Physicians often fail to identify that personal affective issues are the root of much disappointment in their sense of professional effectiveness and fullfillment.
Criteria of Emotional Maturity
- The ability to deal constructively with reality
- The capacity to adapt to change
- A relative freedom from symptoms that are produced by tensions and anxieties
- The capacity to find more satisfaction in giving than receiving
- The capacity to relate to other people in a consistent manner with mutual satisfaction and helpfulness
- The capacity to sublimate, to direct one's instinctive hostile energy into creative and constructive outlets
Principles for Promoting Well-being
Become alert to how physical health, stresses and anxieties may be affecting your daily life. Does your health allow you to have adequate energy and focus? Are emotional and professional stresses affecting relationships with family, friends, patients or colleagues? Is your lifestyle balanced and supportive of good health? Monitor your use of unhealthy coping mechanisms. Notice when you get angry, lash out or reach for a drink or food or a cigarette to deal with stress. Ask yourself what benefit you gain from this response and if this is the healthiest reaction.
Set priorities and structure your life to support good health
Take time to consciously determine your personal priorities and identify obligations you are willing to commit to. Limit commitments to allow for balance in your life. You cannot say “yes” to one commitment without saying “no” to something else. To help you focus on your priorities, set major goals in all areas—physical, mental, financial, spiritual, professional and social. If your top goal is to spend five hours a week of quality time with your family, what are you going to give up to accomplish that goal? Be certain there is adequate staffing provided to afford relief, time off and backup in times of crisis.
Reach out to others
Develop networks with your peers, friends and family who are willing to talk honestly. Talk about issues beyond the immediate clinical issues or day-to-day problems. Don't allow yourself to become emotionally and socially isolated.
Be the one to take the risk of talking about the things that are felt but often ignored
Listen and provide emotional support and challenge. With peers, share the social reality of what living and practicing in current society is like by sharing thoughts, feelings and strategies. Resist the fear that someone may discover your vulnerabilities. Such a fear encourages low levels of trust and tends to isolate us from the social supports we need in times of crisis.
Support systems need not threaten your professional status
You must have personal and professional confidants and accurate feedback. Learn to recognize maladaptive coping mechanisms in yourself and colleagues.
Seek out resources to help you manage stress
Care for your emotional health. Be open to seeking consultation with a psychotherapist. Coaching on emotional health is as essential as care for your physical health. Consider using time management training and systems or technology. Seek out books and online resources. Write in a journal to track and process emotions and stress.
Delegate duties where you can to relieve stress. Let go of the need to control all details of your life. Work to limit your perfectionist tendencies.
Make your physical health a priority
Make necessary provisions to assure adequate, quality sleep. Get regular exercise, manage your weight, eat a healthy diet, quit smoking. See your doctor and follow his or her instructions. Good physical health is a prerequisite for good emotional health.
Develop healthy coping mechanisms
Common stress reduction methods include:
- relaxation techniques such as meditation, tai chi and yoga
- physical exercise
- healthy recreational hobbies
- spiritual contemplation and prayer
These activities can be a positive influence on your stress levels by providing a substantive mental and physical break from work duties. While it may seem difficult to find the time, these essential tools will re-energize you, making your work life and home life more productive, creative, efficient and enjoyable.
Relaxation is different from leisure
Relaxation is quiet time that allows for personal reflection, integration and planning. The stressors of leisure activity, such as sports, outdoor activities, hobbies, or special skills, are enjoyable in part because they are so different from the common stressors of professional life. Leisure activity will also often involve family and friends. Relaxation is also different from doing nothing. Relaxation increases awareness and focuses the mind while resting the body. It is a time to be present, to reflect, and to process experiences and feelings. Systematic relaxation requires concentration and deliberate mental activity. It will lead to lower arousal and release of strain. Many techniques are available for relaxation, including meditation, progressive muscle relaxation, selective awareness, self-hypnosis, somatics, yoga, breath control, and biofeedback. Audiotapes are available to help guide one conveniently through the learning process. For some, religious thought and introspection may fulfill the need for relaxation.
Don't take yourself too seriously. Develop an identity not dependent on your role as a physician. Many physicians use their professional identity as a shield, defining adequacy only through their abilities or aptitudes as a physician. What happens when you – as an imperfect human -- inevitably experience failure? You then have nowhere to turn with the resulting self-blame and self-shame except – unfairly – to attacking your competence. This can result in conflict as to where responsibility to self begins and professional responsibility ends. You may become obsessed with attempting to prove self-worth through increasing amounts of work. Perfectionism is a danger to balanced mental well-being.
Allow yourself space to be human
Realize medicine is not the cause of your problems or unhappiness--you are free to choose the lifestyle and work environment. Confront the options.
Be here now
If your family, religion, community or other activity is actually a priority, spend time with it. Your family deserves planned blocks of time that are sacrosanct.
Focus on the intrinsic rewards of medicine
You probably entered medical practice interested in altruism, basic science, the challenge of the patients who need your skills, stimulation by the broad range of people you work with. There are rewards in medicine you find motivating. If these are no longer present in your life, then this is an area needing exploration