Resilience for Physicians. Taking care of the BASICS

Transcription

1 Resilience for Physicians Taking care of the BASICS

2 Human Function Curve

3 Allostatic load Is the burden borne by a brain and body adapting to challenges, both physiological and psychological. Occurs when recovery from acute event is not accompanied by an adequate homeostatic response to terminate the acute response of stress mediators. If elevated, is associated with increased vulnerability to acute stress and Decreased resilience

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5 How Can We Become More Resilient? capable of recoiling from pressure or shock unchanged or undamaged. Funk & Wagnalls

6 consider the BASICS php.oma.org

7 B is for Body

8 Physical Health: Homeostasis Eat when hungry Drink when thirsty Sleep when tired reduce toxins (eg. caffeine, nicotine) use alcohol safely good health care family doctor disability insurance

9 What do doctors dream about?

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11 Healthy Eating Pyramid Dr. Walt Willett, Eat, Drink and Be Healthy American Journal of Clinical Nutrition, Vol. 76, No. 6, , December 2002 Dr. Yoni Freedhof

12 Michael Pollan: In Defense of Food Eat Food, Not Too Much, Mostly Plants

13 A is for Affect

14 Thinking, Feeling and Self Awareness: Awareness and understanding of our attitudes, moods and feelings Identify and confront stress thinking Perfectionism Paradox of perfectionism: trying to be perfect impairs! Cognitive distortions Share with someone else (reality check): friends, family, colleagues, support group Consider more realistic perspectives

15 Common Cognitive Distortions All or nothing thinking Filtering Perfectionists often discount positive Mind reading Perceived harsh judging Catastrophizing Over-responsibility Feel more in control than they are

16 Changing Cognitive Distortions Am I thinking in all or nothing terms? absolute words; always, never Am I confusing a rare occurrence with a probability? Am I assuming the worst possible outcome? Am I blaming myself for something that was beyond my control? (Antony & Swinson, 1998)

17 What would have happened if I had handled the situation differently? What difference will this make in a week, month, year, 10 years? Will anyone judge harshly? Must I judge myself so harshly? (Antony & Swinson, 1998)

18 Confronting Self-Criticism Self Criticism I deserve to be criticized I remember and dwell on my failings I am disappointed with myself I m never good enough Self re-assurance There are positive things about me There have been many successes I ll be able to learn from this experience Sometimes pretty good is good enough

19 Mindfulness Mindfulness is paying attention in a particular way: on purpose, in the present moment and non judgmentally. Jon Kabat-Zinn, 1990

20 Mindfulness Being in the present moment, non-judgmentally: Decreases automatic pilot negative thinking and responding Reduces rumination on the past, catastrophic future thinking, disrupts automatic craving (want) Allows for a different relationship to problems; increases choice/decreases reactivity Decreases negative self-importance Increases personal resilience

21 S is for Social

22 Relationships and personal support system Friends Family Spouse / partner How has your personal support system been affected by medical training and practice?

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24 Harmony at home seems to bolster one s ability to cope with life s total package. Wayne and Mary Sotile The Resilient Physician

25 I is for Intellect

26 and inventory live according to values and goals realistic expectations live within your means! Financial Work capability: learn to say no make appropriate occupational choices Intrinsic factors (interest in work) more important than Extrinsic factors (pay, working conditions)

27 Don t forget to harmonize work with personal pleasures

28 C is for Community

29 In and through community lies the salvation of the world. M. Scott Peck The Different Drum

30 Healthy professional communities: Respect differences mentor trainees and newcomers collaborate rather than control participate in team building participate in medical politics honour each other s families and personal lives reach out to colleagues in distress neighbourhood watch

31 S is for Spirit

32 Spirituality (Am. Acad. Fam. Phys.): Spirituality is the way you find meaning, hope, comfort and inner peace in your life. Many people find spirituality through religion. Some find it through music, art or a connection with nature. Others find it in their values and principles.

33 Spirituality...the amalgam of the positive emotions that bind us to other human beings and to our experience of God as we may understand Her/Him. Love, hope, joy, forgiveness, compassion, gratitude George Vaillant Spiritual Evolution: A Scientific Defense of Faith

34 Spirituality: connection to a power greater than ourselves Sense of awe and wonder Appreciating the sacred Finding meaning in life Question of God Prayer and meditation

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36 Please share your success stories with us Hamilton physician resilience study: Find a wife or husband who understands the demands of being a doc Put the maximum into retirement savings plan every year Take every holiday you can don t save them up Do not spend beyond your means live simply Retire before you have to Exercise every day, eat less, laugh more, screw regularly not bad, eh?

37 Small changes can result in big differences. Wayne and Mary Sotile Do sweat the small stuff!