DIY Pep Talk

“Wait, I have mantras for this!”

How are you affected by anxiety, rumination, or otherwise tenacious yet counterproductive thoughts and feelings in life? Many of us lose sleep. We lie awake, before falling asleep or having awoken at night, or both. I talk with patients about this regularly, a common problem that manifests for each of us in our own unique way.

Recently a patient mentioned it to me during a routine visit. After decades of stress-induced insomnia of various causes, there was a sense of placid acceptance in his tone and posture, and also hope that he may still find a way to overcome. He listed some prior life stressors, none of which had turned out nearly as badly as he had ‘unncessarily worried.’ He said when he remembers this, he is able to de-escalate in general, but it doesn’t necessarily help him at night. Since meeting me he had also been practicing box breathing to relax and calm his nervous system, which sometimes helps him sleep. So we agreed he could try to combine the two when insomnia hits: Breathe intentionally and rhythmically while repeating a reassuring, de-escalating mantra of his choosing. I’m excited to hear how this goes for him.

For some months I had been ruminating on and off about friction in a longstanding relationship. I journaled, spoke to multiple friends, and also lost sleep, which happens to me rarely. I entertained exiting the relationship altogether, but that was neither justified nor productive. I saw it as a personal challenge to walk my talk of showing up, sticking with it, and being my best relational self, despite feeling unappreciated and disrespected. What other story could I tell about this person and our relationship? The day before an upcoming encounter I felt almost squirelly from anticipation and ambivalence about how to approach the meeting. Then it hit me: I have mantras for this.

  1. I’d rather regret being too kind than not kind enough.
  2. Strong back, soft front.
  3. Do no harm, take no shit.

And just like that my conscience cleared, fight or flight turned off, and dread transformed into optimistic anticipation. I marvel still at how I recite my mantras everywhere to patients, on this blog, in social media posts and comments–I have even made stickers of them–and yet they escaped me when I needed them in a period of distress. I am all about relationships and yet this one flummoxed me–significantly. The mantras saved me–better late than never, and even better just in the nick of time!

I can neither prove nor disprove, but I tell the story that because I presented with honest equanimity and humbly confident professionalism, the encounter went smoothly. The relationship might even have improved? …I can’t say. I think I generally show up this way by nature and practice, but this time I had to talk myself into it. So I wonder, in all these years of friction (at least on my side) in this relationship, how much was actually mine to own, or in my imagination? This dynamic is definitely an outlier, so I don’t want to fixate on it; yet sometimes the exceptions point to areas of deeper potential insight and learning, no? Regardless, I’m grateful for how this episode has illuminated a new awareness for me and sharpened my attention to my own default attitudes and assumptions.

So what are your DIY pep talk methods? How did you come across them and why do they work so well? What mantras hold you up?

Happy Sunday, friends. Have a great week!

Love Notes for Bridging Difference

The PA student wellness talk went great! 42 or so junior colleagues engaged with me and my badly designed PowerPoint for ninety minutes and I had the BEST time! I realized this morning that for the youngest of them (about half the class), the pandemic hit during high school and the beginning of college. It reminds me of The Fourth Turning and how significantly the intersection of phase of life with momentous human events influences our world views. This summer I was challenged to address the impact of generational differences on organizational culture in a corporate wellness talk, and I started to see age and generation as another form of diversity.

“Respect and challenge the hierarchy,” occurred to me for students this year. We elders (some very elder indeed) still run things, and our experience and wisdom matter. We also have much to learn from our juniors, from their fresh and diverse perspectives. If we can all lead, from any chair, by humble and confident example, our professional culture will progress toward stronger inclusiveness and mutual respect.

I continue to seek conversation and connection with both conservative and progressive friends around politics. But I want to go deeper than news headlines and the loudest arguments. I want to know what core goals and values we share, to start walking together to see where our paths diverge. Where are our shared destinations, and why do you choose 90/94 while I choose Lake Shore Drive? What are the dis/advantages of each, what are the trade-offs?

I am really starting to miss more long form posting here, how fascinating! We are 60% through this daily blogging challenge. Many thanks to all who have followed along (Hi Mick and Donna!), and welcome to any new friends! Now let’s see how much love we can find across difference:

  1. Keep your antennae tuned for those who would divide us to serve their own purposes. This is NOT our better nature. Resist them and stay connected!

2. You and I disagree on this today. That may not necessarily be the case in the future. We can keep our minds open to change, without shame or judgement.

3. You don’t believe everything I believe. But let us not let that stop us from staying curious and connecting anyway. May we see light in each other no matter what.

4. The holidays can challenge our patience and resilience to triggers. *deep breath* May we stand firmly in love and ties of respect and shared history to get us through gratefully.

5. Our biases come honestly or not, we inherit many and form others organically. It’s a human thing. But let us hold them loosely and let them go to connect to one another.

6. Today and all days, may our differences feel softer, less threatening, and approachable with openness, light, and optimism for connection.

7. How wonderfully diverse we all are! How boring the world would be if we were all the same! May we appreciate and celebrate every spectrum!

8. To my friends who vote differently and sit with me over a meal or coffee to discuss–thank you. Our persistent and resilient connection gives me hope for our future.

9. I love you because we share important things in common. And the places where we differ teach me, make me better. Because of our love.

10. One deep breath can be the difference between a connecting moment and a destructive one. Let our breath give us the space to make the connecting choice.

11. Humility Curiosity Empathy Kindness Generosity — Is there any theme of love note NOT founded on these?

12. These fun music mash-ups like AC/DC-BeeGees — If we can so easily and artfullly blend divergent melodic creations, why not try with our policy ideas? We are a creative species, no?

Oh, I like this set, friends. Onward to 30!

Uncertainty and Lack of Control

The more I think about it and talk to thoughtful friends, the more I find uncertainty and lack of control at the foundation of the majority of stress and suffering I observe in our fellow humans.

In terms of health, more and more information from commercial blood tests and imaging can be known, but the utility and predictive value of all that extra information is still too often unclear. And so we spiral, worrying about the uncertain future and looking for more tests and the latest ‘hacks’ to ensure the outcomes we want. Capitalist Medicine, as I think of it, preys on our worries, offering test after test without regard to sensitivity, specificity, or predictive value. Too often there is zero clinical consultation before or after people fork over hundreds or thousands of dollars, with minimal explanations for the meaning of ‘green’ or ‘red’ range results. Overloaded and burned out physicians get inundated with messages from worried patients; precious time, energy, and resources are thus expended for unclear and sparse benefit. In time some of these tests, applied specifically and with strong evidence, may help a lot of people. What do we do in the meantime?

@bradstulberg
Author of Master of Change

Follow Brad Stulberg for evidence-based and practical advice on cutting through hype and sticking to what works. Focus on the basics: Sleep, exercise, nutrition, stress management, and relationships. I emphasize relationships because it’s more complex than we want to admit, especially relationship with self, which is basically self-awareness and self-regulation.

What if we’re already great at sleep, exercise, nutrition, and self-regulation, and we’re still anxious, still ruminating more than is helpful on a future that we ultimately cannot control? How do we get to peace with what is, and stop over-worrying about what could be negative, revel more in what is and could be positive? For more and more of us, life feels VUCA: Volatile, Uncertain, Complex, and Ambiguous. Naturally then, we seek stability, certainty, simplicity, and clarity–we grasp at what comforts–even if it’s false. So how do we get to real, true peace with it all?

That’s the inner work, my friends. It’s different and unique for each of us. Whether it’s family of origin stuff (for so many of us), other trauma, or something else (many somethings!), our patterns of anxiety and compensatory attitude and behavior don’t come from nowhere. And we all learn to carry our anxiety, trauma, etc. in our own dys/functional ways. Look at us, getting through life, getting sh*t done, holding it together the best we can! Good on us, FFS!

My wish for us all is that at the end of our lives, whenever and however it happens, we can each feel vastly more peaceful than regretful. That in those last ten minutes, we can look back and feel satisfied that we lived according to our values, spent our time, energy, and resources on worthy causes and connections, and can leave this mortal life with serenity. I have written before that in order to die at peace, I need to live in peace. That means living as comfortably as possible with uncertainty and lack of control, because that is what life is. I don’t mean that we should never feel anxiety, never acknowledge adversity, lose a little hope sometimes, and rail at what enrages us. I want for us to embrace all of it, allow the intense and difficult feelings, move through them (or let them move through us), with the confidence that we can handle it all, get to the other side of anything, and even gain a little wisdom in the process. I think it’s this confidence and security in ourselves and our connections (because we all need help, whether we admit it or not) that helps us make relative peace with uncertainty and lack of control.

Talk therapy
Somatic psychotherapy
Meditation of any kind
Breathwork
Martial arts
Prayer
Spiritual discernment
Mindfulness practice
Medication
Music
Creativity
Bibliotherapy
Walkabout
What else?

I wrote to a patient recently, “I will continue to look for ways to ease your worry.” This is my work. Every conversation informs and educates me on new possibilities, other ways I can help. We go together, my patients, friends, and I, exploring and co-creating according to our values, goals, and aspirations. I do my best not to judge anyone’s anxiety and worry, even as I observe the suffering it causes.
We all have our own unique burdens to carry in this life. Whatever we can do to lighten one another’s loads, let’s find a way to do it, yes?