The Importance of Peer Support

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What a privilege to present again to a group of smart, creative, fun, and engaging designers on Friday.  This time I was asked to address burnout, as so many folks are feeling overwhelmed and stressed.  I did my homework on stress and burnout in the creative fields, and found enough similarities in medicine to feel like a credible speaker.  “It’s not just a job, it’s a way of life,” seemed to capture how we see our respective vocations.

I presented a brief mini-lecture on self-care practices, including habit formation and maintenance in the 5 reciprocal domains of health, and narrative awareness.  The latter is always something we can do when we find ourselves in untenable circumstances:  Ask ourselves what story we tell about the situation, how that story compounds our suffering, and then tell a new story that does nothing to change the objective reality, but can dramatically improve our personal experience of it.  I have learned from work in physician burnout that people don’t just want to be told how to fix themselves.  They want someone to address the problems of the system that oppresses them.  So that’s where I tried to go next.

I started with an Appreciative Inquiry (AI) exercise.  In small groups, I asked participants to share team success stories, and listen for recurring themes around what’s already great about their teams, their work, and their organization.  Words like openness, flexibility, and “we have leaders, not bosses” made the Post-It easel list.  Then, in this headspace, I asked the groups to identify issues they wanted to address.  Instructions were to find important, urgent, and solvable challenges.  Guiding questions included, “Why will the organization be better if it’s addressed?” and “What does better look like?”

Similar to the AI results, common issues arose from multiple groups.  There was general consensus, reviewing the list at the end of 20 minutes, that overall work satisfaction would improve with less digital and more face to face communication, better project clarity, and taking better care of the shared spaces.  I would meet with team leaders and show them the list later in the day.

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When I opened the floor to questions, a self-proclaimed ‘Debbie Downer’ presented a query that I will ponder for many months as I prepare upcoming talks:  “When you ask someone how they’re doing and they say they feel like they’re drinking from a firehose, telling them to adjust their attitude is probably not helpful…  How can we change things that are not in our control?” The Universe had prepared me for this question by sending a new mentor who taught me to ask, “Who owns the things we don’t control?”  Thank you, my loving Cosmos.

I only partially answered Debbie’s question by suggesting she think about how she might influence the owner(s), how she might impact decisions being made in those spaces.  I segued too quickly, I’m afraid, to the question that I wanted to ask the group:  “When someone asks you how you are and you express that you are overwhelmed and drowning, what is a helpful response?”  I thought the discussion that ensued was productive…  It seemed to stimulate people’s intrinsic empathy and compassion.  We recognized the importance of feeling connected, that I’m not the only one feeling this way.  People recognized the relief found in just speaking aloud the list of stressors to a sincere and empathic listener.  We also talked about being prepared to hold space for any potential answer when we ask, “How are you?”  Even if we have no control over the flow out of the fire hose, maybe we can take turns holding the nozzle steady, and at a slightly oblique angle for each drinker, so it doesn’t have to knock us all over when we try to take a gulp.

I had a chance to talk to Debbie a little later (Cosmos offering me a second chance, Thank You Again), and we agreed that stress and burnout, in both medicine and design, are best addressed at both the individual and systems levels.  We can each start with personal accountability for our own experience of the system.  Then we can decide how we show up in the system each day.  We can choose, at any time, to either participate passively in the status quo (which is what we all need to do sometimes), or find a way, however small, to advocate effectively for change.

The latter is much better done with peers, with friends.  Take time to connect (no lunch meetings, let’s just eat together!).  Share stories.  What do we love about this work?  What’s already great?  How could it [realistically] be even better?  How can we help one another, including our leaders, envision and pave the way there?  Who else needs to be enrolled?

My meeting with the team leaders was less structured.  I worried that they left feeling disappointed because I did not offer more concrete advice on personal resilience practices for leaders, and ‘how to lead’ teams in burnout.  But over the hour, I felt no desire or need to lecture.  I queried various aspects of their self- and team awareness, personal resilience practices, and communication.  We briefly reviewed the issues list from the morning workshop, and I left with confidence that they would take it seriously.  It also occurred to me that these designated leaders were already supporting one another in their efforts to lead intentionally, effectively, and compassionately.  Maybe they have also felt overwhelmed sometimes.  Maybe it was also good for them just to talk it out with each other this day.  Maybe we can all do this for one another a little more often.

 

On Labor Day

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For a New Position

May your new work excite your heart,

Kindle in your mind a creativity

To journey beyond the old limits

Of all that has become wearisome.

 

May this work challenge you toward

New frontiers that will emerge

As you begin to approach them,

Calling forth from you the full force

And depth of your undiscovered gifts.

 

May the work fit the rhythms of your soul,

Enabling you to draw from the invisible

New ideas and a vision that will inspire.

 

Remember to be kind

To those who work for you,

Endeavor to remain aware

Of the quiet world

That lives behind each face.

 

Be fair in your expectations,

Compassionate in your criticism.

May you have the grace of encouragement

To awaken the gift in the other’s heart,

Building in them the confidence

To follow the call of the gift.

 

May you come to know that work

Which emerges from the mind of love

Will have beauty and form.

 

May this new work be worthy

Of the energy of your heart

And the light of your thought.

 

May your work assume

A proper space in your life;

Instead of owning or using you,

May it challenge and refine you,

Bringing you every day further

Into the wonder of your heart.

 

–John O’Donohue, from To Bless the Space Between Us

 

I know Labor Day is not about doctors, but I’m thinking about all workers and how we each relate to our work.  I discovered the poem above earlier this summer and loved it.  Rereading it this weekend, it resonated even more deeply and I shared it with some friends.  Since taking on a new leadership role about 20 months ago, it feels like I have really lived into these aspirations, as if the cosmos has held this blessing for me a while already.  I was primed for the call; I summoned every skill and insight I already possessed; still the learning curve has proven steep.   And no success is achieved alone!  The steady, honest, and loving support I enjoy from so many humbles me beyond expression.

Our practice recently welcomed new physicians and staff, and I will soon share this piece with the whole team.  Even for us veterans, it never hurts to look at our everyday work with new eyes, as if approaching it for the first time.

I hope O’Donohue’s words above speak to you in your chosen vocation, even if your occupation does not fulfill all of these lofty ideals (it’s kind of a lot of pressure to put on a job).  I wish you work that is much more meaningful than stressful.  If that’s not the case, I hope for you an effective and peace-giving way to reconcile this and find great meaning elsewhere in life.

And I thank you for the work you do, whatever it is.

 

 

Our 5 Fundamental Needs

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To Feel:

 

Seen

Look what I can do

This is how I can contribute

See me achieve

 

Heard

Hear my concerns

Take me into account

 

Understood

Validate me

Normalize my feelings

Say you can relate

 

Accepted

Tell me I belong

 

Loved

Participate in the Messy with me

Commit to sticking with me through the hard shit

Let me be my whole self with you

Be your whole self with me

 

Children by parents

Patients by doctors

Students by teachers

Workers by managers

The led by their leaders

Spouses

Friends

 

What if?