Category Archives: mindfulness

Uncertainty and Lack of Control

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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?

Confidence and Humility

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Mt. Tabor Park, Portland, Oregon, April 2025

Notes from a lunch conversation with dear friends:

Which is the thing and which is the modifier?

If I had to choose, I’d choose confident humility ahead of humble confidence.

But we don’t have to choose; they are both the noun and the modifier.
No more false dichotomy thinking!

And yet the distinction can be useful.
Depends on context, no?
They can switch and be fluid in real time.

Me in the room with a old white guy patients.
Power dynamics at play.
Relational reciprocity or not, friendly until not, ?undetected landmines.

One goal and its self talk:
Inspire confidence with competence.
Bring what ya got.
Boobs out.
I got this.
I care about you.
You are not allowed to abuse me or my team.
Respect is a requirement to be in this practice.
We will own our shit and you will own yours.

The Leadership Skill That Matters Most

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Photo from my patient who prefers to remain anonymous 🙂

Ask more and better questions.

Here’s how:

Whenever you’re about to make a statement or directive, pause. Ask yourself, “What do I not know?” Be honest and humble, or prepare to be humbled. The mark of an excellent leader is the willingness to be schooled from ‘below’ for the sake of mission and team.

Once your ingnorance is identified, formulate a question. As well as you can, make it an open and honest question, the hallmark of which is that you truly do not know the answer and you are not attempting to lead it. Pause again. Is your question truly open, meaning it cannot be answered by yes or no? If so, proceed. If not, revise to a truly open question.

Listen to the answer without interrupting. Do not speak until the other person has stopped talking for at least two seconds. Resist the temptation to issue your previous directive anyway. Follow the thread of curiosity, however thin or faint, to explore what else you don’t know. Done well, one OHQ leads to multiple subsequent OHQs, often branching and diverging to adjacent arenas all interconnected and mutually influential to the central issue.

It can get overwhelming fast, and I suspect many of us do not engage in this kind of query because the emergent morass of complexity feels so daunting. Rabbit holes are to be avoided in leadership think.

If we ask more and better questions, however, we don’t get rabbit holes. We get ecosystem.

I do this every day interviewing patients. Regardless if it’s weight, blood pressure, blood sugar, insomnia, or depression, nothing occurs in a vacuum. Only by exploring the state of every domain of health (work, sleep, exercise, nutrition, stress, and relationships) can I see fully the interconnected origins and impacts of the issue I need to address (often multiple issues at once). Often about thirty minutes into the interview I say, “Wow, that’s a lot.” I sit with my patient a bit stymied at the muddle. Then we talk about their goals, their values, and what lights or dampens their spirit. Reliably, by the end of the day long exam, we get to an action plan that is both brutally realistic and fully aligned with their highest aspirations. It feels inspired an empowered, forward motion already initiated for the coming year.

The best questions help us survey the jungle, its density and pitfalls. It is only after querying the morass and seeing its wholeness that we can know where to act most incisively and effectively. We know we asked excellent questions when the answers provide the map that leads us through the jungle together and with confidence.

Humility. Honesty. Transparency. Safety. Clarity. Accountability. These are the imprints of leaders adept at asking more and better questions. Consider any organization in your experience; I bet these leaders stand out. How would you describe their presence? How do you feel when you’re with them? What effect do they have on the team and its operations?

In case it’s not already obvious, this practice of asking open and honest questions benefits all relationships. In a world of soundbites that continually overgeneralize and oversimplify, stoking judgment and othering, the more we can retain and protect our humility and curiosity, the more we can ask more and better questions that foster understanding and empathy, the better the world will be. We all lead. Let’s do it better, yes?