One of my favorite sayings is “you can’t stop the waves but you can learn to surf”. I first came across that in the book Wherever you go, there you are, by Jon-Kabat-Zinn whom I am fairly certain is also who coined the phrase.
Kabat-Zinn is a pioneer and expert on the subject of Mindfulness Based Stress Reduction (MBSR) and his ideas have factored heavily in my own work. That saying in particular has been central to my professional philosophy in helping performers become better prepared and more resilient in the face of challenges, and to help optimize their performance potential.
I find the meaning behind that saying especially relevant to the performance conditions that medical performers face. There is so much in the medical literature about the effects of burnout; the difficulties that make it tough to sustain worklife balance, and the toll that acute and chronic stressors take on health and performance.
When you drill down at the causes of these problems it can be disheartening to recognize that so much of which are fairly fixed aspects of the system and perhaps beyond one’s control to change. Factors such as constant heavy workloads, time pressures, navigating through issues of politics and power, dealing with difficult personalities and unrelenting fatigue are not likely to go away anytime soon. The task therefore becomes in preparing oneself more effectively to buffer against the systemic challenges that simply are as they are. I’ll often ask a group of physicians to engage in the following exercise to aid in that process:
1. Draw a circle representing “work” and then list all of the things that could transpire on a daily basis within the bubble that is work, and which can either create or consume energy. Consider people, stressors, tasks, situations, and sources of meaning and inspiration (energy givers).
2. Next I’ll ask them to identify those sources on the list that they actually can directly influence or change in a meaningful way. So, things like workloads, and dealing with difficult people no amount of effort can probably change BUT say readying in advance for certain situational stressors perhaps we can.
3. Of those things that it would appear we cannot change, the question is can we reclaim some of the focus, power, and control we give away to them? The things that are fixed and yet we invest so much emotional and mental currency towards. The end result being feelings of frustration, angst, and undue stress. Ask yourself, “in what ways am I resisting or attaching too strongly to those factors that are fairly resistant to change?”. The workloads are immense and yet you know, they are not about to ease up anytime soon. Certain policies might seem inefficient and unreasonable and yet you must go along with them. Certain people you must interact with might make your skin crawl and yet, they aren’t going anywhere either. If I cannot change these things and if I willingly answer the call each day when my alarm goes off and choose to step into this role where all these things are waiting for me, can I not learn to adjust and inoculate myself from their effects? Can I develop better responses to them? Can I be readier for them? Can I adjust my perception of them? What value would that have for my personal health? How much focusing capacity might I free up if I scaled back the time and attention spent perseverating on those things…THINGS THAT NO AMOUNT OF PERSEVERATING ON WILL CHANGE? There is so much you cannot change that becomes compounded by stressing over it. Stop the cycle. Adapt to your surroundings by working from the inside-out. Catch yourself when you notice your thoughts drifting towards ruminating on those things. Acknowledge what is going on in that moment: you are having a thought about the way things are. We don’t have to resist the thought but we must also be mindful not to allow the thought to overpower our state. Left unchallenged, thoughts become emotional reactions, which dictate to our brain how something is to be experienced. Each time we resist or attach to those things that cause angst or frustration we strengthen the signal to our brain and make it more likely we will experience the very thoughts and reactions we don’t want.
4. Get ready in advance. Us human beings are highly adaptable. The list you created helps cue you to those things we are susceptible to losing energy over. Select one of those things to start and engage in 5 minutes of visualization and mental rehearsal to help inoculate yourself from it and create a more optimal response to it. See the article on this site titled “5 minute visualization and mental rehearsal to trigger readiness”
The godfather of Stress Inoculation Training (SIT), Donald Meichenbaum once wrote stress is, “endemic, institutional and unavoidable”. We can’t eliminate stress in the field of medicine as its highly embedded given the demands and their effects, but we can learn simple, efficient strategies to keep the monster at bay. Start by identifying the ways in which you contribute to the problem through attaching, ruminating, and resisting those things that you cannot directly change. Make a commitment to yourself to cease giving away your power and focus in that direction by preparing to respond to things in a more constructive way. Utilizing the principles of visualization and mental rehearsal can be very helpful in that regard.
“You can’t stop the waves, but you can learn to surf”…indeed you can. The key to managing external stressors is in orienting an optimal internal perception of them. You can begin to change the way things are by altering the way in which your brain perceives, responds to, and performs through potentially stressful events.