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.

Kipling

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.”

Epictetus

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.

Seneca

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.

Seneca

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.

Cicero

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

New Year’s Revelations

It happens every year on January 1st. We join the ranks of the New Year’s Resolutioners who sign up at a gym, vow to stop eating sweets, promise to pay our bills on time, and cross our hearts that we’ll never procrastinate again. Then by February 20th, the gyms are back to their usual patronage, our freezers are full of Ben and Jerry’s, late notices start arriving, and we find ourselves staying up late the night before an assignment is due.

New Year’s Resolutions are frequently doomed to fail because nothing changes when the calendar rolls from one year to the next. For our external actions to change, something must first change about ourselves. Too often we try to change from the outside in: we try to change our actions and hope that will change who we are. Instead, we need to focus on changing who we are, and our actions will naturally follow.

“First say to yourself what you would be; and then do what you have to do.”

– Epictetus

This year why not try something new. Rather than thinking about what actions you want to change, think, instead, about what you want to accomplish and who you will need to be to accomplish it. For example, rather than planning to give up ice cream, if your goal is to be healthier, consider how you can become a person who doesn’t need sugary treats to feel happy. Rather than planning to exercise five times a week, if your goal is to be fit, consider how you can become a person who loves to be active more than they love to do what is easy. Instead of promising to work hard and not surf social media, if your goal is more to be more productive, think about how you can be a person of discipline who can do what needs to be done even when it’s boring. You get the idea.

Once you have decided who you want to be, the next question is how you can become it.
Welcome to your 2021 quest, should you choose to accept it!

Let’s take one example of what this might look like. Since losing weight is the most common resolution made each year, we’ll consider that. If the usual heartfelt but short-lived resolutions worked, then we wouldn’t find ourselves making the same resolution year after year. If you want to change how you eat or exercise, then you need to do more than just decide to do it. You need to become a person who does it. To become that person you have to look more deeply at why you are engaging in an unhealthy behavior or avoiding a healthy one. There are several big reasons that come into play:

1. Avoidance of negative emotions. We avoid tasks or activities that elicit negative emotions such as boredom, frustration, self-doubt, or inadequacy. Instead, we seek out activities that give us quick hits of dopamine: getting likes on a facebook post, scrolling through twitter, or mindlessly eating sugary foods. To overcome the problem of negative emotions, first, look at the desired activity: going to the gym or avoiding sugar. What emotions does that elicit for you? The emotions are caused by your own thoughts. Identify the thoughts as specifically as possible that are causing the negative emotions. Second, create cognitive distance or space between yourself and your thoughts. With more space, you can better become aware and then manage your thoughts. This is a process known as Stoic mindfulness.  

“If you are distressed by anything external, the pain is not due to the thing itself, but to your estimate of it; and this you have the power to revoke at any moment.”

– Marcus Aurelius

As Aurelius wrote, the negative emotions of feeling self-pity or deprivation, frustration, fear that you will fail, and all the other distressing feelings are a result of our own thoughts or estimations. That is great news, because we can change our thoughts. Once you become aware of maladaptive thought patterns, consider what emotions you would want to feel as you approach the difficult task at hand. For example, I like to feel determination, confidence, optimism, hope, or excitement. Then figure out what thoughts you would need to think to create those emotions. Write those thoughts down and keep them handy. Come back to them frequently and pick them up like tools or weapons that you can use when you need to vanquish the foes of complacency, fear of failure, resignation, pessimism, or self-pity. Some thoughts that may be effective for creating more productive emotions are things like:

  • “I can do difficult things”
  • “I can create change in my life.”
  • “I can work hard.”
  • “Hard work pays off.”
  • “I don’t have to be perfect, I just have to do the next right thing.”
  • “I can make the time I need for the things that are most important.”
  • “Isn’t it great that I get to choose how I spend my time!”
  • “I’m going to feel really proud of myself for doing this later.”

There is much more to say on this topic, and many more strategies you can use to assess and manage your thoughts. If you are interested in a much deeper dive, see the Robertson article on Stoic Philosophy, and particularly the middle section on “What did the Stoics do?” for 17 practical cognitive strategies to change how you think.

2. Habits. We tend to do things we’ve always done in the ways we’ve always done them. Change is difficult. To create new habits, consider the habit loop of cue, craving, response, and reward. Find the cues that trigger the negative behavior. Remove the cues as much as possible. Then consider how you can create new cues for the desired behavior. Maybe that’s putting your gym clothes out each night or setting calendar reminders for when you will exercise. Pre-plan your meals so that you pre-decide what you will eat rather than dropping back into the habit of staring into the fridge mindlessly.

If there are cues that you can’t change, then plan ahead what your response will be when you encounter them. For example, the donuts in the break room may be a usual cue for you to scarf a donut before you even register that you are doing it. Instead, have a plan for how you will create a new response to that old cue of seeing the Krispy Kreme box. The new response may be to get a coffee or water, stretch, talk with a friend, do 30 seconds of mindful breathing, remind yourself of your long-term goals, ask yourself what your body really needs, ask Siri to tell you a joke (most of them are so bad you will find yourself distracted from the donuts and pondering just how bad the jokes are).

Finally, create your own rewards. Instead of rewarding yourself with sugar or mindless entertainment, create mental positive reinforcements that reward the behavior and the thought patterns that you want. This may mean congratulating yourself, noticing you did something well, or metaphorically patting yourself on the back. People who use more positive self-talk tend to be more adaptive learners and create positive changes when they do fail, rather than wallow in self-pity and resignation. For much more on habits, see my last post all about habits and willpower, or this podcast episode.

3. Social norms. It’s so common that it’s cliché: we tell ourselves we shouldn’t eat the cookies in the very moment our hand lifts them to our mouths. As a society, we expect things to be easy, we dislike the idea of requiring discipline, we tend to give up or avoid activities when we feel negative emotions about them. Successfully accomplishing your quest to become the person you want to be this year will be easier if you surround yourself with like-minded individuals who will encourage you, rather than sabotage your efforts. Find those people. Spend (socially distanced, 6-feet-apart) time with them. Share your thoughts, failures, and successes. Keep each other accountable. In their book Influencer: The Power to change anything, the authors discuss the idea of 200% accountability. This means you are 100% responsible for yourself and 100% responsible for someone else. Find someone who is willing to help your personal change management quest, and stay 200% responsible for each other.

“The key is to keep company only with people who uplift you, whose presence calls forth your best.”

– Epictetus

Enjoy the quest to change one characteristic of yourself this year. Be ready for frequent failures and stumbles. Prepare for it to be harder than you think. Most importantly, approach it with a sense of humor. As Epictetus wrote:

“He who laughs at himself never runs out of things to laugh at.”

– Epictetus

Resources and References:

  1. Grenny J, Patterson K, Maxfield D, McMillan R, Switzler A. Influencer: The Power to Change Anything. McGraw-Hill Education; 2013.
  2. Dweck CS. Mindset : The New Psychology of Success. Random House; 2006.
  3. Clear J. Atomic Habits : Tiny Changes, Remarkable Results : An Easy & Proven Way to Build Good Habits & Break Bad Ones. Random House; 2018.
  4. Robertson D, Codd T. Stoic Philosophy as a Cognitive-Behavioral Therapy. Behav Ther. 2019;42(2). https://medium.com/stoicism-philosophy-as-a-way-of-life/stoic-philosophy-as-a-cognitive-behavioral-therapy-597fbeba786a
  5. Orman, R and Cheney R, Stimulus Podcast, The Art of Breathing
  6. Orman, R and Shenvi, C, Stimulus Podcast, Understanding Willpower and Habits

The magic of willpower and habits

Do you ever feel so exhausted after making difficult choices or doing unpleasant tasks all day that all you can do is sit on the couch and ‘veg out’? That is a state called ego-depletion. Willpower, it turns out, is a limited commodity. When you resist temptations repeatedly, you use up your willpower. In the state of ego-depletion, two things happen: You have less willpower to bring to bear on the next difficult decision, and you feel temptations more strongly. The cookies that you had been resisting all day are now unbearably tempting.

The best way to conserve your willpower is to not put yourself in situations where it is excessively or needlessly depleted so that you can save it for the important things. Another willpower hack is to create new habits. Going to the gym when you haven’t gone in a long time (ahem.. pandemic) is hard. But once you are used to going every day, it’s easy. It becomes a habit. The same is true of how you manage your time. If you create a habit of procrastination, then it will be your default state. If you create a habit of sitting down and making a prioritized list of what you need to do and then planning when you will do it, then it will take less willpower to get the important things done.

“We are what we repeatedly do. Excellence is not an act, but a habit.” – Aristotle

Habits occur because of a cycle of: cue, craving, response, and reward. Think about the habit of checking your phone. You probably realize that it breaks your concentration when you’re working on a difficult task. Nonetheless, when you hear the notification go off, you likely start to feel a craving to pick it up and see what it is. When you do, then you have a reward. Checking the notification relieves your sense of unease or curiosity. By repeating this cycle of cue, craving, response, and reward, you make the action automatic and harder to break. Every time you hear the cue (notification) you will have a stronger craving to complete the cycle and check it. However, by understanding the habit cycle you can also learn how to create new habits and break old ones.

For a detailed discussion of how to make or break habits, check out this podcast on the topic with Dr. Rob Orman on the Stimulus Podcast. You can listen in your car, when you’re exercising, or as you’re doing chores around the house. It’s available online, on iTunes, or on any podcasting app. We discuss practical, evidence-based ways to minimize the willpower you waste and to break or make new habits.

“Every habit and capability is confirmed and grows in its corresponding actions, walking by walking, and running by running . . . therefore, if you want to do something make a habit of it, if you don’t want to do that, don’t, but make a habit of something else instead. The same principle is at work in our state of mind. When you get angry, you’ve not only experienced that evil, but you’ve also reinforced a bad habit, adding fuel to the fire.” – Epictetus

“I’ll feel more like doing this later” and other lies we tell ourselves

Procrastination means postponing things when we expect to be worse off for it. We know it would be better if we just started the report, studied for the test, sent the email, did the homework, or made the difficult phone call now. But we put them off in large part to avoid the negative emotions we’ll experience when we do them.

Here’s the funny thing. We know we should do the work when we had planned. We have to trick ourselves into thinking it would be better to do it later. So we tell ourselves lies:

I’ll feel more like doing this later.
I’ll be more excited about doing this if I watch another episode first.
I shouldn’t even have to do this in the first place, so I certainly shouldn’t have to do it now.
Doing this now will ruin my day, I should just do it later.
Other people put things off, why shouldn’t I?
Let’s just not think about this right now.

Sound familiar?

Planning vs procrastinating

There’s an important distinction between planning and procrastinating, just as there’s a distinction between being lazy and running on empty. It’s important to figure out which one you’re doing. You can certainly plan to do something later. Planning out when you will do different tasks to get projects done on time is key to managing your time well. It becomes procrastination when you put something off in a way that you know will make your life more difficult, painful, or worse later. Procrastinating could make your life worse because now you’ll be late on a deliverable, because you’ll have to give up other things you had planned to do, or because you’ll have to sacrifice sleep or other things you like.

How can you tell if you’re procrastinating?

Listen for the little voice that’s lying to you. If you’re planning then you’ll feel in control as you map out your tasks, your time, and how you plan to delegate your energy. If you’re procrastinating, you’ll hear a voice that isn’t your better judgment suggesting all sorts of reasons you should do the undesired task later. The voice will have all sorts of clever and creative ways to convince you to leave the job for another day. It’s originating from your own mind, after all, so it knows all your tricks, weaknesses, and temptations.

What to do if you find yourself procrastinating?

You don’t have to procrastinate. It’s a choice that becomes a habit. Here are three strategies to start to break out of the habit.

  1. Recall why you were going to do the task today. This was your allocated time for a reason, recall that reason. What will be worse about your life if you put this off?
  2. Refocus on who you want to be. Instead of trying to beat yourself up into doing something, remind yourself of who you want to be. Habits are built from the inside out. First decide what kind of person you want to be, then choose the actions that create that identity. For example, instead of forcing yourself to do the task, instead, recall that one of the characteristics that you value about yourself is that you are a person of discipline, a person of focus, a person who gets things done, or a person who does what they say they will. Then take the action that a person with your desired trait would do.
  3. Do the immediate next step. To get over the huge activation barrier, break it down into a manageable next step. That could be: turn on your computer, open the file, write three sentences of outline, open the book and read two sentences, do one practice test question, make one phone call, write two sentences of an email. Make it a laughably small immediate next step, one that you can’t possibly talk yourself out of. Once you’ve done it, pick another immediate next step. After time, you’ll gain momentum and find that you’re most of the way through the previously impossible task.

Amateurs wait for inspiration. The rest of us just get up and go to work. – Stephen King, On Writing: A memoir of the craft