A Case of the Mondays


Mondays may be the best day to check in with yourself about what is causing the most stress in your life.

A lot of us are most in touch with our negativity (read: feelings of anxiety, dread, obligation, rage, you get the idea) at the beginning of the week. It makes sense. On Monday, the entire week yawns in front of us. And if you’re a busy physician, the week probably includes several-dozen patients scheduled or expected to show up, of varying complexity and temperament, all needing something from YOU. Plus this week you’ve got Halloween cupcakes to make for your kid’s Halloween party. (If you’ve somehow gotten yourself into a homemade cupcake commitment, JUST SAY NO to Pinterest Pressure! And in the future, JUST SAY NO to homemade cupcake commitments altogether. That’s what Wegmans is for, people!!!)

So since it’s Monday, I encourage you to take an inventory. Grab a piece of paper and a pen and GO:

🤔 What is weighing on your mind most heavily?
🙄 What are you burying/avoiding/trying your darndest NOT to think about?
🚫 What do you desperately wish you could change or delete from your life?

Do not spend more than 5 minutes on this. Bulleted lists are encouraged. The first few things that come to mind are probably the most relevant anyway.

Now ask yourself: What is ONE THING I can do to limit, reduce or eliminate each stressor? One idea per stressor — one doable, reasonable, small thing you can do to make your life easier. Be creative. Do not let people-pleasing or perfectionism be what holds you back from taking action. If you need help with this, call me please!

Now GO DO THOSE THINGS. As soon as humanly possible. And watch as your stress goes from a 10 to a 9, or an 8, or a 7. Anything is better than a 10, right?

I’m serious about calling me or e-mailing me if you need help troubleshooting barriers like people-pleasing and perfectionism. These are real and exhausting and will get in the way of any attempt to reduce stress.


Do B- Work

Do B- Work.png

Yes, you read that right! I’m telling you to SLACK OFF 

Your perfectionism has taken you far. It’s gotten you through medical school, propelled you through residency, and helped you find a great job. It’s the force behind the clear, concise, grammatically correct and error-free documentation you enter into your EMR every day — bright, shiny notes with your crisp e-signature at the bottom of which you are very proud.

And now it’s time to thank Perfectionism for its service and say goodbye.

Because there are a ton of undone tasks in your inbasket right now, cluttering up your computer screen and your mind. You’re being asked to accomplish way more in a given day than is possible. The more you dedicate time and energy to small details that don’t matter much to you in the scheme of things, the more burned out you will feel.

Here’s the secret: Burnout is not about working hard. When you work really hard for hours at something and you love the result, or you get into a flow and time is flying by at warp speed, you don’t usually feel burned out. Tired? Sure. In need of a break? You bet. But not burned out. The deadened feeling that comes with burnout goes hand in hand with other negative emotions like powerlessness, emptiness and anger, which in turn stem from doing things over and over that we don’t want to do or don’t see the value in.

It’s easy to get preoccupied with following rules to the letter and not wanting to “get in trouble,” or with wanting to manage other people’s perceptions of you (who doesn’t want to be seen as brilliant, insightful and clinically astute?). You may also be reluctant to cut corners because of beliefs you’re holding onto about what will happen as a result. Example: “I can’t do concurrent documentation because I don’t want to disrupt my relationship with my patients.” Or “I have to write a thorough summary for every patient in case someone else sees the writeup.”

There’s nothing wrong with those beliefs. They’re fine. But they’re locking you into an impossible workflow. You’ll never get everything done if you try to do everything being asked of you in every single instance. Meanwhile, you’ve got dozens of undone tasks, which isn’t good either! So that’s why it’s vital to figure out what B- work looks like as compared to A+ work, and then make a conscious decision to go with B- work at least some of the time.

B- is acceptable. It would not lose you your license. It covers the bases in a cursory way. It’s FINE. But it’s not worthy of being featured in the Model Charting Handbook. It might have a grammar error because you didn’t read it 10x to proofread. It’s shorter than you might like. Someone could definitely go through and tell you a bunch of things you should have added or clicked. But it captures the essence of the service you provided and the boxes necessary to sign off on the note have been checked.

A+ is for special circumstances. The especially complex case, the patient you’re most worried about. The case where you know there’s five other specialists who will be seeing the notes. Go for it. Write the heck out of it.

This idea can be applied to other things in your life besides notes, of course. Going with the Wegmans cake instead of the Pinterest cake. Sending an e-mail instead of a card. Giving a gift card instead of hunting down a thoughtful present.

If you’re a recovering perfectionist, keep these questions in mind:

🤔 What thoughts and feelings come up for you when you try to let something be good enough? — for a lot of people it triggers a defensive backlash of justification/rationalization for needing to do more and work harder, feelings of guilt and unworthiness, etc.

 Where do you want to direct your energy? (It’s a finite resource!) — think, “being kind and empathic with my patients,” or “keeping my composure when getting the kids out the door in the morning.” Pick a couple of goals that align with your values and make these the focus. Shortcut the rest for a week and see what happens.

📝 What’s my version of B-? What does B- look like not only for my notes but for my parenting, my fitness, my marriage? The point here is not to strive for B- all the time in all areas, but in some areas some of the time — so that you’re freed up to do A+ work where it matters the absolute most to you.

If this was helpful and you want more tools for spotting/preventing burnout, be sure to sign up for my free checklist here: http://subscribepage.com/burnoutchecklist

Confidence is Contagious


Turning Point Park, City of Rochester NY, 10/24/17

I met this guy today, and I want to tell you about him.

I was walking in Turning Point Park in the city of Rochester, soaking up what could be our last unseasonably mild and sunny day until spring. I’d been wanting to come to this place for weeks, having seen photos on Instagram of the crystal blue water and the expansive elevated boardwalk, surrounded by vibrant tree-lined dropoffs.

The park was breathtaking. There was a barge plodding through the waterway, ducks diving for fish (I took a short video to show my kids ), a cool breeze rustling the dying leaves.

I got to the end of the boardwalk and kept going. The path becomes wooded. A giant old tree had fallen down in last night’s rainstorm and was blocking the paved road, so I thought nothing of taking the higher unpaved path closer to the water. I walked a few minutes more before turning around.

As I re-approached the boardwalk entrance, I noticed a man on a recumbent bicycle. He was trying to get back down to the main road from the unpaved upper path, but the descent was too steep. Clearly he had been trying to navigate around the tree in the road, and gotten stuck. I noticed he had a prosthetic left leg and a missing left arm.

“Do you need help?” I said.

“Well…do you have a cell phone?” he said.

“Yes, I do.”

“Maybe just hang out for a minute in case I don’t make it down OK.”

I asked if there were another way I could help him, and he said he should be good, he was going to try to get down at a different point. He maneuvered the bicycle to the top of a well-worn rut in the ridge.

“I’d stand back if I were you,” he said.

He lined the bicycle up with the path and pushed off, steering sharply as the bike met the paved road. He made it.

“Phew!” I said.

“As for getting back up, I guess I’ll figure that out later. Thanks for the assist! Have a good day!” he said.

“Best of luck,” I said.

He took off down the boardwalk, sailing alongside the water on his bike. I thought about him all the way back to my car. This guy was determined to enjoy the gorgeous day and the ducks and the sparkling water — no matter what. He seemed so unfazed; trees in the road are his reality. His mindset was positive and attuned for finding solutions. His confidence was startling in its clarity and left me feeling inspired. I’m more equipped to go about my own day because of him.

And I have no doubt that he’ll find a way back 

Let Feelings Run Their Course

Let feelings run their courseThe other morning, my 2-year-old daughter ate about half of her slice of French toast before carefully removing the remaining bite-sized pieces, placing them on the table, and tilting her plate so she could lick off the extra syrup. She then looked at me and said, “More syrup Mommy!”

My first thought: You’ve got to be kidding me, girl!

I told her that I was fine with her licking the plate if she was done, but that I couldn’t really justify giving her a bunch more straight maple syrup to consume. I put a tiny drop more on her plate and said, “That’s it, sweetheart. If you don’t want the rest of your French toast, it’s OK, but no more syrup.

She, of course, still asked for more. And I said no. And she melted down, because she’s 2.

And before I could do anything else, my 4-year-old son (who was crushing his own plate of French toast) got out of his seat, went to her, and held her.

💟  He didn’t ask WHY she was making such a huge deal.

💟  He didn’t demand that she justify why she was crying.

💟  He didn’t tell her that she was being ridiculous.

He just gave her a nice hug. And before long she stopped crying, let me wipe her face and hands, and went to the other room to play.

This warmed my heart on so many levels, but my therapist self could not help but appreciate my son’s willingness to meet his sister right where she was. He let her be sad, offered comfort, and she was able to process the feeling and move on.

Very often, our response to negative emotion (in ourselves and others) is either:

💬  to try to make it disappear too quickly by minimizing it or pushing it away,

💬  to judge it by arguing about whether it’s OK to have the feeling in the first place; wondering whether the feeling is “justified” or not; labeling it somehow (stupid, pointless, irrational)

Emotions are not good or bad, they just are, and they do not always have the underpinning of perfect logic and reason. They operate on another plane a lot of the time, informed by our past experiences, current vulnerabilities (maybe we’re tired, hungry, not feeling well physically), the story we’re telling ourselves about what’s happening (our perspective), etc.

It’s really good to practice allowing yourself or a loved one to have a little while to experience a tough feeling without questioning it or trying to make it go away. Opening up space for negative emotion helps us build our muscle for tolerating and accepting that sadness, disappointment, anxiety, anger and pain are a normal part of life. When you try to make bad feelings disappear too quickly, you’re sending the message (to yourself or your loved one) that those feelings are intolerable or not OK.

When it comes to sitting with loved ones, validating emotions is an important part of relationship building. To your partner or teen, you may say, “I can see that you’re sad,” or, “You seem stressed,” and then wait. Don’t rush into problem-solving mode. Find out whether they want to talk more or be alone. To your young child, you may say, “You’re sad right now. You’re sad that you can’t have what you want, and I get that.” This helps the child a) learn the names of feelings and b) possibly avoid escalating further — because there’s no need to convince you of how she’s feeling or why.

If you’re the one experiencing negative emotion, naming the feeling and then noticing what specific physical sensations and thoughts come up along with that feeling is an important way to build your awareness and tolerance of negative emotion. Sometimes, just giving the feeling some air time allows it to pass more quickly than if you’d shoved it aside 💜

If this was helpful to you, feel free to like my Facebook page so you see future posts! And be sure to get on my e-mail list here>>http://pxlme.me/YVYdNEl4. I send out special content only to my subscribers. As always, reach out to me anytime by e-mail at dobbinlmft@gmail.com.

Habit 7: Sharpen the Saw


The final habit! I’ve been posting this week about THE 7 HABITS OF HIGHLY EFFECTIVE PEOPLE, and today we’re on Habit 7: Sharpen the Saw.

Habit 7 is basically about self-care, so it fits in really well with the work I do with so many of my clients. The main point Covey makes with Habit 7 is you won’t be able to accomplish much of anything in your life if you neglect yourself. It’s important to think about self-renewal across these four areas:

🥑  Physical – eating, exercise, sleep, treating medical issues promptly

💙  Social/emotional – nurturing relationships, building awareness of emotions

📚  Mental – reading, writing, learning, teaching

☮️  Spiritual – expanding spiritual self through meditation, music, art, prayer, or service

You can neglect one or more of these areas, but at your own peril. There’s only so long you can keep up with a busy life if you are falling apart on the inside or your relationships are a mess. There’s a myth in our culture that devoting time to self-care and self-improvement is a luxury, or is selfish, but it’s the exact opposite. 👀 We are more likely to become selfish and inconsiderate and insensitive if we don’t take responsibility for our own health and wellbeing 👀

A lot of people hit times in their lives when they need some help getting rebalanced. Many of my clients need a place where they can JUST BE for awhile, where they can hash out what’s creating stress and then together we can figure out a plan. There’s always another way, but we can often be blind to possible solutions because we are too tired or too burned out, or simply too close to the issue to see our way through. That’s where therapy comes in!

If you’ve enjoyed these posts I’d love to hear what resonated most! Which habit is your favorite? Comment below or send me an e-mail at dobbinlmft@gmail.com. For more good reads, sign up for my (spam-free ) e-mail newsletter here: http://pxlme.me/YVYdNEl4.

Habit 6: Synergize

The Whole is Greater than the Sum of its Parts

There’s a reason why some of the best solutions come from collaboration with others.
Think about it. TV shows and movie scripts are hashed out in a writer’s room. An author writes a book, but the manuscript goes through rounds and rounds of editing and proofreading before the book is published. New products made by Apple, Google, Facebook and Amazon are conceived, imagined, discussed, and problem-solved in teams before the final versions are released.
When we combine forces with others, our creativity truly is boundless. This is Habit 6: Synergize. It builds in particular on Habits 4 and 5 (Think Win-Win and Seek First to Understand; for more on previous habits from THE 7 HABITS OF HIGHLY EFFECTIVE PEOPLE, it’s all on my blog: http://pxlme.me/2gLl6y5A). To get a chance at synergy — the intangible feeling of flow, of magical creation-from-scratch — you need to have an abundant, collaborative attitude, a strong sense of your own voice and values, and a penchant for listening and understanding others.
The main point Covey makes with regard to synergy is the importance of appreciating differences. You won’t get exponential results if you surround yourself with people who think exactly like you, have all the same strengths, have similar personalities and worldviews. It’s certainly easier and more peaceful to seek familiarity. But to get synergy, you have to be willing to wade into what can feel like threatening waters and open yourself up to what others have to offer.
Habit 6 is not just for entrepreneurs. Think about your family. Sometimes when there’s a problem (i.e. no one can agree on what to do on a Saturday afternoon), if you can all sit down and hash out the possibilities and what people are thinking and feeling, a new option emerges — one that everyone can get excited about. But in order to do this, you have to MAKE SPACE for everyone’s perspective. You have to set aside your own rigid ideas about what needs to happen and how so that you can consider your partner’s ideas and feelings, and your children’s. It’s work! But it is amazing how this process can pull a brand new idea seemingly out of nowhere, and then the energy behind it is aligned, setting you up for a great day.
Covey says that you know you’re in synergy when you:
💜  Have a change of heart
💥  Feel new energy and excitement
🤔  See things in a new way
👩‍❤️‍👩 F eel that the relationship has transformed
🎇  End up with an idea or a result that is better than what either of you started with (a new alternative)
I realized in reading the chapter on Habit 6 that this is part of why I am so passionate about group workshops and group therapy. When you throw a bunch of people together, what gets created is so much bigger and more powerful than what each brings to the mix on their own. It’s almost beyond words, what I experience in group therapy settings. It feels like magic. It’s so poignant, so powerful, so compelling that it draws me in, makes me lose track of time, restores my faith in humans and our capacity to care for and learn from each other.
Tomorrow will be the last in my series on the 7 HABITS! In the meantime, if you want to get in touch, shoot me an e-mail at dobbinlmft@gmail.com.