Friendsourcing Motivation

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Sunrise, Sylvan Dale Guest Ranch, Loveland, Colorado. Photo courtesy of Dr. Anne Dixon

Greetings, friends!  How goes it, halfway through January of the New Year?  How are you doing with those resolutions?  I always feel conflicted about announcing such commitments, preferring to call them ‘intentions’ (see here, here, here, and here!).  I’ve read too many articles dismissing resolutions as mindless, unhelpful, and ultimately a waste of energy.  And yet, the start of a new year naturally prompts reflection and renewed motivation for self-improvement, which are good things.

Once again, taking a more nuanced view helps here.  It’s not that resolutions are bad.  It’s that we need to be thoughtful and realistic about them, as the linked article above suggests.  Whatever we call them, commitments to behavior change can lead us to transformation.  But it’s anything but simple or easy!

My post on experimental questions got a boost in views this past week.  I wonder what prompted that?  I wish I knew who was reading it and why, what they think, and what it means to them?  Since that post was published, I have continued to ask my 4 newest questions, of both patients and myself.  The recent traffic on that post parallels the evolution in my own reflections and answers:

In the coming year, what do you see as the biggest threat to your health?

My hedonist impulses, no question:  Ice cream and office sweets, mostly, but also online washi tape sales and paper, clothing, and shoe stores.

What is the biggest asset?

My friends, also no question, my pit crew.  They encourage me, keep me honest, and lend perspective.  They teach me and inspire me.  They hold me up.

One year from now, what do you want to look back and be able to say about what’s important to you?

In January 2021, I want to look back and say that I got fit again, that I regained the exercise discipline I lost in 2019.  I got control of my eating, decreased my sugar intake by at least half.  I put my phone down and was more present with my kids.  I was more intentional and executed better on how I spend my time and energy overall.  I exercised agency over my life better than ever before.

What support (external to yourself) do you already have and/or may still need to recruit, in order to make that vision a reality?

On November 10 when I posted these questions, I honestly had not answered this one yet.  It was harder than I had anticipated.  Since then, as I continue to ask patients, I see that I’m not the only one stymied.  My first response resembled my patients’, something akin to, “Well, I just have to do it.”  We type-A, independent peeps often rely first and foremost on ourselves.  We don’t ask for help.  And even though I have written and spoken ad nauseum about the importance of support, I found it difficult to identify my own need for it.  This is why I have added the ‘external to yourself’ clarification to the question.  Support comes from somewhere or someone else.  And we all do better when we have it.

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Friendsourcing Motivation

The whole time, the answer was right there in front of me.  The biggest asset to my health is my friends.  We know that social support (sometimes in the form of peer pressure) can be the key to success in behavior change.  Why else would people attend Weight Watchers meetings, or to go AA?  I need a workout buddy and a healthy eating buddy, I realized—I can tap my assets!  Eureka!

Easier said than done, however.  Who should I ask?  What should it look like?  Over a month or so, I worked out my specifications:

  • I need support from friends, not strangers (thus fitness classes will probably not be my jam)
  • I don’t want to be constrained by schedules with my buddies—flexibility is key
  • I need a two-way arrangement—someone who also has a goal that I can support them in
  • The arrangement must be concrete and accountable, but not feel oppressive

Tadaaaaah—Habit Share*!

On our sunrise walks in Loveland last weekend, two friends from LOH and I agreed to be one another’s buddies.  It was perfect—we all wanted the same things; we just needed an easy way to connect.  One of us, the youngest, most tech-savvy one, found the Habit Share app.  It’s free and perfect.  We each define our own goals, and simply share them with each other online.  We receive notifications when our friends check in, and we send messages of encouragement and solidarity.  It’s perfect!  I have already shared the app with patients and other friends, and am now connected to two more friends.  Our habits range from exercise to reading, to flossing.

Holy COW, what a difference!  Just knowing that I’m tracking my goals, and that my friends are seeing and supporting me, it’s been exponentially easier to motivate and execute these seven days than the entire past year.  It’s easy, aesthetically pleasing, costs no money, and connects me with people I love.  It is–wait for it–PERFECT!

I know, I know, it’s only been a week.  Who knows what all of our app screens will look like in another week, a month, or three months from now?  Will we all still be connected and holding each other up in a year?  Who can say?  But what’s the utility of thinking that far ahead?  Yesterday I set the new goal of getting up early once a week to write.  Today I can check it off.  I still have a chance to say no to ice cream, work out, turn off my phone apps by 10pm, and floss!  My friends will know when I do it, and they won’t judge me if I don’t.  It’s all good, and we can all take it one day at a time.

So, what support (external to yourself) do you have, or may still need to recruit, to make your best-self vision a reality?

*I have no financial or other interests in this business.  In fact, I want to contact them to give them feedback about how to make it better, but I cannot find a ‘contact’ page on their website…

All Good Things Must End

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Setting moon, Sylvan Dale Guest Ranch, Loveland, Colorado.  Photo courtesy of Dr. Karen Cornell

Friends, Leading Organizations to Health has graduated Cohort 11, the Class of 2020.

Ten months ago I started at my Hogwarts, the leadership training program that has definitely made me a better leader.  But more importantly, it made me nine amazing new friends and a much better person.  Today, on the last day of the last retreat, it all came together in the most beautiful way, and I am beyond grateful.

These ten months were the best elective educational experience of my life—they really gave college and med school a run for their money.  We immersed in a curriculum dense with abstract concepts of interpersonal communication and organizational change management.  We then translated the theories into tangible skills in an experiential learning lab, applied to specific challenges brought by my 7 cohort mates and me.  Over four in-person retreats and monthly Zoom calls, we shared, supported, and coached one another in the tenets of relationship-centered leadership.

We bonded in a similar way to residents on call:  Gathered for training, bringing different backgrounds and perspectives, participating in a common curriculum but each with a unique learning path, eventually to disperse and practice in different settings across the country.  We eight now share a connection of stories and struggle that nobody else can know.  We are a tribe.

Thus, I grieved the goodbyes long before we arrived in Loveland this last time.  But I also trusted our master facilitators to help me manage this, by both their loving and authentic presence and the very structure of the program, which is founded on contemplation and self-awareness.  I also felt an abiding faith in the friendships we all grew this past year.  As with my best friends from college and medical school, I knew we would maintain contact and connection, just in a different way.  We can’t stay in the nest forever—now is the time to fly.

In thoughtfully constructed journaling exercises and discussion groups, we reflected, consolidated, and synthesized ten months of learning.  We also examined our personal and professional evolution over this time, growth and movement in fluidity and complexity.  We explored aspirations and imagined the future state of this work in our natural habitats.  Finally, we sat in a closing circle.   Having each shared our own reflections, the group offered each friend observations, affirmations, and well wishes in what I can only describe as the most loving communion.  Each person’s strengths were articulated and amplified.  We acknowledged one another’s challenges.  We celebrated each other’s engagement, perseverance, contributions and triumphs.  Finally, sustained mutual support was extended around the circle, wholeheartedly and without qualification.

In my opinion, we formed the kind of community that we all want to lead.  Tony and Diane led us all by example, deliberately, artfully, and mindfully.  They live the principles they teach; they lovingly and patiently showed us the way.  In the end we discovered our own capacity to each write our own next chapter(s).  By making us feel seen, heard, understood, accepted and loved these ten months, our teachers inspired us to do the same for others.  And that is the strongest foundation for building our houses of positive change agency.

Now we go forth.  We’ got this.

November 25:  My Journals Make Me Better

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NaBloPoMo 2019

“You both have multiple journals that are all partially written in?” I asked, feeling vaguely twitchy.

On an online forum where I like to think I’m making new friends, three of us have bonded over our shared love of journals.  I wrote to the group last week, “I may have almost as many blank journals as I have books–the potential in them, the invitation to fill them with experience and life–they just make me so happy.”  The other two musketeers described their journals of various sizes, shapes, and designs, scattered about their homes.  They get written in whenever inspiration strikes.

That idea made me a little uncomfortable—that thoughts and ideas might be strewn about in different books, lying randomly around a home, disconnected, alone!  Hence the question above that I keyboard-blurted tonight.  I thought at first, “I can’t do that.”  Then I realized, I do do that—I have at least 4 journals going at the same time.  But I do organize them (not that my friends don’t—I have asked them to clarify).  I have a personal one, where I keep all original content. This one has at least three different designs of washi tape tabs, for blog ideas, presentation ideas, and other recurrent themes.  One is for work–a record of meetings, tasks, initiatives and their progress.  In a third I take notes at conferences or other formal learning.  Yet another holds insights from coaching calls and exercises from LOH.  I carry at least two, sometimes all, of them around with me every day. It’s common for me to have at least two out and be writing in both of them at the same time–taking notes from a meeting or presentation in one, then writing reflections, insights, and revelations in the other.  I often flip them over and write from the back covers, to keep lists and other short, serial records.  I attach email printouts and sticky notes, and when I reread I highlight and write in the margins.  These are well-used and well-loved books.

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In 2010 I went to a Mindfulness in Medical Education retreat.  I was physically ill that week with a respiratory virus.  But I had been mentally and emotionally unwell for months, turbulent and restless inside.  All I could do was ruminate, turning thoughts, conversations, and memories over, raking the same terrain, uncovering nothing new, no insights to show for all that psychic energy spent.  On the first night of the retreat we were given some quiet time and a pad of paper.  I filled my mug with hot tea, climbed into the bay window, and started writing.  For a month I had had inexplicable and persistent cubital tunnel syndrome—inflammation of the ulnar nerve at my right elbow that caused such sensitivity and pain in my forearm that I could hardly stand wearing long sleeves.  That night I unloaded the whole of my pent up frustrations onto that legal pad, many pages worth—a total brain dump.  I always journaled growing up, and somehow it had been years since I had last penned for myself.  I had forgotten how cathartic, how therapeutic, it was.  The next morning my arm felt normal.  I have kept a journal ever since, and that pain has never recurred.

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Another friend mentioned recently that he may leave his house without his wallet or his keys, but he never steps out the door without his journal.  I can totally relate!  Now I suspect there are more of us than I thought.  It’s the most satisfying feeling to have a reliable, accessible repository to record insights, ideas, and discernments, whenever they occur.  When I cannot do this—usually when I’m driving—it’s like having to pee until I can get out the journal at the next stoplight (or pull over).  It occurs to me occasionally to stop accumulating blank journals.  I’ve already set a moratorium on buying yoga pants and washi tape (for now).  But if a blank journal calls to me, I will buy it.  It’s good for my soul.

November 21:  Cardio Catch-Ups Make Me Better

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Ummm, this may not be my photo!  It was on my phone from 2017 and I can’t remember where it came from–I usually ask friends for permission to use… If it’s yours please claim it!

NaBloPoMo 2019

Is there something you should do but you don’t always want to?

Exercise perhaps, or laundry?  Dishes?  Cleaning and decluttering?

Last year I listened to Better Than Before by Gretchen Rubin.  It was a fun, relatable, well-researched and –reasoned book on habit formation and change.  I have recommended it to many patients for its myriad practical strategies.  One that particularly resonated with me was the idea of pairing.  Basically if we combine the thing we should-but-don’t-want-to-do with something we like or do-want-to-do, we are more likely to form and strengthen the habit of the ‘sbdwtd’.

In one of those Eureka! moments of instant understanding and integration, I started saving my favorite TV show to watch while doing the interval program on my elliptical.  Thanks to the hubs for positioning the cardio machine right in front of the TV in the basement!  Sadly, The Big Bang Theory has concluded and there are no other 30 minute shows quite so compelling to get me moving.  Thankfully I have my favorite podcast and Liked Songs list on Spotify, so I’m not totally sedentary.  On days when I’m really motivated, I still do the 7 minute workout or a TRX program.

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Do you wish you could connect more often with friends?

Years ago I remember talking on the phone while unloading and putting away groceries or folding laundry.  My friend was in San Francisco, I in Chicago.  We knew each other’s days off and would just call when we had a moment, and talk if we were free.  Farther back, in college and med school, we could all just hang out at each other’s apartments, pretending to study, but really just eating and talking.  Now we text, which is nice, but it’s not the same.  Somehow it feels harder to get folks on the phone anymore, and even harder to meet in person…  I miss my friends.

I’m getting a little better, though.  Sometimes I make phone dates with people for my commute.  It can be challenging across time zones, but we make it work.  It’s finite and somewhat reliable—I have to spend 30-40 minutes in the car at some point on any given morning and evening on workdays.  I even managed to connect with two Counsel members for pep talks before important meetings recently.

This month my new friend Alex and I started a new connection method, the Cardio Catch-Up.  She lives in DC and has to walk her dog.  I still need to work out, which I usually do in the evenings.  So we arranged a call over exercise tonight.  It was perfect!  I had to commit to a certain time, and my friend held me accountable.  I got on the machine and didn’t even notice the time going by (okay it just went by a lot faster), while we bonded over our LOH learnings, musings on human behavior and tribal dynamics, and our shared progressive values and aspirations for the planet.  I got my workout in, check.  And we both alighted on themes for future blog posts.  Tonight’s nascent idea:  Is the contagion of urgency the best vehicle for motivation?  Who knows where it will lead, into what it will grow, with what it will merge?  Regardless, it was born of an optimal pairing.

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The Cardio Catch-Up is the perfect multi-win:  Move the body, release stress and tension, connect with another beautiful human, exercise the mind, and inspire the spirit.  Who wants to do it with me next week?

November 5:  Peer Coaches Make Me Better

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NaBloPoMo 2019

When you’re working through a challenge, who helps you?  What is it about them, how are they most helpful?  How not?

Through the years I have learned what I can get from certain people.  I know to call this person when I need validation, that person when I need a devil’s advocate.  I also know which people to avoid altogether—those who cannot be trusted with my vulnerability or confidence.

But when I need to hold space and tension with an issue, to patiently look at it from different angles and process the perspectives, I look to my peer coaches.  I feel gratitude and gladness for these friends today, after my LOH group had our monthly peer coaching call.  As we progress through our 10 month leadership training, we take tenets and skills home from each retreat to practice.  Monthly Zoom calls have no agenda, other than to reconvene, share, and mutually support.  Every time I come away appreciating just a little more how nothing in life—work, personal things, social context—can really be separated from anything else.

These friends are not my first or only coaches, however.  In 2005 I started working with Christine, my life coach.  Every session, 14 years later, is still transformative.  How is this possible?  Curiosity.  Christine coaches every call squarely and unwaveringly from this perspective.  It was not long before I realized how powerfully this method could alter my own encounters with patients.

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The best coaches have no preformed or decisive answers.  They have the uncanny ability to ask the best questions–Open, Honest Questions (OHQs)–which then lead clients to their own best answers.  They help frame and reframe problems.  They point us to alternate perspectives and help us open our minds to narratives other than the ones we too often grip so desperately.  It was my second year in practice when I started asking coaching questions to patients, and I have never since feared any symptom, syndrome, or answer.  When there is no clear diagnosis or answer for someone’s distress, I can just keep asking until something helpful emerges.  Most often it’s not a single piece of information that gives clarity; rather, it’s the story that materializes.  Coaching skills help me help my patients find and tell their stories of health and wellness, illness and pain, agency and action.

Here are the tenets of true Open, Honest Questions, from the LOH syllabus:

  • The best single mark of an honest, open question is that the questioner does not know the answer and is not leading toward a particular answer.
  • Ask questions aimed at helping the other person come to a deeper understanding (help them access their own inner teacher).
  • Ask questions that are brief and to the point without adding background considerations and rationale—which make a question into a speech.
  • Ask questions that go to the person as well as the problem or story—for example, questions about feelings as well as about facts.
  • Trust your intuition in asking questions. Inviting metaphors or images can open feelings, new lines of thinking, and unexpected possibilities.
  • Try to avoid questions with yes-no, right-wrong answers.
  • Avoid advice disguised as questions.

My best friends are my peer coaches.  And now I have my LOH cohort-mates.  We make no judgments about one another’s circumstances, feelings, or experiences.  We make the most generous assumptions about our motives.  Our role in each other’s lives is almost never to give advice; rather it is to hold space, listen reflectively, offer moral support, hold up core values, and help one another query thoughtfully and honestly.

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Questions asked and reflective statements made on the call today:

  • If you left work tomorrow with enough money to be unemployed for 6 months, what would you do?
  • How does it feel to speak (your issue) out loud?
  • When you think about current state compared to past, how does it feel physically in your body?
  • Sounds like you’re working on a core tension.
  • What do I/you want now?
  • What’s roiling around in you?
  • Who around you can get creative with you?

We each bring diverse questions and challenges to each call.  But somehow we always relate deeply, and listening/querying helps us each learn from every other.  Today I saw central themes emerge around identity, contribution, voice, and meaning.

In the end, I think there are few things more important in life than meaning and connection.  These are the gifts from my peer coaches, and they always make me better, no question.

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