How To Feel Better

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As physicians, we’re typically pretty good at assessing how others feel, both physically and emotionally. Unfortunately, we’re often less adept at identifying how we personally feel, especially emotionally. When we’re in doctor mode (which is pretty much all the time), what I call “Doctor Brain” kicks in. We’re constantly on high-alert, looking out for danger. We’re so focused on everyone around us, stopping to check on our own emotional health isn’t natural. Thus, stress and unhappiness become our normal.

Welcome to my brand new podcast, Stress-Less Physician. I’m your host, Dr. Sara Dill. I’m a board-certified dermatologist, pediatric dermatologist, and life coach for doctors. As a dermatologist, I was happy with my success but miserable overally. I couldn’t shake that overworked, non-stop stress that plagued me. I couldn’t obtain the elusive “work-life balance” others talked about.

So I set out to find the solution, and I did. In my coaching practice and through this podcast, I share with other physicians what I’ve learned and how to change their outlook like I did. I learned that stress is a symptom and thoughts are the root cause. And I’m here to help others learn what I have. Let’s start with how to feel better.

What You’ll Learn 

• Recognize emotions

  • Four basic emotions

  • Note bodily sensations

  • Don’t just work harder

  • Pinpoint your emotional flavor

• Reinforcement of emotions

  • How long emotions last (at first onset)

  • Perpetuating the cascade

  • Meaning makers can direct their feelings

• How to feel better

  • Reframe where your emotions originate

  • Find the cause

  • Know and name your feelings

  • Describe your physical response

  • Believe new things

  • Embrace emotional adulthood

• Happiness blocks

  • Frequency of emotions

  • Negativity bias

  • Doctor brain

• Feeling better practices: How to…

  • Set daily intention

  • Ask upward spiral questions

  • Conscientiously cultivate gratitude

Contact Info and Recommended Resources

Connect with Sara Dill, MD, The Doctor’s Coach

• Website: saradill.com
• Work with me: saradill.com/coaching
• Email: [email protected]
• Get a FREE consultation with Sara! Sign up here: saradill.com/schedule
• Facebook
• Instagram

A bit about me…

I’m Sara Dill, MD, board-certified dermatologist and pediatric dermatologist. I went through life getting straight As, following the rules, and getting into the right schools (Harvard, UC San Diego, Brown). I believed the way to be a good and successful doctor was to work hard, always say yes, and put patients (and everyone else) first.

But while I was successful, I felt perpetually stressed out, overworked and unhappy. I was always looking for that perfect work-life balance, which never appeared. So I became determined to solve this problem. I had worked too long and hard to simply accept being overworked and stressed out for my whole medical career!

I took a sabbatical from practice and studied life coaching. I completed two life coach training programs, numerous other courses, read 100s of books, and used coaching to transform my own relationship to work.

What I learned was that stress is a symptom. It all has less to do with the actual hours you work than with your thoughts about your work.

With this knowledge, I took control of my life and stopped being just one more overworked and stressed out doctor. So can you! But you don't have to take years and read hundreds of books to figure it out. I did it so you don't have to. And I’m here to help. Using a combination of coaching tools and mindfulness, I coached myself back into a thriving dermatology practice I truly enjoy. With the rest of my time, I coach other physicians on how to stress-less and enjoy their work and life more.

Transcript

I’m Dr. Sara Dill, and this is the Stress-Less Physician Podcast, episode number one. Welcome to the Stress-Less Physician podcast. I’m your host, Dr. Sara Dill, MD. Using my unique combination of coaching and mindfulness tools, I will teach you practical ways to reduce your stress level, feel happier at work, and create a better balance between your medical career and personal life. If you are a busy practicing physician who wants to design a life and medical career that feel good to you, you are in the right place.

Hey, everyone, welcome to the podcast. I am so excited to be talking about the subject of how to feel better. I thought I would make this the number one episode for this podcast because I think this is why people turn to coaching, why we all or some of us read self-help books or self-improvement books, and maybe why you’re tuning in today.

So, I just wanted to start by talking a little bit about feelings. I’m definitely going to do a podcast episode on this later. But if you’re like me, I actually spent a lot of time, probably most of my life, until I got interested in coaching, to try to figure out how to feel better. I spent most of my life trying not to feel whatever I was feeling. Unfortunately, the first step to feeling better is to start by trying to recognize how you feel now.

So, when I first started my first coach training program, it was with Martha Beck, maybe back in 2013. I spent the first few weeks just checking in with how do I feel? How do I feel now? How do I know? I actually put a little reminder, one of those pop-up things on my cell phone at the time, and it just said “how do you feel?” And I would check in and sort of try to figure it out. And it sounds sort of silly, but I honestly often had no idea. And I certainly wasn’t very used to checking in with how my body felt or what kind of emotional state I was in, I sort of considered my body just the way I moved my brain around to get to the hospital and do stuff. Otherwise, it was really just supposed to be silent and performed when I needed it to perform.

So if this sounds at all familiar and you are someone who isn’t very savvy about identifying emotions, you can often just start by asking: Do I feel sad? Do I feel mad or angry? Do I feel glad? Or do I feel afraid? Those are sort of four basic emotions: sad, mad, glad, afraid. And just start practicing checking in how do I feel? So you start by identifying them naming the emotion, maybe noticing some bodily sensations, right? When you feel glad, how do you know versus when you’re afraid? What are some of the sensations that might clue you into that?

The second practice is actually feeling your feelings and allowing them. That’s what I’m going to talk about in another podcast episode. But most of us, I think, in medicine, often try not to feel our emotions. And instead, we just try to put our head down, excel and work hard. So I’m just going to ask you to check in right now. How do you feel right now? Feelings are just a one-word answer. So again, sad, mad, glad, afraid. There are actually a ton of different emotions, though. And sometimes it can be helpful to look at a chart that lists them all. It can sometimes help you identify them. So maybe you’re like, “I don’t know, I’m just stressed.” A lot of us when we say we’re stressed, it can refer to a lot of different kinds of emotions. It might be anxious, it might be exhausted, it might be worried, it might be afraid, cranky, irritated, frustrated, worn out. It could be lots of different ones.

So you might just want to check in, if you’re someone who just says I’m just stressed out, what kind of stress? How might you describe that? Is there a flavor to that that you could better identify? The better you can identify how you feel now, the more authority you have over that and the easier it will be to start to work with your feelings and start feeling better. So, what causes our feelings? I’m going to define feelings and emotions as basically the same thing. I’m going to use those terms interchangeably.

The way I like to think about feelings or emotions as a reason originated from our thinking, whether we have conscious thoughts or subconscious thoughts, so emotions are feeling started in our head as a thought that then causes a variety of sensations in the body via a neurochemical pathway or neurochemical cascade. The lifespan of an emotion is about 90 seconds, unless we keep reinforcing it with additional thoughts. This, to me is great news. Because generally, for a lot of us, we don’t like feeling negative emotions. But if we know that it’s not going to last that long, it can make them a little bit less scary. The difference between feelings or emotions and sensations, like cold or hunger, pain or discomfort, is that sensations start in the body, and then travel to the brain, where they might generate some thoughts and then you might have some different emotional responses about it. You could be cold, and then you could have the feeling of dislike or maybe anxiety; sometimes hunger brings up anxiety in some of us. So again, feelings start in the brain and travel to the body.

Why are feelings important? Feelings are incredibly important because everything we do, we do because of how we want to feel, or how we don’t want to feel. So, I want you to think about this. Think of a goal, whether it was going to medical school, whether it is achieving some sort of health or physical goal. Why do you want it? The answer in the end is typically because of how you are going to feel. So maybe we have a goal of helping a patient. And the reason we want to help the patient is we want them to feel better. And then we feel better, right? Maybe we feel proud of ourselves, or we feel like we are a good person, or we’re doing a good job. But really, this idea of everything we do we do for feeling is really the main reason why we need to start tuning into our feelings and being able to identify them.

And I think all of us understand this and that most of us just want to feel better, we want to feel happy, maybe we want to feel contented, we want to feel fulfilled, we want to feel loved. These are pretty universal feeling states that most of us would describe as desirable. So human beings are storytellers, we are meaning makers. This means we have the ability to control or shape the narrative or story in our head. And this can affect how we think. And if our thoughts are what create our emotions or our feelings. This means we can really shape or control how we feel. I love to think about this. In each and every moment, we have a lot more ability to affect how we think and feel. And we can do this by choosing whether to believe or disbelieve the thoughts in our head.

So I’m not going to suggest that we can control the thoughts that pop up in our head. Our mind generates thoughts like the mouth generates saliva. Our mind generates thousands of thoughts a day. Our choice point comes in with, one, when we identify, “Oh, that’s a thought” and two, whether we choose to believe it or disbelieve it. I love this, quote, “How you feel is not based on the facts of your life, but is based on how you think about the facts of your life.” I’m going to repeat that: “How you feel is not based on the facts of your life, but is based on how you think about the facts of your life.”

That is so empowering to me, one of the most important things I have learned in reading hundreds of books and going through two life coach training programs and all of my personal journey, is that just because I think something doesn’t make it true. That one idea has completely revolutionized my life. And so especially if you start thinking about how your feelings are determined by your thoughts, that alone can really change everything for you.

So I want to outline five steps to feeling better. And I want these to be very practical, so that you can start to implement them right away and get a little traction here. So step one - step one to feeling better is to know the difference between what is in your mind versus the outside world. I just want to suggest again, and this is very counterintuitive than the way most of us grew up thinking, is that your emotions are not caused by external events. You feel the way you do because of a thought or a sentence in your head. Regardless of what is happening in your life, what you think about it either makes you feel better or worse.

So step two, find the internal cause for all of your emotions. Again, facts don’t cause feelings; our thoughts about those facts do, our thoughts about the facts of our life, cause our feelings. The reason this is such good news is that you do not need to change anything in the world to feel better now. I’m going to say that one more time, you do not need to change anything in the world to feel better now. That does not mean that you don’t want to change some of the facts of your life. However, you don’t have to change things to start to feel better.

Step three in the five steps to feeling better, is to know and name your feelings. So again, this goes back to what I mentioned earlier. Rather than trying to avoid feelings, or resist them, or deny them, it’s very helpful to practice allowing them, accepting them and not being afraid of them. I always was worried that if I allowed myself to feel some of my feelings, especially anger, or fear, or worry or frustration that they would just explode and sort of take over. So I got very good at sort of pushing them away, stuffing them away, trying to resist them. The problem is that that is actually what makes them bigger.

So again, I love this idea, and this actually comes from several different studies in the scientific literature, that the half-life of have an emotion, of a feeling, generally feelings last about 90 seconds when you don’t resist them. And that really represents that sort of neurochemical cascade and the variety of sensations that accompany different emotional states. 90 seconds, I can do, right, and you might notice, “oh, I was feeling worried and then I got distracted and I thought about something else. And the worry went away until my mind went back to those thoughts that were creating worry.” I think some of us may be have this experience with grief as well, where you’ll be fine and then all of a sudden, you’ll have a thought about maybe a loved one who has died or some other situation and you’ll feel this intense grief, and then it sort of evaporates again.

I’d love to just offer you that if you’re willing to feel any feeling, if you know that you have the skill to allow and to process any feeling, you can start to take bigger risks in your life and go for bigger goals. Because the worst thing that can happen is a negative emotion. You go for a big goal and you fail, you’re going to feel shame or embarrassment or something like that. If you know how to feel shame or embarrassment, you know that it doesn’t last that long. It’s coming from your thoughts. It’s no big deal. You might notice that you start to be less worried about setting big goals for yourself. That’s the beauty of really starting to name and allow and feel your feelings.

So how do you actually know and name feelings? So, the way I think about it is first you name it: sad, mad, glad, afraid, stressed, whatever it is frustrated, irritated. So you name the feeling. Again, a feeling is one word. If you have a lot of words, that’s probably a thought. And then describe to yourself, how does it feel in your body? Get curious. Breathe into it, try to relax. Notice if your shoulders are up, if your body’s tense. Can you just breathe and relax and get curious? The way I like to think about it is if you had to describe how you were feeling to an alien who had no ability to feel any emotion, how would you describe it? Maybe it’s a little flutter in your chest, maybe there’s a little tightness, maybe there’s a little heat. Does it feel like movement? Does it feel heavy? Does it have a color?

I like to remind myself that these are just sensations in my body caused by a sentence in my head, it’s not a problem. And then I want you to practice identifying the thought or the thoughts that are causing your feeling. So it might look like I’m feeling irritated. Irritation for me, feels very up in my chest. My shoulders feel sort of tight. I feel like I’m holding them high. I feel a little agitated. It feels sort of like a lot of movement, it sort of makes me want to do something. I often feel irritated because I’m thinking that someone shouldn’t be doing what they’re doing, a patient shouldn’t be late. They shouldn’t expect me to see them over my lunch break, those are some of the thoughts that I would identify. So just check in.

Step four, remember, we’re going through the five steps to feeling better, are to manage your thoughts. So here, we start with identifying your current thinking, what are you thinking? What kind of emotions is it creating for you? Is it serving you? Maybe you have some unhelpful belief systems that need to be upgraded. If you’re listening to this podcast, maybe you have some belief systems about how a doctor needs to work hard, or how patients always come first, or how you need to make sure that other people appreciate you or any of those things.

If you want to feel better, however, or if you want to have different results in your life, you need to start by changing your thoughts and your beliefs that are giving you the current results that you have. It is 100% possible to believe new things, this is absolutely a skill that I’m going to teach you and that can dramatically transform your life.

And step five, in feeling better is to embrace something that I like to call “emotional adulthood”. Emotional adulthood is when we ourselves take 100% responsibility for how we feel all the time. So, believing that other people or circumstances in the world, or things that are happening are the cause of how we feel disempowers us and leaves us helpless to change. Because then we need to change the world, or we need to change other people so that we can feel better. So emotional adulthood is the opposite of blaming or shaming others or ourselves. When we’re blaming ourselves, or we’re blaming other people for our feelings, we can’t change. So never use this idea of emotional adulthood to then make it mean that you’re the one that’s at fault. It’s just this idea that if my thinking about the world is what’s causing my emotions, then I’m the one who’s responsible for how I feel all the time.

So again, when we’re blaming other people, or when we’re blaming ourselves, we can’t change, it really blocks us. So, trying to stay with curiosity, interest, openness. What are some of the obstacles to feeling better? Why don’t we just feel better once you know this? So, some of the happiness blocks; one is what I mentioned earlier, is our mind generates thoughts all day long. So, on average, a lot of the studies out there have estimated that we have maybe 60,000 thoughts a day, that’s 6-0-0-0-0, 60,000 thoughts a day. So, we can’t just spend all day trying to control our thinking.

We also have this hardwired negativity bias of our brain that I’m sure a lot of us are familiar with. So the negativity bias is really hardwired in. And this negativity bias idea refers to the fact that humans give more psychological weight to bad or negative experiences than to good ones. This means that we’re always looking for the negative, we’re looking for what’s wrong, for a mistake, for what we missed, for what might kill us, or a patient. This negativity bias most likely has a very beneficial evolutionarily hardwired or survival benefit, right? It likely helped us survive as a species, but it does not help us thrive or be happy.

There’s a quote from Rick Hansen, who’s a neuroscientist and researcher and author. He says, “Our brain is like Velcro for the bad, and like Teflon for the good.” So that to me is really a very clear description of the negativity bias. Our brains are Velcro for the bad that happens, Teflon for the good. An example of this might be how you have 20 positive patient encounters and maybe one challenging patient or negative encounter, which is the one that you’re going to think about and perseverate on? it’s the negative one. Nothing’s wrong with your brain; it’s working the way it’s designed to. It’s simply not helpful in creating a more positive experience of your life.

And another happiness block is our own medical programming, which I like to call “Dr. Brain.” I’m definitely going to have a podcast episode on this. So, Dr. Brain is sort of like our negativity bias but on steroids. So, in medical school and in medical training, we’re taught to always be looking for the problem, right? We run differential diagnoses on everything. We’re always looking for what’s wrong, what are we missing? Mistakes are to be avoided at all costs. So, there’s this heightened sense of alertness and danger that most of us walk around with. No mistakes, doing things perfectly, not asking for help. Looking for the problem. So no wonder so many of us physicians find so much wrong in medicine and in our own practice, it adds to the inherent negativity bias of the human brain. And Dr. Brain, plus our negativity bias really sets us up for this pattern of overworking of burnout, and personal and professional dissatisfaction that so many of us have experienced or are experiencing today.

So this is one reason that we have to learn how to use our brain and not simply let it run the show. Our brain likes to run on autopilot. But left to itself, it’s going to be a pretty negative narrative inside our head. And that is totally normal. So no wonder so many of us physicians find so much wrong in medicine and in our practice, we see what we look for. Again, this is one of my favorite quotes, “The mind is a terrible master, but a wonderful servant.” I sort of think of the mind as a very enthusiastic golden retriever, we have to tell it what to go look for it, we have to tell it what we want to focus on. So we need to use our own mind and don’t just let it use you.

I’m going to have a separate episode on some quick happiness hacks that you can start to implement. But I wanted to, again, review some feeling better practices that you can start today. A lot of these seem very simple, but they can be quite powerful. So, one is setting intentions. I like to start with this with a lot of my coaching clients is to start with a daily intention. So, decide every morning, how do you want to think or feel or act? Do you want to maybe be relaxed? Do you want to feel grateful or happy, maybe efficient or available? Decide how you want to show up that day, just pick one, and then start to practice it.

You are 100% going to revert to old patterns. This is not a problem. This is normal. The goal here is to notice and to interrupt and to redirect. So again, if you decide, today I want to feel engaged. You’re just going to keep reminding yourself of that. How can I feel engaged? How am I engaging with this patient? Am I feeling engaged now? How am I feeling? Again, it’s that pattern of noticing how am I feeling? How do I want to feel and redirecting?

Another practice you can do is starting to ask yourself better questions. What kind of questions does your brain ask? Do you ask yourself empowering, high-quality questions that produce creative and inspiring answers? Or do you ask sort of dead-end questions like what’s going to go wrong today? If you ask your brain a question like that, the golden retriever part of your brain is going to go find all the ways that today is not going to go well. An empowering question, a high-quality question might be, how can I have fun today in clinic? How can I leave on time? How can I help as many people as possible and not be exhausted at the end of the day? So again, our golden retriever mind is going to go out there and find some answers, that is going to help you create sort of an upward spiral.

I like to ask, how can I make today even more awesome. How can I make today even more awesome? I love this idea, “If you ask a better question, you get a better life.” So just start to notice, what are the questions that I ask myself? Are they dead end? Are they empowering? How could I ask myself better questions that are going to help create a better life, the life that I am looking to create for myself.

And another happiness hack or another way to start to feel better is to practice gratitude. And I know a lot of you might be rolling your eyes, but it’s not as touchy, feely as it sounds. There’s a whole lot of science on the power of gratitude. So numerous studies are out there showing the positive benefits of consciously cultivating an attitude of gratitude. What we focus on grows, what we pay attention to, again, directing our brain to pay attention do what we want it to, to the thoughts that we think determine how we feel. Practicing gratitude is a shortcut to feeling better every day. By consciously looking for the positive, we can counteract the tendency of our brain to focus on the negative. And this is a practice, right? Our brain is very used to just going back to default patterns, that’s totally normal. Your job is to redirect it, to start looking for the positive, to choose things to focus on that make you feel genuinely grateful. I love this idea that gratitude dissolves negativity.

So, a quick little gratitude happiness hack is every day, can you think of three things for which you are grateful? I would have you pick new things every day. They can be as simple as a hot cup of coffee, sometimes that’s what I turn to, or running water. If you’ve ever had your hot water heater go out, hot running water. Bonus points if you can write them down, right, you really want to cultivate and savor these thoughts and really generate an intense feeling of gratitude. Notice how it feels in your body to feel grateful. This actually works. I know again, it sounds a little simple, it sounds a little easy, maybe it sounds a little touchy, feely, but the science is there. I would just say try it and see what you think.

Our mind again is a highly sophisticated, seek and you shall find machine. So what you focus on, grows, look for what’s good, and you will find it; look for what’s wrong and you will find it too. What you think determines what you feel. So in this case, perception is your reality. I’m not saying this is easy to start thinking new thoughts to feeling better, but it is possible. And you might notice when you think that thought maybe it is possible to feel better by noticing what I’m thinking and having my mind consciously think about different things. Notice if that even makes you feel a little bit better. Check in. You don’t ever have to believe anything I tell you. Always like test it. Take it out there and test it in the wild. See what your experiences is. I’d love to hear from you. I love to just end on this quote from Shakespeare. “For there is nothing either good or bad, but thinking makes it so.”

So, thank you so much for joining me today for this first episode. I have so much I want to share with you. So definitely stay tuned and we will continue to explore how to stress less as a physician and enjoy your life way more. If you have any questions, please feel free to email me at [email protected]. That’s [email protected]. I answer and read all my own emails. And feel free to sign up for one of my three free consultation sessions that I have every week if you want some personal attention and want to find out how coaching and applying these tools might help you start to stress less and enjoy your life more.

If you are a busy practicing physician ready to start feeling less stressed, enjoy work more and learn how to create a more balanced and sustainable medical practice and life, sign up for a consult call with me at saradill.com That’s S-A-R-A-D-I-L-L.com. It would be my privilege and pleasure to work with you.