Kindlelife

Insight, Inspiration, Motivation

Catch ’em Early!


On my radio show, Stress Busters’ Corner, on the Health and Wellness Channel of Voice America, (http://www.voiceamerica.com/show/2423/stress-busters-corner), I was discussing with my guest, Wayne Markell, who is a Platoon Commander for the Emergency Medical Service (EMS), the issue of Stress and Burnout amongst the paramedics.

Wayne talked about how he encourages his staff to “raise their hands” and be vocal about how they feel, and when they feel distress. He talked about how the staff are encouraged to seek help, for the sake of their own mental health.

As a coach, who believes in (mental) Health Promotion, I think that is precious little, and unfortunately, that is how it is with most healthcare professions. We are expected to seek help, if and when we need it.

If a person is not seeking help, the automatic assumption is that they are coping just fine. Indeed, many of us would say just that, if asked directly, how we are doing! Therein lies the peril!

I strongly believe that all healthcare professionals should be aware of their own vulnerability, and be willing to reflect on their lives, and be able to recognize signs of impending burnout, and seek help long before it happens.

I would actually go one step further, and say that we should target people who are seemingly doing just fine, and help them become aware of their own strengths and weaknesses, their own stress triggers, and help them develop more tools to deal with stress. That way, we catch them before the stress becomes a problem in their lives, and the negative consequences are kept to a minimum – just as I like to say, that the best time to stop somebody from hurting themselves by smoking, is even before they light that first cigarette!

March 18, 2015 Posted by | Personal Journey, Psychology, Refocus and Thrive, Self Improvement, Stress and Resilience | , , , , , , | Leave a comment

Burnout – FAQs


In my last post, I answered one important question that physicians often ask, when the question of looking after themselves is brought up.

Another question that was asked of me recently, was this: “OK, so, I recognize that I am burnt out, but it is such work (sic) to get help! When I think of seeing a coach/counsellor, I worry that they are going to give me ‘homework’ and that is added burden to my already burnt-out life! So, I prefer to just go on, hoping that things will get better. Isn’t it better to do that, than to jump into something (coaching) and then halfway across, find that I am treading on thin ice, and then be unable to turn back?”

Quite a poignant point, don’t you think? Well, there are many points raised in this question, which I shall try and address.

The first point is that it is, of course, important to recognize burnout – but what is more important is to figure out, what is it costing you to stay in status quo??? If you are already aware of your situation, then either you are very self-aware, or something is already going wrong, in your life/career. Chances are, based on the question, that the latter is more likely. What is the price you pay, for not fixing the problem? Is it discontent at work, disrupted relationships – with colleagues/family members/friends, lack of time for self, illness-physical or psychological, or is it lack of recreation time, or a lack of well-being? How badly does this affect you, make you unhappy? How badly do you want to change this situation? Once you figure out the value of change, and if that value is big enough, then you will have the motivation to change.

The idea of “hoping that things might get better” is really hoping against hope, if you do nothing about it. You cannot sit on the sidelines of your life, and ‘hope’ for things to get better. It just doesn’t seem to happen, at least, not with any reportable frequency!

As far as coaches giving you ‘homework’, I think the term itself conjures up a very negative emotion! While most coaching sessions end with the client making a commitment to an action towards their stated goal, it is entirely upto the client to decide how they want to get to the goal, and what the reasonable action is, to get there. For example, if a person decides that they want to have a positive attitude at work, a simple step towards this goal would be to become aware of one’s thoughts/speech, at least a few times during the day, and if it is negative, replace it with a positive thought. Writing things down would make this exercise more effective.

This does involve some work, indeed, but if the motivation is to change one’s thought pattern, and if you want it badly enough, then you cannot help noticing your thoughts, and you would not consider this as unpleasant ‘homework’. The only way to change your life is to change something that you are doing – to that extent, there is homework to do. There are habits to change, and this can only happen with conscious action, done repeatedly.

The idea of turning back is interesting. The whole point of starting a new program is to make a significant change for the better in life. People only do this when they feel unhappy enough with their current lives. Any change, however, is a step towards the unknown. It is a step outside your comfort zone. And a person would only do that when their current situation is uncomfortable or unsatisfying. To expect things to e easy is rather naïve. When considering the idea of turning back, the question is – towards what? The same situation you were turning away from in the first place? What good would that do? Most worthwhile successes in this world have happened when people have stuck it out just past the point where they wanted to turn back! So, one can only start knowing fully well that any change is going to cause some discomfort, but it will be worthwhile in the end.

Please send me any questions/suggestions you have, that I can address in future posts.

 

 

May 28, 2013 Posted by | Personal Journey, Psychology, Self Improvement | , , , , | Leave a comment

Preventing Burnout


According to Maslach and Jackson, who created the Maslch Burnout Inventory (MBI), the symptoms and signs of burnout can be grouped under three headings:

Emotional Exhaustion,

Depersonalization (or Cynicism), and

Ineffectiveness.

The cost of such a condition, in a physician can be immeasurable – not just for the physician, but for the family, the colleagues, and for the community at large! Unfortunately, when trying to be strong, in the face of repeated stress,  physicians think they are doing the right thing, that has been taught to them, and is expected of them. They believe that everyone around them is looking up to them for strength and support, and any sign of weakness on their part would be harmful to everyone.

This, in reality, is far from the truth. We are doing nobody any favours, if we allow ourselves to suffer to the point of exhaustion, overwhelm and burnout. No patient would want to be served by a physician who is so emotionally depleted that he suffers from ‘compassion fatigue,’  nor would they be very understanding if a mistake was made by a physician who is exhausted, or didn’t really care enough! So, it behooves us to take care of ourselves, so that we can serve those whom we have committed to serve.

How do you prevent Burnout? Here are a few steps you can take, to avoid burnout.

1. Be Aware: Any change starts with self-awareness. We first need acknowledge that this is something we are all susceptible to, and that there is a certain courage in recognising problems and seeking help as required! If we think that we are in some way immune to the stresses, or that we are capable of handling it all on our own, we could be deluding ourselves.

It is important to know and detect the symptoms and signs early, and have an idea of what you are willing to endure, and for how long.

2. Be proactive: Smart people solve problems, by avoiding them in the first place. For example, every physician requests tests, and will receive the results in some form (electronic or paper). Isn’t it the smart thing to do, then, to set up a system, whereby the results will be looked at and acted upon, in a seamless way, least delay? Once this is in place, the chances of missing an important report can be minimised. Similarly, we can have different structures in place to deal with referrals, phone calls, etc. Maintaining a well organized and functioning office is perhaps the best thing one can do, from the professional point of view.

There are many things we can do on the personal level as well, like taking care of minor ailments to avoid major complications, clearing small misunderstandings in relationships to prevent build-up of resentment, and so on.

3. Be very clear of Your Values and Your Mission: You need to know what are the values that are most important to you, as a person, the violation of which will bring you pain. It will also help, if you know what you really hope to accomplish, through those values – in the near, and the distant future.

4. Prioritize: Once you know what is important, you can try to get more of what you want in your life. This includes knowing what is not important, that takes up our time and energy, that you can cut out of your life.  This also means being able to say “No” to things that encroach upon your priorities.

5. Take care of your body, mind and spirit: Eating regularly, eating the right foods, and exercising should not be something relegated to when you have time. It would help to have some activity outside of work, that can help stimulate you in a totally different way, and make you happy. Volunteering is great, not just to balance out the stresses, but also to get some endorphins flowing! A spiritual practice helps to navigate the ocean of life, the currents of which can at times be very turbulent. Make sure you take time for renewal on a regular basis.

6. Build a support system: Have a good team around you. Choose your colleagues carefully, if you are in a position to do so. Make it a point to cultivate good relationships with supportive people, whom you can call upon, when you need help. It also means that you should have trusted people you can delegate all those tasks to, that you don’t really need to do yourself.

7. Learn to be a good team-player: It is important to try and understand that people are different, and that having different people is what makes a team strong. So, when conflicts arise, remember that it is most likely due to a simple difference in mental wiring or a difference in priorities. If you learn to understand the differences, and can learn to negotiate, and to work together – then you can avoid a huge source of stress in your life.

 

I have simply put together a few suggestions, many that have worked for me, and some, that I am still working on.

Please e-mail me with any comments, suggestions or questions.

 

 

 

 

 

 

February 25, 2013 Posted by | Personal Journey, Psychology, Self Improvement | , , , , , | Leave a comment

What is Burnout?


While talking with a colleague recently, I was asked this question – and I realised that the word ‘burnout was used a lot, and the signs of severe burnout, the point where it hits you in the face, is easily recognisable. However, burnout is something that has to be recognized before it reaches this stage, and there are many people who seem to be functioning reasonably well, and yet, do have many of the symptoms of burnout, which they put down to stress.

There is a big difference between stress and burnout. The main difference is that a person under stress will feel better when the stress is relieved, whereas a burnout person has no hope that things will be any better, even if the current stresses are relieved. Burnout is the result of too much stress, often repeated, without enough recovery in between, over a period of time.

The term was first used by Freudenberger, who described it as a “state of mental and physical exhaustion caused by one’s professional life.” This is characterised by exhaustion, cynicism, and a sense of inefficacy.

Causes of Burnout: There are many factors that lead to burnout. While most cases occur due to stressful work environment, burnout can occur in a stay-at-home parent, or in a person working two or more jobs to make ends meet, without any vacation or leisure. It can also occur in the obsessive compulsive person who expects too much of himself- and everybody else!

Burnout can thus be due to a combination of work environment and responsibilities, lifestyle, and personality traits. Some of the factors are as follows:

Work Conditions: (anybody in the healthcare field know what these are like)!

Overly demanding job, with high expectations

Working in a chaotic or high pressure environment

Feeling a lack or loss of control over the work

Lack of recognition or reward for good work

Lifestyle Factors:

Too much work, no time for relaxation or socialization

Inadequate sleep

Too many responsibilities

Being too many things to too many people

Lack of or inadequate support

Personality Traits:

Perfectionistic tendencies – expecting too much from self and others

Pessimistic attitudes – related to self and the world

High-achieving, Type A Personalities

Need to be in control – reluctance to delegate

Burnout is something that happens over a period of time, and can be prevented, if the symptoms and signs can be recognized early enough. It is important to be vigilant and pick up these signs, many of which may be subtle.

The symptoms and signs may be categorised as follows:

Physical:

Feeling tired and drained most of the time

Lowered immunity, feeling sick a lot

Frequent headaches, back pain, muscle aches

Change in appetite or sleep habits

Emotional:

Sense of failure and self-doubt

Feeling helpless, trapped, and defeated

Detachment, feeling alone in the world

Loss of motivation

Increasingly cynical and negative outlook

Decreased satisfaction and sense of accomplishment

Behavioural:

Withdrawing from responsibilities

Isolating yourself from others

Procrastinating, taking longer to get things done

Using food, drugs, or alcohol to cope

Taking out your frustrations on others

Skipping work or coming in late and leaving early

In the next post, I will be discussing methods of avoiding burnout, as well as measures to manage burnout, once it has occurred.

 

 

January 14, 2013 Posted by | Personal Journey | , , , , , , , | 4 Comments

Time for Reflection and Renewal


Christmas is gone, the New Year is fast approaching. What better time for self-reflection and renewal can there be?

Confucius said, “By three methods we may learn wisdom: first, by reflection, which is noblest; second, by imitation, which is easiest; and third, by experience, which is the most bitter.”

How does one go about this process? How does one know it is being done ‘right’?

The important thing is to set an intention. Then, set the stage, to quieten one’s mind, by putting aside about three uninterrupted hours for oneself. Create a space – where one can sit, without any distractions – a clean space, without any clutter, and those who like it can further enhance it with candles or whatever else they like.

As for the process itself, the first thing to do is, take stock of one’s life. I usually do this under different headings including physical, mental, emotional, financial, career, spiritual, family, friends, community, etc. I also specifically look at what went well in the last year and what could have been better.

If there are any experiences that are strong enough to still produce a significant emotional response, then try to work through them, by first acknowledging the emotion. It is important then to ask oneself some ‘smart’ questions, in order to understand the experience better, and to work through the lessons therein. If the experience was a negative one, and we want to improve things, then it makes sense to understand what made it a negative experience, and what needs to happen to make it better. The most important thing is to recognize our own role in the creation of that experience, and what we need to change within ourselves to create a positive experience in the future.

It stands to reason that one must be honest with oneself for this kind of reflection to work, if one is doing it without the help of a coach or a friend who can be objective. Writing things down is a great way to reflect, since one cannot deny what one has written, when reading it again later, no matter how surprised one may be!

Writing often helps to clarify matters a great deal. It is important that the writing be spontaneous and not edited, for good lengths of time, so that the subconscious mind has enough time to express itself.

Ultimately, it is imperative that one makes a plan, for all the reflection in the world does no good if no action is taken. The plan has to be as clear, as specific and time-bound as possible, with smaller steps laid out for bigger goals, and rewards also specified for achieving milestones.

Accountability is the one thing that is often forgotten, in all the goal setting that is done, and sets apart the 5% who are successful, from the rest! A life coach offers the best possibility of accountability, but in the absence of one, the best way to make oneself accountable is to have structures in place to counter any possible obstacle to following the plan. Obstacles may include lack of motivation, resources, time, energy… you name it. One has to foresee what these are likely to be, based on one’s lifestyle, and put in plans to overcome these as they arise.

While such detailed reflection and planning can be done at the end of the year, self-reflection ideally should become a daily habit, and will bring great rewards, if practised regularly, especially along with regular journaling.

December 30, 2012 Posted by | Personal Journey, Psychology, Self Improvement, Spirituality and Religion | , , | Leave a comment

Why Physicians Burnout – and Why They Don’t Seek Help


In my last blog post, I wrote about the problem of surgeon burnout. Although the particular paper cited was about surgeons, burnout is not a problem of surgeons alone. It is common amongt all physicians, and even among medical students and residents these days. It is becoming more prevalent, as the stresses in life all around us seem to be getting worse.  I have been pondering on the reasons for this, and have come up with the following:

Physicians are High Achievers – Most of them have been high achievers from their school days, and have been consistently working hard, putting in long days and nights, through their medical school and residency, and even afterwards, in most cases.

Delayed Gratification that wasn’t! Many of them chose to “work while their companions played” (a little poetic justice used there), thinking that if they worked hard now, they could have the good life later (trust me, I know. My father promised me that if I worked really hard in the last 2 years before college, and got into med school, I would never have to work so hard again)! They often come out of their residency with huge student loans, that they find themselves working even harder to pay off. If they have a family, or other responsibilities, then it is one thing after another, and before they know it, they hit the middle ages, and feel cheated.

The Ever Changing Health Care System– It is becoming more and more difficult to practise medicine with the diminishing resources, and increasing expectations, that there is a great deal of frustration on a day-to-day basis.

High Expectations – Physicians are seen as knowledgable, and ‘life savers’ by their families and their patients, and when they do not get good results, they often find it difficult to accept. While they enjoy their successes, many take the treatment failures quite badly. They also want to be really good at what they do, and so are their own worst critics.

Sources of Strength – Physicians are the sources of strength for their patients and families, at their most vulnerable times, ie, when they are sick, or have a sick relative. Because they carry out this function really well, most of the time, they are somehow seen as strong people, and so, they try to live up to that image subconsciously, even in the face of their own stress.

Why do they not seek help?

Unfortunately, physicians are their own enemies, in that they are the last to acknowledge their own problems, and even when they do recognise it, are unwilling to seek help. This may be because of two main factors.

Fear of appearing weak – Physicians may not want to seek help because they are afraid to be seen as weak in any way, considering they are the sources of strength at home and in the community.

Lack of Support – There really isn’t much support to the physician at risk of burnout, or who is going through excessive stress. There are physician hotlines for when they have reached a pathological level that they are unable to function, and have either broken down completely, or worse, are considering suicide!

What we really need is coaching to help guide them through troubled waters, and PREVENT suicidal ideation, rather than treatment for it.

Tell me, what do you think might be some other factors in physician burn out, and what you have found helpful in your own experience, to overcome it.

March 10, 2012 Posted by | Personal Journey, Psychology, Self Improvement | , , , , , , , , , | 6 Comments

   

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