Calm Down and Connect

NaBloPoMo 2021:  Do Good, Kid

If you’re a child of the ‘80s and you’re looking for 45 minutes at a time to flash back during mindless cardio, I recommend Halt and Catch Fire on Netflix, a historical fiction series about the advent and uprising of personal computing and the internet.  It’s like watching a slow motion, multi-car emotional pile-up on the highway in your home town.  You see the speeding Porsche coming around the bend, just as the drivers of the F150 that rear-ended the Corolla and pushed it into the MAC truck, all friends of yours, start to realize what just happened.  You feel dread rising, your muscles tense, you know what’s coming.  You cringe and mutter (shout), “Nooo, don’t do it, slooow doooowwnnn!!”  And you can’t look away.

Hubris, ego, vision, Machiavelli, **relationship**, complexity, trauma, identity—I tapped these words onto my iPhone notepad during one particularly vexing episode, while bouncing on the elliptical.  I find myself both cringing and knodding at the raw, intense, and artfully, lovingly rendered drama of human foibles on this show.  There is something about every character that I can relate to.  I’ve been there, I think (feel?) so often.  I’m invested in these characters and their relationships; I want them to succeed—to ‘do good’.  Halfway through season 2 now, I notice what makes me squirm the most: Witnessing decisions made in the throes of emotional hijack—hurtful words slung in rage, impossible promises made under threat, carnal impulses followed in limbic heat.  It’s fiction, which gives me safe distance to reflect on how I know better, while recognizing my own absolute vulnerability to these same and other lapses.

It doesn’t take much, when someone treads too close to a strongly held identity, a fiercely held belief, or an otherwise sensitive spot in my psyche, to upend my attitude from calm clinician to defensive tackle.  I may not lash out in words right away, but I wonder how this affects my decision making going forward, especially at work.  When I experience recurrent threat, rejection, disdain, or disrespect, real or perceived, from or toward you, what stories do I start telling about you (us)?  How do these morph into entrenched assumptions that then cloud my judgment and compromise my objectivity?  In short, how does my being a normal, emotional human put my clinical decision making, and thus my patients’ health and outcomes, at risk?  How so at home?  It’s all potentially dangerous.

I can think of a few ways to guard against relational and decisive pitfalls here:

  1. To calm down, I can take a few deep breaths, remind myself that we are all humans.  We have the same fundamental needs to feel seen, heard, understood, accepted and loved.  I can ask questions, like, ‘What part of me or the other person is not having a need met here?’
  2. Practice ODP:  Observe, Describe, Participate.  This is a mindfulness tool from dialectical behavior therapy that I learned of recently.  I can take my subjective reactions and judgments and substitute objective observations and neutral descriptions.  This helps me slow down, get space and clarity.  Then I can refrain from speaking and acting from a place of hijack.
  3. I can also practice RAIN:  Recognize, Allow, Investigate, and then Nurture my experience, to gain both understanding and acceptance of myself and my circumstances.  Radical acceptance and compassion form the foundation of right relationship with self and others.
  4. Consult objective others.  Colleagues, friends, extended family, therapists—people outside of the index relationship and who have no stake in its workings can give valuable perspective and insight.  Even better if they can make honest observations about me and my hijack patterns, so I may learn and adjust, over and over.

Our lives are most meaningful, I agree with my friend, when we find deep connection with others. But too often it is our encounters and the very relationships we have with people that keep us from connecting. How ironic. Wow, these posts (and this blog) really do revolve around only a few central themes…

Self-awareness and -regulation are key to a life well lived—that is, a life at the end of which we are more likely to look back with the fewest regrets. Keeping practices and connections that tether us to our highest and best selves, even as the gales of life threaten to blow us away, is how we exert positive agency. We make the best decisions and tell the best stories about ourselves and other people when we are truly grounded and stable.

What practices keep you steady?

Commit and Flex

NaBloPoMo 2021:  Do Good, Kid

How do you see the relationship between commitment and flexibility? 

Son submits college applications in the coming weeks. I worry that he puts too much pressure on himself to choose the ‘right’ school (I assume that he will have choices), as if so many permanent things depend on this one life decision. In truth, this door swings two ways, not just one way. He is thoughtful and self-aware, and will make a conscious decision. Then I hope he immerses himself in his chosen school, goes all in with classes, clubs, culture, and people. There is always the risk that it won’t be a good fit, despite all of his efforts and intentions. And it will be okay; he can change schools, take a year off, study abroad—so many options!

Two friends in medical school graduated at the top of our class and matched in general surgery residencies.  They both hated it.  One is now a neonatologist, the other a pathologist.  My residency classmate left in the middle of our intern year because her husband’s job required them to move.  They all committed and flexed.

In science and medicine, we often think we know something.  We study, analyze, discuss, and conclude.  We sometimes make sweeping changes in decision making based on the evidence to date (think hormone replacement therapy, cancer screening, and baby aspirin, for example).  But we don’t stop monitoring.  We keep asking questions.  Sometimes what we thought we knew turns out to be wrong, and we must step back and change direction.  It’s not because we were stupid, or because we had some nefarious intent.  We simply can’t see the whole picture sometimes, and still have to act, so we do the best we can with what we have.  And we must be willing to change both our minds and our actions when we learn and know better. 

In The Infinite Game, Simon Sinek discusses the idea of existential flexibility, which he defines as “the capacity to make a dramatically huge strategic shift in an entirely new direction to advance our cause.”  We flex in actions while maintaining steadfast commitment to our purpose and mission. He gives examples of companies who did this successfully (Apple), and who did not (Kodak). 

For myself and so many of my patients, we must constantly commit and recommit to our health habits and practices. The method I used to lose 25 pounds in 9 months when I was 34 does not feel feasible now that I’m 48. I recently read a Noom article on decision making that resonated deeply (I have no interests in this business). “Make a choice and move forward with conviction. Prepare to be wrong. Be ready to pivot. And be willing to make a different decision. You can always make a different choice.”

Whether it’s suffering, fun, college, residency, clinical guidelines or mindful eating, we get to choose.  Doing the same thing over and over again is totally okay, and so is changing.  It’s just much better if we are actually choosing either, and that we know why.

Choose Your Fun

NaBloPoMo 2021:  Do Good, Kid

IT’S BREEEAAD!!!  Sometimes.  I am now well and truly obsessed; by the end of tomorrow I may have baked six masses of sourdough in five days.  So far I’m 2 for 4 to call them actual ‘loaves’, and the next two don’t look particularly promising, sadly.  But I am having so.  Much.  FUN!!! 

The last two posts read a little heavy, I think?  And yet in writing them I felt light.  Why is that?  Maybe because each day this past week I have had something to look forward to:  Something creative, rewarding, experimental, tactile, and sharable/social.  I joined three sourdough groups on Facebook this week—they are awesome!—full of such supportive, encouraging, knowledgeable, and generous bakers, not to mention positively mouthwatering photos!  They inspire and give me courage to keep trying, joyfully, despite repeated failures.

Looking back, what do I generally find fun?  Painting, volleyball, public speaking, pottery, TRX/HIIT, medicine…  In all of these funs, maybe it’s mostly the community that makes it so?  Team (sports and speech, medical)?  —Of course, it’s the people.  …No, it’s the relationships.  Wow, back to that again—I guess it really is my Why.  Duh-HA, again! [cosmic laughter]  It’s been 18 days—if you’ve read each post this month, have you also noticed the many recurrent, looping themes?  “If it’s important, it will be repeated…”  Seriously, and not just in one karmic lifetime, I think!

Okay, so now I know what’s naturally fun for me. But here’s a more interesting question: How do I choose fun when it doesn’t come naturally? Mount Laundry demands to be scaled. Clutter Demon dares me to slash and dismember its corpulent, multiplex potbelly. Tedium City chases back taxes from days or weeks (months?) of neglect. Just as we can choose our suffering, we can also choose our fun—turn slogging into surfing. Dance music and audiobooks help a lot, and of course going/doing with friends! …Also timeboxing: I can do anything for 15 minutes! And if I can elevate my mood to start, that just makes everything better anyway.

In that vein, I leave you with Daughter’s discovery whom I love, a college student in Wyoming who makes one minute videos of vintage recipes.  May B. Dylan Hollis lift you and give you some fun today!

The best of Sven yet