Your Weekly Dose of Positive Medicine: using the science of happiness to help physicians thrive
Your Weekly Dose of Positive Medicine
Using the Science of Happiness to Help Physicians Thrive
”You always hold the rights to your effort, but never to your results. All you own is the right to try”
Positive psychology, the scientific study of human flourishing, has begun to uncover some landmines for physicians to avoid along the path.
One such landmine is affective forecasting which is the study of what will make us happy.
Choosing our spouse, our career as physicians, what other goals to pursue are largely based on how much happiness we think these decisions will bring us.
What the research is showing is that we are not very good at this prediction.
We want to be happier, live a life of flourishing but we often chase the wrong things and wrong paths to get there. Even more disturbing is the fact that we are often disappointed when we get the very things that we think we want.
Generally, we are pretty good at predicting whether something is going to be pleasant or unpleasant. We are lousy, however, at predicting the intensity and duration of our future emotional reactions to this event.
In other words, we can correctly predict that making partner in our group will make us happier. Where we go wrong is predicting how much happier we will feel and how long this happiness boost will last.
We also overestimate how bad we will feel when considering a negative event in the future. This error is called impact bias and has been studied and found to occur repeatedly in a variety of populations and contexts.
College students overestimated how happy or unhappy they would be after being assigned or denied to their first choice dormitory. Couples routinely overestimated how unhappy they would be 3 months after a breakup. Nontenured college professors overestimated how unhappy or happy they would be 5 years after being denied or granted tenure.
Impact bias is a problem for us because we may actively chase or avoid an outcome that in the end will not optimize our well-being. For example, if we overestimate how much pleasure we will get from purchasing a new car, we may be better off spending our money in a different way.
Like many findings in psychology, there is an evolutionary advantage to impact bias - it serves as a huge motivator making us work extra hard to obtain things we think will be really great and avoid things we think will be very bad.
What the research shows is that in general, things or outcomes that we chase are not as good or as bad as we think they will be.
We can use impact bias to our own advantage. We can still pursue meaningful goals in our life - whether that is a leadership position in our department, a new hospital contract to expand our group, or a bigger house to accommodate our growing family.
Recognizing that impact bias is at work, we can realize that achieving these goals would be great but not so great that it warrants us to bend the rules, treat people poorly or neglect other important aspects of our life.
We can focus on the journey of personal and professional growth rather than become fixated on a destination which we know won’t live up to its hype.
Simply stated, keeping impact bias in mind can give us the freedom to pursue valuable things while not neglecting that which we should value - our character, our relationships and our actions.
Now on to this week's ideas...
This week, we are featuring Jordyn Feingold, MAPP. Jordyn holds a masters in applied positive psychology and is the co-founder of the Positive Medicine Program, and a 4th year medical student at the Icahn School of Medicine at Mount Sinai, working toward her combined MD/ Master’s of Science in Clinical Research.
1. If You Don't Own the Defeats, You Can't Take Credit for Victories
"What one of my mentors shared with me in just a few sentences truly changed who I am as a person and who I strive to be as a physician. He told me that ...all we can do is our best based on the information we have.
Sometimes good things will result, sometimes bad. When we’ve tried our best, we cannot “own” the bad outcomes, and in fact, it is egotistical to think we have that much power."
In this Op-Med article, family physician Nicholas Sasson recalls advice that he was given early in his career. When we have tried our best, the results are out of our control. His mentor went on to say that if we aren't going to own our defeats, then we certainly can't own our victories. This detachment from the results (both good and bad) and focus on the process (doing our best) is a central tenet in ancient wisdom texts from the Bhagavad Gita to the Stoics.
2. Focus on the Inputs
"These few months have proven to me again how little connection there is between my “productivity” and my happiness. One thing I have noticed, though: I can be happy if my output is weak, but I’m rarely happy when my input is weak."
In this post, David Cain discusses the impact of simply focusing on inputs. Since the problems of output are often problems of input, focusing on what we can control (our actions, habits and behaviors) each day is a better path to happiness and fulfillment. Many self-help advice focuses on end goals and desired results. What if we turned our attention to the front end of the process and let the outputs flow naturally? We could live a more relaxed, satisfied, and (yes) productive life.
3. Three Good Things: Lessons from the Science of Happiness
"A big part of positive psychology is about positive interventions, which are intentional activities that are aimed at cultivating positive emotions, behaviors, and thoughts. These days when everything just feels so nebulous, just being able to plan and take some control over the situation, which otherwise feels like we are losing so much of the control, I think is often driving a lot of the positivity that I'm experiencing."
In this short podcast, Jordyn Feingold, a positive psychology practitioner and a 4th medical student at the Icahn School of Medicine at Mount Sinai shares three evidence-based exercises that can help you see the bright side of life, even in dark times.
Physicians Helping Physicians Spotlight
Jordyn Feingold, MAPP. Jordyn holds a masters in applied positive psychology and is the co-founder of the Positive Medicine Program, and a 4th year medical student at the Icahn School of Medicine at Mount Sinai, working toward her combined MD/ Master’s of Science in Clinical Research.
1. Can you tell us a little about your career path and what led you to your current role?
I am a fourth-year medical student at the Icahn School of Medicine at Mount Sinai, graduating in 2021 with my combined MD/MSCR (master’s of science in clinical research), and am currently applying topsychiatry residency! My clinical and research interests primarily involve applications of positive psychology (the science of human flourishing) to the practice of medicine for both clinician and patient populations.
With clinicians, I work to address burnout and promote well-being through teaching and interventions aimed at positioning the pursuit of well-being as a critical clinical skill for clinicians at all stages of training and practice. With patients, I am specifically interested in applications of positive psychology forthose with chronic diseases such as Inflammatory Bowel Disease and Irritable Bowel Syndrome (and other functional GI disorders), and how interventions aimed at the psyche can ultimately improve symptomatology and quality of life for patients with these disorders.
I first discovered positive psychology as a pre-med undergraduate at the University of Pennsylvaniawhere the field was founded. After learning that there was a degree one could earn in positive psychology (the MAPP: master of applied positive psychology), I decided to pursue this educational pathway before applying to medical school, with the goal of starting my medical career through the lens of optimal human functioning. Whereas the “medical model” is largely about getting rid of disease and dysfunction, positive psychology (and by extension, positive medicine) is about promoting what’s best with people and building whole-person health and well-being. I am committed to a career as a ‘positive’ psychiatrist in which I can help my patients and colleagues build well-being in addition to preventing the development of and treating psychopathology.
2. Given the state of mental health in medicine, how can physicians (trained as lone wolves in a culture that often pits us against each other) form a cohesive community that can help to support each other?
I believe that this culture starts before anyone ever gets to medical school, but arises during undergraduate pre-med environments in the “weed out” courses such as Organic Chemistry and Biochemistry where students are often graded on a curve (where only a certain portion of each class can get an A for example). Students are highly attuned to the difficulty of getting into medical school, and thus, this “lone wolf” culture is perpetuated in colleges and may be hard to shake upon arrival to medical school.
It has been my mission since starting medical school to foster an environment of collaboration and peer support through the creation of a longitudinal well-being program called PEERS: Practice Enhancement, Engagement, Resilience, and Support, which is a “curriculum” of peer-support groups that build in periods of reflection, connection, and teaching of positive psychology interventions for all medical students, led by senior medical students, at regular intervals throughout medical school. The goal is to create a space for peers to be vulnerable with one another, share challenges, and support one another. I think it is critical to normalize discussions of vulnerability and build in time during training and practice for the sole purpose of connection. Ideally, programs like PEERS would exist across the continuum of medical training and practice to reinforce these goals.
3. What do you enjoy most about the work you do? What are you most excited about now?
I feel the most engaged in my work when I am actively teaching medical students, be it through the Positive Medicine elective course that I developed at Mount Sinai or the PEERS groups, and especially the PEERS Group Leader Trainings in which I help to train the senior medical students to facilitate the PEERS sessions for junior students. We use a ‘train-the-trainer’ model and it is just so cool to train ~60 students every year in principles of positive psychology as well as facilitation and validation for running these support groups. I am very excited to continue this work and expand it for all-comers on our virtual Positive Medicine Program to reach a global community of health care professionals to teach Positive Medicine principles!
4. What do you wish you had known as a young physician?
Since I am a young [almost] physician, I will turn this around to what I hope to remember as a more senior physician. I hope to never lose sight of the privilege it is to treat patients; I hope to bring the literal beginner’s mind that I have with me now to all patient encounters and see every new patient for who they are and their unique life experiences; I hope to maintain the practical idealism I have as a trainee throughout my career and avoid being ‘jaded;’ I hope to practice what I preach in terms of pursuing well-being, above and beyond the absence of burnout or distress; I hope to never forget as a doctor what I know as a human being.
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Two Quick Things Before You Go...
As physicians, now more than ever, we desperately need to do a better job of supporting each other. If you are struggling with the current demands of medicine, please know that a FREE confidential formalized peer support for physicians by physicians is finally in place. Contact Physicians Confidential.
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