The Power of Pausing

“You can do anything, but not everything.” –David Allen

I have shamelessly taken this title from Eckhart Tolle’s excellent book the Power of Now. Mindfulness, which Eckhart beautifully describes in his book, is gaining ever increasing backing from the scientific literature. While mindfulness practices are excellent tools for stress relief, self-development, and maintaining health, learning to pause is just as powerful.

Recently in medical school, I had hit the proverbial wall of burnout that required me to take some time off for myself. I was lucky enough to have the excellent support of my family and friends to help me bounce back. However, upon reflection, I realized that what I had experienced could have been easily avoided. I was simply doing too much!

What drove me to keep pushing myself until I completely burned out? This is coming from someone who is a big proponent of less is more. However, as physicians in training, we tend to be extremely disciplined and hardworking, always seeking to positively impact people’s lives in a meaningful way. Therefore, it is all too easy to fall into the trap of incessant doing. This tendency became magnified for me in medical school, when I had the opportunity to participate in so many wonderful and enriching learning experiences. Since my job as a student is to learn, it seemed like I MUST take advantage of every one of them. I learned very quickly, the hard way, that if I do not say no to some opportunities, even if they are unique and wonderful, I will not be able to sustain my journey through medicine.

Intuitively, if we know doing a little less is essential not only for our mental health, but also for our effectiveness, then why is it so difficult to pause and say no? I can’t speak for everyone, but in my personal experience, there seem to be three things driving my desire to do more and more and more.

First, the main driver is Imposter Syndrome, which basically is when you’re unable to acknowledge your accomplishments and fear that you will be exposed as a fraud. During my first year of medical school, I was flooded with feelings of self-doubt and insecurity. Did I really deserve to be here? Should I have gotten in? To combat these fears I took a very unsustainable approach to my studies. I felt I needed to work extra hard to prove my worth, and so that I would not be caught unprepared in case someone found me out for a fraud.  My learning was fuelled by insecurity, fear, and anxiety, so I  was carrying that feeling with me during my family practice and clinical rotations; this feeling never went away because that target of competency that I felt I needed to hit is a moving target as I progress through school. It is like a dog chasing its own tail.

Building off of that point, the second driver for me is the belief that we live in a scarce world in which there are only a few opportunities. Thus, I think I need to constantly be doing something in order to ‘get what I deserve.’ This belief does not prevent me from being successful or achieving great things, but it makes it harder. Instead, I’ve learned to take what leadership expert Stephen Covey calls a Win-Win paradigm. It’s the belief that life is an all you can eat buffet. For example, as I previously said, at the beginning of medical school I had feelings of self-doubt and anxiety about me belonging there. What was my instinctual response to that? To prove I was better. However, that was actually approaching schooling with a win-lose perspective. It not only really stressed me out, but reduced my performance. Once I instead focused on learning for my patients, and focused on how to help my peers learn the material as well, the incessant desire to keep doing more and more dissipated. By working with others and sharing opportunities we all learned and did better.

Lastly, as a medical student, I have a strong burning desire to help others. However, as the old adage goes, I cannot pour from an empty cup. Therefore, counterintuitively, I’ve learned that the best way for me to help other people is to be ‘selfish’ and take care of myself first.

I am still personally working to regain the power of pausing. What I have realized is that I need to build in time for breaks and self-renewal into my schedule, just like I do with my classes, clinical rotations, studying, etc. Some strategies I have been using recently to make sure I don’t burn out are:

• Move – for a minimum 20 minutes a day. It doesn’t matter if it’s yoga, cross fit, running, cycling, tai chi, basketball etc. JUST MOVE!
• Sleep – for a minimum of 6 hours a night and try to stick to a regular sleep wake cycle.
• Un-schedule – Do NOT fill up your schedule – unscheduled time is not a negative!
• Schedule – but only add something to your calendar after you’ve thought about it/slept on it. It is easy to impulsively say yes to too many opportunities, then later regret being overcommitted.