What’s the big deal about coaching?

Coaching can help you break through barriers, get unstuck, rediscover your passions, and be more effective in your life and career. 

When my kids were little, they took gym classes. At five years old, they didn’t need a professional coach. They had fun and learned some skills at a local tumbling gym. However, if they were high-performing or Olympic athletes, there’s no question they would need a personal coach. The same is true of us. We need coaching not because we need remediation or because we are novices. Instead, we need coaching because we are already professionals, and to improve we have to be deliberate in our approach.

For the last two years, I have been coached once or twice a week. Those sessions have helped me work through personal and professional thought barriers. They have helped me understand myself better and how my thoughts and assumptions were holding me back or causing me to self-sabotage.

For the last two years, I have also coached others individually and in groups. Through being a coach, I have seen people make changes in their lives and careers and, most importantly, in how they think. Small changes in direction or approach can yield major changes over time.

“Coaching is unlocking a person’s potential to maximize their growth.”

John Whitmore

One-on-one coaching is different from any classes or courses you could take because of the individualized attention and confidentiality. Coaching is not mentorship, therapy, or advice. Coaching is future-focused and seeks to empower individuals with the ability to move forward and grow. Coaching is like having a personal trainer for your mind.

“A life coach does for the rest of your life what a personal trainer does for your health and fitness.”

Elaine MacDonald

My goal is to partner with individuals to catalyze growth and renewal in their lives through coaching. My assumption is that you come to the table as someone who is creative, resourceful, and whole.

If you are interested, sign up for a bundle of mini-coaching sessions. Let’s work together to think through what your life could be like and how to get there.

“Who, exactly, seeks out a coach? If you ask a coach the answer is usually the same: Winners who want even more out of life.”

Abigail pickus

To-Do List Don’ts – Part 2

To-do lists can help ensure we are working on what matters most to us. A to-do list can also reduce the cognitive load in trying to keep track of too much in our brains. Research shows that just the act of writing something down that comes into your head can help reduce the mental energy it takes to keep track of it, and can allow you to focus better on the work that you are doing. So task lists are important not just for planning, but for allowing us to focus more fully on everything else that we are doing. Here are the last 5 of 10 to-do list don’ts to help you in your quest to finally create a system that will work for you. These will make more sense if you read the first 5 don’ts.

Each task is an experience waiting to be born… When you look at your task list that way… this will become your future.

Ryder carroll, creator of the bullet journal (quoted in wired)
  1. Not prioritizing. Once you have your (very selective) list of projects with subcategories of tasks on your list, the next step is to prioritize them. Figure out what you need to do first based on deadlines, team needs, and importance. If we don’t prioritize then it’s easy to get behind on projects, and also it becomes all-to-tempting to do the easy, urgent, or fun tasks, and put off the important-but-less-urgent tasks that will really help transform our careers or that are important to us. Prioritization may be on a monthly/yearly time-frame, but then on the it’s important to prioritize within your day. What are the 1-3 things that you definitely want to do? Being intentional about your priorities can help keep you from wasting time on things that don’t matter to you. In my own practice, I’ll either write out a quick ‘daily do’ list of my goals for the day, or I’ll add numbers next to the check boxes on my to-do list for what I want to do that day. Under-achieve here. If you make a list of 25 things you deem high-priority for the day, chances are you won’t do most of them.  

The key is not to prioritize what’s on your schedule, but to schedule your priorities.

Stephen Covey
  1. Not putting tasks onto your calendar. The goal with a to-do list is not to catalogue all the things you would like to do with your life, but to facilitate doing them! The next step from to-do list is to put time on your calendar when you will do it. This may be on a weekly or daily basis depending on how you schedule your time. Put the tasks on during a time when you can do them well. I usually schedule deep work for mid morning or early afternoon, which is when I work best. Don’t schedule your most difficult work for a time when you know you will be exhausted from difficult meetings or at the end of a long day if you can help it. Block out the deep work times in your day and then decide what you will do with them. Some writers advocate the death of the to-do list and that we should work purely from our calendar by time-blocking and adding everything we want to do to our calendars. While I’m a big fan of time-blocking, I still find it helpful to keep a to-do list so that I can easily see all the projects I’m working on at once, and I can adjust or delete things on my calendar without losing track of what I need to do next. This is important for me, as my schedule can change in the last-minute if I get called in to cover the Emergency Department if a colleague is sick. I need to have a repository for all my projects and tasks so that I can quickly clear my schedule and re-prioritize.  

The shorter way to do many things is to only do one thing at a time.

– Mozart
  1. Giving up because a system isn’t perfect. You will likely never create a system that will transform you into a productivity ninja who never feels overwhelmed or over-tasked. Instead, find something that works and stick to it long enough to figure out a system that works for you. Perfect is the enemy of good here. Also, know yourself. I am frequently in awe (and sometimes jealous) of the beautiful bullet journals that some people maintain. They are often more art than organization, but I feel like I should try something like that. Keep the unrealistic expectations in check. If you know, for example, that you will overload a digital to-do list, then stick to paper. If you know you will lose a paper list, then find a simple digital app. It doesn’t have to be perfect, it just has to work for you.  
  1. Failing to celebrate. Here’s the truth: our brains like dopamine. We will always tend to do things that give our brains more dopamine. You can harness that to create the habits you want by celebrating. Did you do that micro-task? Yay! You turned your computer on and opened the file that is intimidating you. Celebrate. Engage some positive self-talk. Celebration is one of the key features of creating successful habits. In fact, the main premise of Tiny Habits is to make ridiculously small actions that form the seeds of habits. Those seeds are watered by celebration and positive self-talk. Did you manage to not lose the to-do list this week? Strong work. Did you prioritize? Round of applause. It may sound silly and would probably sound condescending coming from someone else, but celebrating your small wins is what will carry your habits and actions further than any self-criticism.  

When you celebrate, you create a positive feeling inside yourself on demand. This good feeling wires the new habit into your brain. Celebration is both a specific technique for behavior change and a psychological frame shift.

BJ Fogg (Ideas.ted.com)
  1. Failing to reflect. The reality is, “a scant minority of us check off everything every day. An equally tiny minority simply Cannot Even and are curled in a fetal ball awaiting imminent firing. But most of us? We’re just sort of … meh” (Clive Thompson, Wired). Look at the things that you didn’t check off. Should they be lower priority? Can you delegate them? Do you even want or need to do them in the first place? Did you avoid them because they are frustrating or induce self-doubt and fear of failure? Or are these things that you want to spend your short, mortal life on? Reflecting on what you are doing and why can help you ruthlessly prioritize for the future to make sure you are spending more time doing what matters to you… which may not be work at all.  

To-Do List Don’ts – Part 1

A functional system to manage your projects and tasks can save you heartache, missed deadlines, and mental overwhelm. But here’s the key, it has to be functional. The best-laid plans and resolutions to finally use that to-do list app, put everything into your google tasks, or get yourself together often fall by the wayside faster than gym memberships in February. We bounce around from app to bullet journal to notebook trying to find something that we can finally stick with.

Every single time you write down a task for yourself, you are deciding how to spend a few crucial moments of the most nonrenewable resource you possess: your life. Every to-do list is, ultimately, about death.

Clive thompson, (Wired).

To-do lists can help us make sure we are working on what matters most to us. Here are the first 5 of 10 to-do list don’ts to help you in your quest to finally create a system that will work for you. 

  1. Giving up and not having one. Very few people can function without some sort of system to manage their projects and tasks. A few people are able to work purely from their calendars or keep everything in their heads, but most of us need some sort of list to keep track of things. Even if your past attempts have failed, it’s worth trying a few new ideas to create a system that will work for you. Without a to-do list, it is very easy to get sucked into the trap of just doing the things that are urgent or the things that are easy. You also may find yourself missing whole projects, deadlines, or opportunities that are important to you. 

Dost thou love life? Then do not squander time, for that is the stuff life is made of.

Benjamin franklin
  1. Having too many lists and losing them. Maybe your problem is not that you don’t have a to-do list, but that you have 25 different to-do lists, all on different post-it notes that are scattered around your home, office, car, purse, or are scribbled on the back of napkins, boarding passes, or even your hand. Pick one place to put everything. You can categorize it by home, personal, administrative, and by different work projects. Find a place that will be easily accessible so that you have a reliable physical or digital place to go. I’ve tried almost all the apps and programs out there to be able to compare and contrast them. My favorite app-website combo is Trello for keeping track of lists. However, I personally come back to my trusty pen-and-paper method. I keep blank sheets of paper in a folding clipboard in my bag, and I write headings with the tasks under them. Each heading is a different project or initiative, and the tasks are below them with check-boxes and deadlines if applicable. The beauty of a piece of paper is I can’t overload it, I can see all the projects easily, and I love the feeling of checking them off when done. Once a sheet starts to run out of room or most of the things are checked off, I start a new paper and copy over things that are still active or unfinished. This act of re-writing forces me to assess whether I still want to do them, whether they are important, and why I didn’t get to them in the last few weeks. I also keep a separate list of things that I want to hold onto for longer. For example, my to-be-read list of book recommendations lives in Trello, along with my ‘Someday Maybe’ list of things for the future. Those don’t need copying out every few weeks and are easily accessed when needed. 
  1. Listing projects rather than tasks. If you put something enormous on your to-do list, such as write grant, buy house, or get new job, then it’s very easy to succumb to mental blocks and overwhelm when you look at the item. The negative feeling will then drive you to do easier work as you tell yourself: “Let me just deal with my email before I go get new job!” Or you may avoid the project or the list altogether. One of my favorite lessons from David Allen’s Getting Things Done book is the importance of understanding the difference between projects and tasks. Projects are anything that will take more than one step, whereas a task is typically a single step and can be done in a single sitting. Listing tasks rather than projects will force you to think through what the tasks are for a given project. Depending on the complexity, there may be many tasks and sub-tasks. You don’t necessarily have to map them all out at the start, depending on the project. Start by listing the most important things and the tasks that are bottlenecks that you have to do first to move the project forward. The more overwhelmed you feel when looking at a given project, the smaller the tasks you should write. We frequently procrastinate to avoid negative emotions associated with a task. Procrastination is “a way of coping with challenging emotions and negative moods induced by certain tasks — boredom, anxiety, insecurity, frustration, resentment, self-doubt and beyond” (Charlotte Lieberman, NYTimes). Making tasks as small and manageable as possible helps reduce the negative emotions and overwhelm. If it’s a particularly frustrating task, find ways to make it fun: do it with someone else, do it in a location you like, do it with good music on, and break it down into micro-steps in your mind so that your brain doesn’t throw its hands up and walk away whenever you contemplate the work. As an example, writing papers is one of the necessary but often frustrating parts of academia. Specifically, wading through a panel of reviewers’ negative comments as they shred your manuscript that represents months or years of work can be a task that is laden with negative emotion. The task on my list may be: Revise manuscript based on reviewer comments. By breaking the revision down into achievable tasks, I can focus on the immediate next step rather than on all the frustration and self-doubt that arise when reading criticism of the work. In my mind I break it down into micro-tasks:
    1. Turn on computer
    2. Open file
    3. Read overall summary
    4. Review positive feedback
    5. Read rest of feedback
    6. Go through paragraph by paragraph and perform edits, etc.  

The real problem is a lack of clarity and definition about what a project really is, and what the associated next-action steps required are. 

DAVID allen
  1. Not coming back to it. It’s all well and good to have a long, organized list of all the tasks you have to do, but it won’t help you unless you come back to the list and then plan when you are going to do the different tasks. Create a cadence, whether it’s in the morning, at the start of the week, or several times during the day, when you go back to your list and either schedule or do the tasks. Frequent list-checks allow you to prioritize and adjust and make the most of time that you may have when a meeting is canceled or another task takes more or less time than you had planned. Keep the list with you physically or digitally during your working and planning time and check it at least daily to update your plans or update the list. I typically look at my list at least each morning when I get to my office. I take a few minutes to review the most important tasks. I’ll already have most of the day time-blocked out (see item 7 next time for more on time-blocking) with what I want to do, but then I can plan to use interstices for other faster tasks in between time blocks.  
  1. Putting everything on it and then getting overwhelmed tossing in the towel. This is important. Be selective, like more selective than my non-pescatarian 9 year-old daughter who will only eat 1 food item per food group. Be even more selective about what goes on your list. Let’s get a little existential here. We all fall prey to the idea that: If I just got myself together, I’d be able to do everything I want, I’d be a great spouse, parent, sibling, co-worker, mentor, mentee, and I’d finally achieve inbox zero and everything checked off.  Digital platforms make it particularly easy to add more and more to our lists. We often feel an initial sense of optimism and structure when we see our growing lists within our pre-determined categories on our latest app. However, we then enter a period of avoidance and dread when we contemplate opening the app to see our lists that have enough work to carry us comfortably into the next decade. So we delete the app and go back to whatever system or non-system we were using before, or we pick up the next trendy option. We are notoriously bad at valuing the future. This is true of future money and future time. An hour of my time today may be incredibly precious, while I might give away an hour of time next month more easily. Value your future time and self at least as much as your current time.

We have a limit, a very discouraging, humiliating limit: death. That’s why we like all the things that we assume have no limits and, therefore, no end. It’s a way of escaping thoughts about death. We like lists because we don’t want to die.

Umberto Eco (in The Atlantic)

Deep Reset for a Midlife Renaissance – Part 1

I’m in the middle of a deep reset. This is a time in which I’m assessing my current practices, how I spend my time, where I focus, and deciding what habits and practices I want to keep or change. Having just finished my MBA and received tenure at work, it is a natural time to take stock and reassess. We’ll call it a midlife renaissance. This is a helpful practice to do every few years or so. I don’t do it in January, to avoid the cliché of the New Year’s resolutions that are abandoned before Valentine’s Day. Without periods of reflection, it’s easy to find yourself being productive and efficient, running 90 miles an hour, only to find out you’ve been running in the wrong direction.

Your future is created by what you do today, not tomorrow.

– Robert Kiyosaki

There are three major areas I’m evaluating as part of the deep reset: Work, interpersonal, and wellness.

Let’s think about the work or career realm first. It was a running joke in my MBA class that many of us pursued the degree to help figure out what we wanted to do next. Then, in our flowing graduation robes and stylish mortarboards caps, our relatives and friends gathered to watch us walk across the stage and to ask us all the same question: What are you going to do now? – And many of us felt like we were still no closer to figuring it out. No matter how old you are, I don’t think you have to know what you want to do when you grow up. But it’s helpful to have guiding principles.

In a recent discussion with the deeply thoughtful and talented Dr. Rob Orman on his Stimulus podcast, we talked about his ‘pillars’ or key principles that mattered to him. His guiding principles are to:

  • Spark joy in the lives of others.
  • Be present as much as possible.
  • Be of service.
  • Facilitate awesomeness.

By holding up his decisions and activities to the light of those principles he is able to guide his choices and priorities. For myself, my guiding principles for my work and career are that I want to:

  • Relieve suffering.
  • Solve progressively more challenging and interesting problems.
  • Be able to work with creativity and autonomy.
  • Work with great people that I can learn from.

As long as these principles hold, I would be happy with many different potential jobs or careers. It could be relieving suffering among patients, among students, among faculty, or for clients. It doesn’t matter as much what realm I am solving problems in as long as I am able to use my strengths and abilities in interesting ways to bring creative solutions. This is the first step, to figure out what themes are most important to you. In another post, I’ll tell you more about deciding what results you want.

What are the key requirements or pillars for your work or life?

Build your own dreams, or someone will hire you to build theirs.

– Farrah Gray

How to fill the unforgiving minutes

How many times do we tell ourselves: I only have 5, 10, or 20 minutes free, I can’t get anything done? I frequently think about the lines from the poem If by Rudyard Kipling:

If you can fill the unforgiving minute
With 60 seconds’ worth of distance run,
Yours is the world and everything that’s in it,
And – which is more – you’ll be a man my son.


What can possibly be done in 60 seconds? It turns out a lot of important things can be done in 60 seconds if you sprint. Quite literally, think about the fastest hundred-meter dash. The record time is 9.58 seconds. In one minute, that run could be done six times over. How many unforgiving minutes have we wiled away doing nothing of value? If we strung all the unforgiving minutes that we spend scrolling through Facebook, staring at the ceiling, or cataloging all the things that we should be doing, they would add up to hours a day. The key is being intentional about those small pieces of time instead of letting them pass or giving our attention away mindlessly to the lowest common denominator.

It is true that for complex projects that require a deep focus, we do better if we have larger time blocks. However, we can frequently get a decent chunk of work done even in smaller time blocks if we are intentional about it.

Instead of wasting those smaller increments of time, what if we used them in ways that propelled us forward? The first barrier is always in our own minds. Here are three tips to overcome the barrier and make the most of those small interstices of time.  

1. Change the narrative. Instead of continuously telling yourself it’s not worth starting anything since I only have a few minutes, change the narrative to I’m curious how much I can get done if I sprint for 10 or 20 minutes. Often, I’m surprised by how much I can fit into that time frame if I approach it with openness, curiosity, and an internal challenge. The competitive twinkle in my eye moves me forward to see what I can do like I’m racing against myself.

2. Keep a list of some tasks that can be done in 10 or 20 minutes but avoid getting sucked into excessive email. Email tends to sprawl and expand into all the time you give it. If you can, make the short tasks things that are either easy or fun. If you aren’t sure what to do when you have 5 minutes free, then you’re more likely to waste the time. If in doubt, try spending the time meditating to help clear your mind.

One of the most valuable things I do during five-minute breaks is to write down all my thoughts. This helps reduce the mental clutter and creates the clarity of a “mind like water.” This practice is particularly important the more stressed, overwhelmed, or busy your life feels. People I have worked with often describe a buzzing or cloudy sensation when all the thoughts whirring in their heads are annoying, indistinct, and sometimes toxic. Taking one or five minutes to gather all your thoughts onto paper and clear your mind helps clear so that you can concentrate better.  

3. Leave tasks as cliffhangers, so that when you come back to them you can jump right back in. I think about the concept of in medias res, a Latin phrase referring to the practice of starting a narrative in the middle of the action. At work, we frequently feel like we need ramp-up time before we can get going. Instead, jump into the task in medias res, at a sprint. Some writers recommend stopping in the middle of a chapter or even in the middle of a sentence when you’re writing so that when you come back, you’re right back in the action. You could also leave easy, low-hanging fruit. If you know you have to edit a figure, leave that work for when you just have 15 minutes free, and you can easily knock it out then, while saving your bigger chunks of time for the harder work of writing or planning.

We can never get more hours in the day, but we can gather up and live intentionally in the small pieces of time that we waste because we tell ourselves they don’t matter. So much of our lives are spent in the sum of little 5, 10, or 20- minute increments. Think about how you can create more value, peace, or mental clarity by filling those unforgiving minutes with distance run.

How to (almost) never have a bad shift

Walking through the sliding glass doors at 10:55pm on a Monday, I found myself wondering if it would be a good shift or a bad shift. In Emergency Medicine a “good shift” has to strike many delicate balances. It can’t be too busy, but it also can’t be too Q-Word-That-Must-Not-Be-Named. It should have some high acuity patients, but not so many that care becomes unmanageable. The staff and residents should be fun but should also work efficiently. On reflection, a “good shift” seemed to rely on many factors all of which were outside my control.

After years of feeling at the mercy of all the external factors that determined how my shift went, I realized my thinking needed to change. The philosopher William James famously said: “I don’t sing because I’m happy, I’m happy because I sing.” I needed to learn to sing. 

To understand how to create good shifts irrespective of external factors, I turned to the ancient philosophy of Stoicism. One of its core tenets is that we must focus on what is within our control.

“Happiness and freedom begin with a clear understanding of one principle: Some things are within our control, and some things are not. It is only after you have faced up to this fundamental rule and learned to distinguish between what you can and can’t control that inner tranquility and outer effectiveness become possible.”


Too often we ignore his admonitions and we focus our efforts on things that our outside our control while paradoxically relinquishing control of things that are within our control. Things within our control, per the Stoics, are our own thoughts, emotions, and actions. We relinquish control of them by allowing our emotions to be unduly affected by external things. “That person said something that made me upset,” or “I’m angry because I couldn’t get something I needed.” On the other hand, we try to control things that are outside our circle of control, such as other people’s actions or opinions, politics, coronavirus, or even the weather. We try to control them in our minds by resisting their presence, continuously wishing them away, or perseverating that they should be different. In order to have the inner tranquility and outer effectiveness Epictetus encouraged, we must give up the fiction that we can control things outside ourselves and maintain better control of ourselves.

Here are three practical steps:

1. Maintain agency over what you do have control over. Agency means taking rather than abdicating responsibility for your thoughts and emotions. You can also think of agency as power. If you prime individuals to feel powerful they show greater “executive functioning, optimism, creativity, authenticity, the ability to self-regulate, and performance.”(1) When you give up control of your own thoughts and feelings, you are giving up your own power. By claiming ownership over your own thoughts and feelings, you are accepting that whether you have a good shift or not is entirely up to you, not external things.

He is most powerful who has power over himself.


2. Even out your standard deviation and raise your mean. Imagine a graph of your personal shift quality vs time. Some shifts are truly terrible. Others are fantastic. Most shifts, however, fall within 2 standard deviations of our mean. By choosing to make most shifts a ‘good’ one, it does not mean artificially trying to like the terrible shifts. Instead, it means smoothing out the variation, and raising the mean itself.

3. Change your own mind. Shifts are difficult. They often consist of an 8 or 12-hour exercise in tolerating a continuous stream of small frustrations, insults, barriers, and setbacks. The Stoics have many provocative things to say about enduring hardships. Marcus Aurelius wrote: “Ask: What is so unbearable about this situation? Why can’t you endure it? You will be embarrassed to answer.” The only way to be able to decide to have a good shift is by changing our own minds.

To bear trials with a calm mind robs misfortune of its strength and burden.


We can change our minds by employing a practice the Stoics called meditation, which is similar to cognitive therapy.(2, 3, 4) Stoic meditation consists of becoming actively aware of one’s thoughts, analyzing them, selecting the thoughts we wish to entertain, and rejecting futile thoughts. At 2am when I am unable to get a patient a ride back to her nursing facility, the thought “I should be able to get the patient home” is futile and leads only to frustration. The thought “this should have been fixed already” is useful only if it leads us to action to fix it, but on its own is a waste of precious cognitive bandwidth.  Entertaining futile thoughts leads to a sense of learned helplessness that reduces our ability to think creatively and solve problems. 

Perhaps the most shocking of Aurelius’s statements on enduring hardships is this one:

If it’s endurable, then endure it. If it’s not endurable, then stop complaining. Your destruction will mean its end as well.

Marcus Aurelius

The ED, the challenges of providing healthcare within a broken system, and patients in need of help will be here long after each of us. We must endure the challenges while we also work to remedy the problems.

The mind adapts and converts to its own purposes the obstacle to our acting. The impediment to action advances action. What stands in the way becomes the way.

Marcus Aurelius

When we work to overcome a challenge, we gain the inner tranquility and outer effectiveness that were the things we needed most in the first place. By managing our minds, we can repurpose obstacles into opportunities to build strength.

This is my challenge to you: Maintain ownership over the things that are in your control. Choose your thoughts intentionally. Raise your mean and decide to measure the goodness of a shift not by the external circumstances you face but by your attitude in the face of those circumstances. Then, and only then, will a good shift be something you create, not something you hope for.

This article was first published on KevinMD.

How to persevere

The end of COVID is in sight but there are still months to go. Maybe you have been struggling with getting things done while working from home and de facto homeschooling your kids. Perhaps you’re feeling cooped up after a year of going only from your home to the grocery store and work. Or, maybe you’re chronically exhausted from the constant mental strain of the year and find yourself mindlessly surfing on your phone and avoiding the tasks you had planned to do more often. How can we persevere when our strength has been collectively sapped over the last year and our sense of grief at what has been lost will persist even when isolation and distancing are over?

To answer this, I’ve turned to three very different physicians and scientists. Here are practical ideas drawn from their wisdom, expertise, experience, and experiments for how to persevere through our current and future challenges.

1. Create meaning –  Viktor Frankl’s book, Man’s Search for Meaning, easily ranks on the list of top five life-changing books for me. In it, Frankl, an Austrian psychiatrist and holocaust survivor, explores what allowed some individuals to survive the unthinkable conditions of concentration camps without losing their humanity or giving up hope. After his liberation, he formalized his findings into a form of psychotherapy called logotherapy, from the Greek logos, or meaning/reason. He observed that when his fellow inmates were able to maintain a sense of meaning for their lives despite having been stripped of everything else: their wealth, connections, family, belongings, homes, clothing, health, and freedom, that they were able to maintain hope and their sense of self. He explains: “Logotherapy is composed of three basic principles. The first basic principle is that life has meaning in all circumstances, even despondent ones. The second principle is that the main motivational force is the desire to find meaning in life. Lastly, the third basic principle states that humanity has the freedom of attitudinal choice, even in situations of unchangeable affliction.”

Frankl articulated three main ways in which individuals create meaning for themselves even in the worst possible circumstances. Consider which one resonates most with you and how you could focus your energy on creating more meaning in that area.

i) Creative. This is through creating new things, whether it’s writing, or creating new online content, or creating new programs, or designing new ways of teaching, new care delivery models, or new protocols.  

ii) Experiential. He talks about how one evening in one of the camps, there was a beautiful sunset and the inmates called to each other to come outside and see it. They were able to find meaning through the experience of beauty in that moment even with all the horror going on around them. Experiential meaning can come from the experience of beauty in nature, music, art, or in the experience of inter-personal relationships and connections.

iii) Attitudinal. I think of this as the warrior mindset. You find meaning through being brave. You find meaning through courage, through the attitudes that you display, and the person that you are in the face of challenges.

So reflect on this: How do you find meaning in your life? When we don’t have meaning in our lives, we have an existential vacuum. Just like in physics, vacuums quickly get filled up. We tend to fill up our existential vacuum with other things: distractions, easy work, mindless entertainment, or unneeded food or alcohol.

We can create meaning even in the worst circumstances by bearing witness to our uniquely human potential.

We must never forget that we may also find meaning in life even when confronted with a hopeless situation, when facing a fate that cannot be changed. For what then matters is to bear witness to the uniquely human potential at its best, which is to transform a personal tragedy into a triumph, to turn one’s predicament into a human achievement. When we are no longer able to change a situation… we are challenged to change ourselves.

Viktor frankl

2. Combat ego-depletion. It takes energy to create meaning, to turn our tendencies towards despair and inaction into hope and action. It also takes energy to do difficult things. When you’re on a diet, have you noticed how you may be able to have a small, healthy breakfast and lunch, but then after dinner you have no willpower left and you indulge in ice-cream, brownies, wine, and Netflix? The reason for that, the psychology literature tells us, is because we have a finite amount of willpower.

Roy Baumeister has written many of the articles on the topic, and they’re summarized well in his book, Willpower: Rediscovering the Greatest Human Strength. The experiments show that when we exert willpower in one area, whether that’s at work or dealing with children’s school at home, it drains the willpower we have available to us for all other areas. I think of it like a pitcher. You have a finite amount of willpower, and as you use it, you’re pouring it out. By the end of the day, you’re in a state called ‘ego-depletion’. Your willpower pitcher is empty. In that state you both feel temptations more keenly and you have less ability to resist them. So, you indulge, collapse in bed, and vow to do better the next day, only to repeat the cycle.

To break the cycle of constant, complete ego-depletion, first, understand and notice what depletes and what restores your willpower pitcher. Resisting temptations depletes willpower. Removing temptations from your notice can preserve your willpower. For me, this means turning off notifications on my computer when I’m working so that I’m not tempted by their easy distractions. I turn off my phone or watch while working. I put the cookies in the pantry, so I’m not tempted by them. All of these small actions reduce my willpower expenditures throughout the day.

You also have to restore your willpower pitcher. That means taking time to do things that bring you joy. For me, exercising, being outside, connecting with friends, baking with my kids, or reading a good book restore my willpower. Self-care is not about mindless or selfish “ME-TIME,” it’s about meaningfully restoring your sense of self and your ability to continue to do difficult things.

3. Connect – One of the cruelest aspects of COVID is that it hamstrung our ability to cope with difficulties by isolating us from the very friends and family we usually lean on for support. It amplified and exacerbated the sense of loneliness and isolation that was already rampant. Prior to COVID about half of Americans reporting feeling lonely. Loneliness leads to worse performance at work, with 16% lower profits, 37% higher absenteeism, and 49% more accidents. In addition, the health effects of loneliness are staggering, with 30% higher rates of coronary artery disease, and negative effects on longevity that are equivalent to or worse than those caused obesity, drinking, or smoking.

I found that people who struggle with loneliness, that that’s associated with an increased risk of heart disease, dementia, depression, anxiety, sleep disturbances and even premature death.

Vivek murthy to npr

Vivek Murthy, the former and current surgeon general, wrote a timely book about the importance of connection, called Together: The Healing Power of Human Connection in a Sometimes Lonely World, released presciently in April 2020. In it he explains the importance of creating connection to our health and ability to thrive and overcome challenges. He argues that loneliness undergirds many of our current public health crises, such as alcohol and drug addiction, violence, depression, and anxiety. Often there is a sense of shame around loneliness. We avoid admitting to others and to ourselves that we are lonely because we thank that could mean we are unlikable or deficient. Instead, think of that feeling of loneliness as an indicator light reminding you to ‘refill your tank’ and spend more time meaningfully with others.

To combat loneliness and create connections, Murthy exhorts individuals to spend time with others each day in a meaningful way, giving them your full attention rather than trying to multi-task or scroll on your phone. He also encourages us to create connections through service to others and to understand ourselves better through intentional time in solitude or meditation.

Think about your own life. How much of an existential vacuum do you feel? How can you instead create more meaning? Do you feel constantly drained and in a state of ego-depletion? How can you protect and preserve your willpower and also refill your pitcher more frequently? How isolated or lonely have you felt? Where can you connect meaningfully with others through your work, home, or service?

We persevere better together. Join me, on a quest to constantly create more meaning, restore our sense of self, and foster intentional connections.

A version of this post was first published here on the medical blog, KevinMD.

The Joy Quest

Joy is the holy fire that keeps our purpose warm and our intelligence aglow.

Helen Keller

At the start of this year, I decided to go on a Joy Quest.

Too often, we rush from one mental worry to the next and we don’t take the time to notice, experience, and create the joy that’s either already there or that can be added to our daily lives. The joy and opportunities for joy are there, like jewels strewn over the ground, yet we rarely pause to pick them up.

What if, instead, we made a conscious effort to notice the big and little things that bring joy and meaning to our lives? We can create joy and meaning in our lives in small ways, in moments of connection, beauty, reflection, and service. We can also create longer term joy and meaning through things that we accomplish that bring meaning. I recruited a close friend to go Joy-questing with me in early January, and it has enriched our experience of the last few months immensely. Here’s what we have done.

I. Notice the joy that’s already there. My 6-year-old son takes great pride in making my coffee every morning. He is proud of being allowed to work the Keurig machine on his own. He picks out a k-cup, carefully avoiding the cinnamon-flavored ones, and then even gets out the heavy whipping cream and pours – usually too much of it – into the mug. As soon as he hears me wake up, he runs down to make the coffee and bring it up to me. One morning, I realized that I had just grown to accept this coffee-making routine. I typically thank him, get out of bed, and begin running through all the lists in my head of things I have to do. I realized I had been missing the opportunity to notice how joyful it is that my littlest child makes my coffee every morning. It clearly brings him joy and delight, and when I stopped to notice it, it brought me joy, setting my day off on the right track.

Rather than wandering around in problem-solving mode all day, thinking mainly of what you want to fix about yourself or your life, you can pause for a few moments throughout the day to marvel at what’s not broken.

Kristin Neff, author of Self Compassion

II. Experience the joy intentionally. Beyond just noticing the moments of joy, consider how you could savor them, make them last, and draw them out throughout your day. Collect them up like pearls on a necklace that you create. Consider what the experience of joy feels like in the moment. To me it feels like a lightness, a freedom, a fullness, as if nothing else could be added to make the moment more perfect. It feels like warmth, stillness, contentment, hope, meaning, like there is a radiance about the moment. Notice, experience, and describe the sensation to yourself. By being more mindful of the moments of joy, you amplify the experience of them. Just as by dwelling and burrowing deep into anxiety or worry, you amplify the experience of those emotions. The 17th century French philosopher, Montaigne, said: “My life has been filled with terrible misfortune, most of which never happened.” Instead of filling our mental bandwidth with the worries and anxiety about misfortunes that will likely never happen or that, if they do happen, we can cope with, what if we could say: “My life has been filled with moments of joy, most of which I could easily have missed.”

III. Create more joy. There is lots of joy to be had that is already out there in our lives. But what if you could intentionally manage your thoughts to create more joy. Today I had to work on a “difficult” project. It was a PowerPoint presentation on a topic I wasn’t very excited about, so I felt apathetic. I had to create slides about a topic I didn’t know much about, so I felt self-doubt that I wouldn’t be able to do a good job. The slides were also supposed to have been done by someone else, but I ended up having to make them, so I felt frustration and resentment. All those feelings led me to want to procrastinate and seek out “easier” work or mindless entertainment instead. I paused to reflect.

Rather than follow that path down procrastination lane to the road of regret, I asked how I could create joy in the task. At first, my mind rebelled: There is, most certainly, no joy to be had in this project, it said. So, I asked why I was even doing it in the first place. I connected the project to my bigger mission, values, and identity, and realized I wanted to do a good job with it, because it is important to me to be a person of discipline who creates high-quality work. I also decided I could create joy in learning about the aspects that would be new to me, rather than wasting time feeling intimidated by them. I asked how I might use my creativity as much as possible in the project to make it more fun. How could I gamify it for myself by setting mini-goals and knocking them out every 10-15 minutes, rather than waiting until the final project was done to cross it off my list. Using an intentional mental model, I was able to tackle the PowerPoint design head-on, take pride in my work, and even find moments of fulfillment and (gasp!) joy.

In the longer term, as you start to become aware of where you are able to create and notice joy more, consider how you could do more of the things that bring you joy and meaning, and less of the things that don’t. Consider what things bring short-term, immediate joy, and what things create meaning for your life over the course of months or years. If you have the flexibility, try to add more of the things that bring meaning, and prune away the things that don’t, creating a schedule in line with your values.

Worry never robs tomorrow of its sorrow, it only saps today of its joy.

Leo Buscaglia

Wait! I thought this was a blog about productivity and time management. Yes, it is, and when you are thinking thoughts that create positive emotions, you work better, avoid procrastination, and can improve your productivity. Even the Harvard Business Review agrees that reflection can enhance productivity, and you should do more of it even if you hate doing it.

I encourage you to join me on the Joy Quest. Take a moment before you mentally rush off to your next task or to-do list item, and notice something that has brought you joy today. Finally, share it! My friend and I regularly text each other to ask where the other has found joy that day. You can multiply joy by sharing it with someone else.

Friendship improves happiness and abates misery, by the doubling of our joy and the dividing of our grief.


Time management strategies with a new baby

Each of the four times I brought home a new baby I found myself wondering: What did I used to do with all my free time!? As I adjusted to the new baseline of sleepless nights and a constant awareness of “who’s watching the baby?” I wondered at how it was always possible to insert a whole new human into our already busy lives. Before the new baby we’d felt that we were maxed out with work, other young children, school, or residency training. Yet we managed to squeeze a newborn in. And then another, and then another, and then another.

When a new baby comes, everything changes. With the new time pressures, you have to hold everything you do up to scrutiny and figure out what can stay in your life and what has to go. With a new baby you also have an incredible opportunity to see the joy and meaning in each moment. Here are three lenses that have helped me think about my time in any phase or stage of life.

This is the key to time management – to see the value of every moment.

Menachem Schneerson

Time Management Strategy #1: Have a Strategy!

Having a newborn often means anything that is not absolutely necessary has to be set aside. Imagine you’re a general considering how to deploy your troops. Here, our troops are our time and effort. When the pressure is on and you have limited resources, that’s when you must be the most strategic with your choices. Ask yourself: What are the high-value activities and tasks I must do to take care of my family and myself? Next, think about what things can only be done by you, and what things you can outsource or delegate. If you’re a nursing mom, only you can nurse or pump, but any number of stores can deliver your groceries. So strategically create time to nurse but ditch the trips to the grocery store if you can get delivery.

Being strategic means cutting the slack, the waste, and the inefficient times from your schedule to make time for the new important things. If you used to take leisurely trips to the gym, you may have to replace them with quicker, more efficient workouts. For me, with each kid, I had to take a look at my free time and see where I was wasting it. I had already cut out TV years before, but I realized I was wasting more time than I needed to on social media. So I became more intentional about creating time to be present with my kids and power down the phone.

Think strategically about your own renewal, too. What things do you need in order to keep your sanity? Is it time alone? Time at the gym? Or time with friends? Create that time strategically. This may mean negotiating with your spouse or finding a babysitter. Spending time renewing your own mind is critical. Also, be aware that while binge-watching Netflix, scrolling social media, and vegging out on the couch may be relaxing, they are not always renewing for our minds. Focus on renewal, not just relaxation. For me, renewal meant time for reading. The late-night nursing time was a special time when I would dive into and lose myself in a great book. I was still tired in the morning, but felt more refreshed than if I had just stared at the ceiling wishing I were sleeping.

Time is beyond our control, and the clock keeps ticking regardless of how we lead our lives. Priority management is the answer to maximizing the time we have.

John C. Maxwell

Time Management Strategy #2: Prioritize

Once you decide what things you must do, the next step is to prioritize them. Remember Tetris? You had to fit different shapes together to optimally fill space. That’s what your time management is like now. Look at your day. What tasks do you have to get done for yourself, your work, or your family?

What shape are those tasks? By that I mean: how long will they take and what type of focus will they need? Some tasks require only a shallow focus. They can be done while also watching the kids or doing other things. Certain tasks need a deep focus and a quiet space.

Make a list of the things you want to do, then number the top three to five things in order of importance. Next, think about how you can fit them into your day, matching the tasks that need a deep focus with the times when you are able to focus. During nap time, can you do the work that requires a deep focus? Can you swap off baby duties with your partner and close the door for your deep work? Can you get shallow work done quickly by shooting off emails or ordering groceries while nursing, pumping, or rocking the baby?

The new-parent-Tetris game has the added complication that the pieces keep changing shape, moving around, or refusing to stay put. They may have new needs that pop up unexpectedly! So be prepared to be flexible and to change your plans. When plans or needs change, remember: you are the general deploying your troops. Reassess your plan and move the pieces around in real-time by re-applying the concepts of strategy and priority.

For me, when I get to the office or my work space, I make a list of the things I want to get done and then number them in order of importance. I intersperse 1-2 hour blocks of ‘deep work’ with 20-30 minute blocks of ‘shallow work.’ This lets me make sure I get the most important things done.  It also ensures don’t fritter all my time away on email or other shallow tasks.

To a child, “love” is spelled, “t-i-m-e.”

Zig Ziglar

Time Management Strategy 3: Focus on Efficiency

Efficiency is key when you have a new stressor on your time and more than you can do in a day. However, the question of efficiency always has to come after strategy. First, make sure you’re doing the right things, then work on making sure you’re doing them efficiently. Efficiency will allow you to create the margin you need to be present when you are with your new baby.

To be efficient, you have to plan ahead and be intentional with your time. You also have to be honest with yourself. Look back on the last few days. Where was there time that was wasted? Where could you use your time better? When you were trying to do a task that required a deep focus, were you focusing well, or were you also trying to multi-task or scroll on your phone? By focusing well on tasks that require a deep focus, you can get work done more quickly to create more margin later.

When I work, I monitor how well I’m focusing, and I use specific tactics to help focus deeply. When I’m at the office, focused on an intense task, I turn off all my notifications.  I take off my watch, stow my phone, and set an alarm for 5 minutes before the next meeting I have to be at, so that I don’t have to keep track of time. That allows me to work with a deep focus and get things done more quickly and with higher quality.

Ultimately, by managing your time well, you can create more meaning in your life. You can get more done while you’re working and you can create more meaningful time with your family.

Most people feel like their plates are full of things to do. With a new baby, your plate likely just started overflowing, and you now have some difficult choices to make. How can you take certain things off your plate (strategy), move things around on your plate (priority), or grow the size of your plate (efficiency)? You will find that with time, it gets easier, you get better at it, and you learn to fit things in creatively. Using these three concepts will help speed that process along. Eventually, you’ll hit your stride and feel pretty good about your time… just in time for the next baby. Finally, remember: if you aren’t as productive and effective as you were before the baby, that’s ok – time spent with your new baby is worth every second.

There’s only one thing more precious than our time and that’s who we spend it on.

Leo Christopher

A version of this post was first published on the Mindful Return blog. Mindful Return is a program run by Lori Mihalich-Levin, JD, that helps new parents plan “a peaceful, empowered, and radiant return from parental leave.” Lori and I delivered a free webinar on Taking Control of Your Time as a New Parent. We share big ideas, practical strategies, and what worked for us. You can access the recording by registering through the link.

How to do things when you just don’t want to

What is it for you – the big, daunting projects, or the boring, mundane tasks? Those are the two most common things that professionals I work with procrastinate on. Sometimes it’s because they can’t muster the motivation, other times, it’s because of the fear of failure, or an avoidance of the emotions the task will inspire. In this post, I’ll present some strategies to get going when you don’t feel motivated. To conquer the tasks we hate, the work that bores us, or the project that intimidates us, we must first conquer ourselves.

Man conquers the world by conquering himself.

Zeno of Citium

First, consider what things in your day you struggle to find motivation to start?

Why do you think it is those specific things? Is it that you don’t see a purpose to them? Or are there other more pressing things you think you need to do? Is it because you know when you start working on them that you will feel boredom, frustration, insecurity, or other negative emotions?

Whatever the reason you have avoided a task, first you need to ask if it needs to be done at all. If it does, then ask if now is the right time to do it. Once you have decided now is the time to get it done, here are some practical ways to help you do it.

  1. Tie it into your big vision. Why is this task important to you? If it something mundane, like signing charts for physicians, can you tie it into your big vision or mission of helping patients or being a good doctor? If it is a necessary but annoying part of your job, can you tie it into your big goals of having a job and providing for your family? If it is a project at work that you aren’t excited about, can you tie it into your big goals of being promoted or of gaining more responsibility, autonomy, or trust at work.
    • Write down the things that are important to you, your big mission, values, or vision. Put them up somewhere visible. Some of mine are: To be a good doctor, to relieve suffering, to be a good mentor, to be someone people can count on, to work with creativity and autonomy.
    • With each task you find yourself avoiding, see how it could tie into one of the things on your list.
  2. Break it into laughably tiny steps. One of the most powerful ways to get over the activation barrier of starting something that you don’t feel motivated to do is to break it into minuscule steps, then find the motivation just for one small step. At each point, ask “what is the immediate next step.” Write them out. By breaking it down and only trying to do one small step at a time, you can often find the motivation you need, and then build up momentum so that before long, you’ve been working on it for an hour and accomplished a dozen tiny steps. The less I’m feeling motivated, the smaller I make the steps. If I make them laughably small, sometimes the humor stuns me out of my negative thought spiral: pull covers off face, turn off alarm, put one foot on the floor, etc. The simplicity and humorous smallness of the tasks makes them seem easier in the moment. For example, to work on a paper or report, the steps might be:
    • Turn on computer.
    • Open the relevant file.
    • Skim existing document.
    • Write one paragraph in the results section.
    • Open excel.
    • Find the data I need.
    • Create one graph.
    • Paste graph into report.
    • Etc…
  3. Leverage your identity. What features of your personality are most important to you? What characteristics do you want to work to create? Do you pride yourself on being, or do you want to become, a person who is dependable, conscientious, disciplined, productive? Leverage the strength of the identity you have or that you are creating to replace motivation. This can look like telling yourself: I don’t feel like doing this, but I’m going to do it because I’m a person of discipline. I’m a person who does what they say. I’m a reliable team member. I’m someone people can count on. I’m someone who follows through on their plans.
  4. Find joy. Often we try to motivate ourselves through fear, hatred, or guilt. We think if we hate our bodies enough, that we’ll be more motivated to eat healthfully. Instead, we end up in a shame cycle. When we feel badly about ourselves, instead of motivating us, it more often drives us to the very thing we’re trying to avoid: ice cream, junk food, and sedentariness. Then we feel worse and try to muster up more hatred for ourselves. Thus, the spiral continues. We do the same things with work sometimes. We try to make ourselves feel guilty so that we will do the work. Instead, when we feel bad, we then find ourselves mindlessly scrolling social media sites or retreating to easier, more immediate work, like emails. Observe your thoughts and see where you may be using negative feelings to try to motivate yourself. Instead, look for the positive things.
    • Write down the ways that you have used negative motivation and consider whether it has worked for you or what the outcome of those negative motivators has been.
    • Write down some small ways you can find joy either in the process of the task you need to do, in the feelings of accomplishment when you are done, or in becoming the person you want to be.

Where can you find joy in what you need to do? I may not love going to the gym, but I know I will be happy with myself afterward. I’ll feel proud of myself for following through with what I said I would do. Sometimes there’s even lots of joy to be found in the task. Learning anything is painful but also inherently joyful, whether it is a new program, a new Zumba routine, or a new excel function. Creating the new identity for ourselves as a person of discipline, reliability, and productivity can also be joyful. Conquering ourselves, as Zeno said, while certainly hard work and painful at times, can also be joyful.

5. Radically self-forgive when you mess up…. This one will come in an upcoming post. Stay tuned!

“The successful person has the habit of doing the things failures don’t like to do. They don’t like doing them either necessarily. But their disliking is subordinated to the strength of their purpose.”

Albert Gray, The Common Denominator of Success