote, “Work is a rubber ball. If you drop it, it will bounce back. The other four balls are made of glass…drop one of these, it will be irrevocably scuffed, nicked, perhaps even shattered.”
Knowing when to pursue the extremes and when to seek the middle is the essence of wisdom.
In a practice filled by daily activities with colleagues, staff, and patients, women physicians often feel isolated emotionally. “A 24/7 career gets in the way of making personal connections.” Women physicians succumb to a masquerade as strong and independent, even in their darkest moments of self-doubt.
In 2012, after I interviewed women in my local medical community to discover what support they most wanted, the monthly Women’s Physician Circle was born.
Internist Dr. Andrea stated, “I looked forward to the group… as a sounding board for some of my difficulties in dealing with the public, as I have no other support system…. It seems like I should know how to do this by now, but …I will never be comfortable with the nasty, demanding, or angry people that I encounter in my office from time to time.” As the Circle listened thoughtfully, another physician agreed.
Women need to share their stories, doubts, fears, and solutions with each other. A medical culture that encourages sharing helps harried physicians find comfort and increased connection with peers.
Since 1938, The Harvard Study of Adult Development, which tracked lives of 724 men from a cross section of socioeconomic groups, asked about work, home lives, and health. The clearest message is: Good relationships keep us happier and healthier.
- Social connections are really good for us, and loneliness kills. People who are more socially connected to family, friends, and community are happier, physically healthier, and live longer than other people.
- Quality, rather than the number, of close relationships are more important.
- Good relationships protect our brains and bodies. The memories of people in relationships where they can count on the other person in times of need stay sharper longer.
Installment on the good life
Relationships require an investment of time and energy. A client confessed, “I put fun and connecting with friends on my calendar, but I don’t keep my word to myself. Other things bump it.”
For your busy life, try blending several aspects of your life into one activity:
Work and Family
Involve your family in a work-related community or CME event.
Work and Friends
Get tickets to share a local event with colleagues.
Invite a colleague for lunch each month.
Work and Health
Take a 5-minute walk break with a co-worker.
To invest now in your future best self, think where to put your time and energy. The good life is built with good relationships.
Change Is Happening
Are you experiencing a change, or know you need to change, but feel conflicted?
When my husband interviewed for an out-of state job, my immediate responses were confusion and fear. How will we stay emotionally connected? Am I willing to move?
Are Your Feelings Confusing?
Talking to a colleague about the prospect of this change, I barely could hold back my tears. I paused to notice that I was feeling sadness at the possibility of re-location and concern about his career if he did not get the position. I was afraid of the unknown and also excited by opportunities in a bigger city.
We’ve all experienced emotional confusion. Maybe you’re confused about changing your practice, your career, or a significant relationship.
Importance of Identifying Feelings
Awareness of your feelings can drastically reduce stress and improve your responses. Although feelings seem like murky ground, power and clarity results when you acknowledge emotions.
Feelings are important because they alert us to a need. My sadness about the prospect of my husband relocating indicated my need for emotional connection. If I didn’t identify my underlying need, I was at risk of responding badly. My behavior might be to withdraw, when what I wanted was connection.
Noticing how you feel is required to replace non-productive behaviors of resistance, withdrawal, or attacking in the face of change.
Knowing Your Feelings
Emotional awareness is a skill that anyone can practice. By these methods, become more in touch with your emotions:
Notice and name your emotions. Notice your emotions as you feel them. Name them to yourself. Say, “I feel proud,” when a patient interaction goes well; or, “I feel disappointed” at not being selected for the committee.
Track one emotion. Pick a familiar emotion — like frustration — and track it throughout the day. Notice how often you feel it and the circumstances.
Build your emotional vocabulary. How many emotions can you name? To expand my awareness, I use a list I found on Google.
Keep a feelings journal. Take a few minutes each day to write about how you feel and why. Journaling your experiences and feelings builds your emotional awareness.
Be creative. As you read poetry or listen to music, try identifying the emotions an artist is trying to convey. Then recognize how you feel in response.
“Let’s shine the light of consciousness on places where we can hope to find what we are seeking.”
The words of Psychiatrist, Marshall Rosenberg, encapsulate how emotions can be a tool to help understand what is really going on in any particular situation. Ask questions, such as, “Why did I have this response?”, and “What can I learn from this?” Questions allow you to pay better attention to what’s happening, instead of just reacting to life’s circumstances.
Key challenges to physicians include low reimbursement, loss of autonomy, and patient overload. As these issues are unlikely to change any time soon, there is high dissatisfaction among physicians.
However, the way we process issues can change today. We all have heard, “Life is 10% of what happens, and 90% of how you react to it.” Many challenges we experience can be traced to stories we tell ourselves, which are in our control. Although there may be a good reason for these stories, they produce bad outcomes.
Dr. Lisa, a hospitalist, was the physician lead for a pilot project to increase palliative care requests prior to discharge. In our coaching session, she shared that, while enthusiastic about the project, she didn’t have confidence she could keep attending physicians engaged. Dr. Lisa questioned her ability to be convincing about the project’s value, as English was her second language. “How can I possibly manage all the details, when I don’t even keep my house organized!”
As Dr. Lisa began to implement her program, she realized the problem was not her language or organizational skills, but unsupportive stories in her head. Things began to change as Dr. Lisa became aware, took control of the narrative, and started telling herself a different story.
Five ways to take control of your narrative:
- Recognize the voice in your head. It doesn’t matter where the story is coming from (your parents, a teacher, a colleague); just recognize that it is happening.
- Jot down what the voice is saying. Perhaps it says:
- “You’re too old/young.”
- “You’re under-/over-educated.”
- “You don’t have the right experience.”
- “You can’t leave after all you invested.”
- “You don’t have time.”
- Evaluate whether this story is empowering. Under many stories is a fear waiting to be updated. Is this story supportive of who you want to be in the world and the outcomes you want?
- Write down a different story. I’m not talking about pie –in-the- sky thinking. Just tell yourself the truth from another perspective. If we get to choose the story in our heads, why would we not make it an empowering one?
- Start telling yourself the new story. Every time your inner narrator begins telling the old story, stop it. Say to yourself, “No! Here’s the truth.” Then repeat your new story.
New stories, new lives
Dr. Lisa and I crafted her new story:
Yes, I am foreign born, and my perspective helps me think outside the box. I am passionate about this work and the impact it will have on patient care. My enthusiasm matters. My role as physician lead is not to manage all the details, but to enroll others. I have everything I need to be successful in this situation.
Using her new story, Lisa stepped over imagined obstacles and took steps to move the project forward. Within six months, Lisa had collaborated with staff that could exert influence at key points to result in more palliative care requests. The project outcome and how Lisa felt about herself both were better than she imagined. Now, instead of focusing on the behavior Lisa wants to change, she pays attention to the story she is telling herself!
How do you think your behavior or outcomes are linked to the story you tell yourself?
There are things in the world we can control, and things that we cannot. You always have a choice of how you are going to respond. Take control of your stories. You have the power to make things happen.