Ep. #2. Yes, We Do Have To Talk About Our Feelings.
In this episode I discuss how every action we take, or don’t take, is motivated by what we are feeling at the time. I discuss the four different ways we deal with our emotions (Resist, React, Avoid, Allow). I review the importance of not judging our thoughts or feelings. Finally I cover how we can learn to process our emotions.
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Show Notes and Time Stamps
In this episode I discuss how every action we take, or don’t take, is motivated by what we are feeling at the time. I discuss the four different ways we deal with our emotions and then finally how we can learn to process or live with our emotions.
(01:48) Feelings are everything.
(02:53) Our feelings don’t come from our circumstances.
(04:18) Can we always change our thoughts?
(05:01) What is an emotion?
(06:09) 4 ways we deal with emotions
(06:52 ) Reacting
(09:17) We do not judge our thoughts or feelings.
(09:49) How to process emotions.
(11:22) How to live your life with your emotions.
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You are listening to the beat physician burnout podcast episode number two.
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In the last podcast we talked about buffering, or how we use external things in our lives to avoid urges and feelings we don't want to have. In this podcast I'm going to go through the different ways we can deal with emotions and how to process them so they don’t just keep coming back.
Feelings are why we do everything in life. We often act, or don’t act, from the feeling we are having right now. If you think about feeling angry you're going to take different actions then if you're feeling calm. If I am feeling anxious I may give up and take no action and go to bed. We also take actions because the way we imagine it is going to make us feel in the future. Think about why we became physicians. We certainly didn’t do it just to have the initial MD or DO go behind your name. We thought we would have a feeling of respect or security because of the income or challenged by the continual changing and learning that happens. Another example is why we save money. We don't save money just to see it in our 401(k) account. We save because the feeling we think we are going to have, financial security. We sometimes go to the refrigerator for something to eat not because we are hungry but because we are feeling bored.
The key to this is to remember that our feelings do not come from some external source. They come from inside of us. They come from our thoughts. If I am thinking that my employer only cares about the money and not the patients, this makes me angry and frustrated. The actions that I take when I'm feeling angry and frustrated tend to be ones like: being impatient or short with patients and staff, losing my temper and getting in trouble! If I can change my thought to something like “I am a good doctor and I can still take care of patients in this system” then I feel much calmer and maybe acceptance of the system I cannot change. From calm and acceptance I can take better actions. I can stop my mind from spinning and focus in order to get my work done the best way I can. My default is to blame the system for my feelings. And if you’re thinking you can't change the system, I completely agree with you. I feel the healthcare system is broken and needs to be changed in many ways but as an individual physician, I am not likely going to be able to do that. But I do have control over my thoughts, Feelings, actions. And the key, which is the hardest part to except, is that the circumstances do not have to change. We can change our thoughts, feelings, actions, results with the exact same circumstances.
Now does this mean that I am always going to be able to stay calm and accepting? Absolutely not. We are human. People forget that we are human and we can only take so much. Here is the way I described this, picture a wood pile, each patient, each request, each roadblock during the day adds more sticks of wood to that pile. Then the administrators send an email telling us we are not working hard enough and not meeting our RVU goals. So picture that as them throwing paper on the wood pile. Then the ER calls and says they have three admissions all at once and that's like putting gasoline on the wood pile. Then they ask us “why did you blow up?” So sometimes we probably are going to show up in ways we don't want. But by understanding thought work and realizing we can make a difference, Hopefully we can minimize these. There is a concept in coaching called “radical responsibility” that means we are 100% responsible for creating our life. I change this a little bit with doctors because we live, breathe and work in a system that we cannot change. But I do feel we can be the co-creators of our life.
So let’s define what a feeling or emotion is. Feelings are basically a vibration in your body. They start from your brain and travel down to your body. These are different than physical sensations such as hunger, pain or cold which start in our body and travel to our mind. Sensations come from our body physiology and then our brain translates them. Sensations are involuntary, hunger.
Have you ever had a time where something feels wrong in the pit of your stomach but you can't figure out what it is? This is when you need to look at your thoughts. What am I thinking that is making me feel this way. Some thought has triggered this feeling.
The four ways we can deal with any emotion are
And we’re going to go into each one of these in more detail.
The first option is resisting the emotion. So when we resist and emotion it is trying to push it away. This may work temporary. If you picture the huge beach ball that you're trying to hold underwater—that is resisting a feeling. If you were to just hold the beach ball in your hands that would be a completely different experience equal to feeling that emotion. And as we know with the beach ball example, Eventually it just pops right back up even stronger into the air. And that’s the exact same thing that happens with emotions we are trying to resist.
The next option is reacting. Why do we spend so much time resisting our emotions? Because they are uncomfortable. We are afraid of what might happen if we allow ourselves to experience the feeling. Let's take anger, we sometimes mistake feeling anger with actions of anger. We associate the emotion with the times in our past where we have acted or reacted to the feeling in a negative way. Maybe I reacted to my anger by yelling at someone or I blamed the universe for its unfairness. I might have given someone the silent treatment or talked behind their back. I don't want these things to happen again so I feel like I can't allow that emotion. Allowing the emotion does not mean you have to take any action at all. Our PFC has to agree before any action. some of us may think about punching our boss! But our prefrontal cortex still has the ability to override all of our actions.
The third option we have when it comes to our feelings is to try to avoid them. This is buffering, what I talked about in the last episode. We tried to distract ourselves from unwanted feelings by over eating, over drinking, over using social media.
The last, and best, option is to actually allow the feeling or feel the feeling. The first step when you have an uncomfortable feeling is to name it. This is what we call affect labeling. As physicians we are really bad at this. We have been told throughout our training that we're not allowed to feel certain things. If you're tired, ignore that, get back to work. If you’re sad because a patient just died, hide or suppress that, get back to work. So many times when I am asking physicians what they are feeling, they start telling me thoughts or areasons why they are feeling instead of naming it. Sometimes we only use the broad feeling such as good, bad, fine. It really does make a difference to label them. There is an attachment of my feelings Excel sheet in the links. The top line has the most general feeling such as AFRAID. Then under afraid is a long list of more specific feelings related to being afraid. Alarmed, anxious, apprehensive, defensive, disturbed, guarded and so on.
Next we need to remember that we are not our feelings. We need to be non-judgmental of our feelings. Just because I am feeling angry right now does not mean that I am an angry person. This is often difficult because we all I have so many opinions and judgments. Judgment just makes it harder to allow ourselves to feel the emotion. Remember that we have a huge array of different feelings we will have throughout our lifetime. This is just part of a normal human life.
So the first step in processing emotions is to name them. Remember they are just a vibration in your body and will pass. Sometimes it is helpful if you can describe to yourself the feeling. Try to be as specific and detailed as possible. Where is it at in your body? Is it fast or slow? Is it hard or soft? Is it light or heavy? Is it tightness, Aching, stabbing? Is it tingling? What color does a feeling have? Is it pulsatile? Intermittent or constant? Does it radiate? Do you have other associated symptoms such as weakness or nausea? How does this feeling make you want to react? Why do you think you are feeling this? What is the underlying thought that is causing you to have this feeling? If you’re thinking this sounds a lot like the questions we ask in our HPI, you’re right. I know this may sound a little woo woo but it really does help. After you describe it and allow it most likely the feeling Will have passed. We realize that we're not going to die from any one vibration in our body. After doing this process so many times I just know that the vibration will pass. I can be willing to allow and sit with any emotion because I am not afraid. Sometimes trying to describe my emotion in my body feels weird to me and it is easier for me to say to myself over and over again “I am processing anxiety. Or I am processing anxiety and that’s just part of my journey.” Because I know for a fact that the feeling will pass and it’s not going to kill me.
Sometimes the emotions don't go away quickly. Sometimes I am anxious all day long. I know what that feels like in my body. I feel weak and a little dizzy. I feel my heart pumping faster and feel a little short of breath. But when I know that this feeling is not going to hurt me I can also carry on with my day. I can be anxious and continue to work. I am willing to carry my anxiety in my “imaginary purse” throughout my day. It doesn't have to be one or the other. Sometimes we tend to only think in extremes such as black-and-white. I don’t have to say “I can’t do anything productive until my anxiety goes away” but instead say ” I can have anxiety AND I can continue on with my life”. Most changes, even great changes in your life,, come with some anxiety or uneasiness. But we still want to leave our parents house to go to college. We still want to get married. We still want to start a new business. We just carry the emotions with us.
This is some of the most important work I do when I coach.
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