It was 23:45, and Ben was exhausted from working the last three long days; he was already 45 mins late finishing work. This lateness, which happened more often than not, was not his fault. The system, sick patients and an overwhelming sense of guilt that if he didn't do it, then no one would drove him to see more and more patients and do the 'right thing' to help his colleagues to the left and right of him and most importantly to help the patient in front of her.
Despite this, there was a growing resentment, anger, and an expanding vacuum of feeling nothing. The compassion fatigue was now in full flow. With a young family, he knew that this recurrent lateness and conflicted feeling between doing the right or expected thing and the growing and gradually relentless negative emotion of repeating this pattern led to the slow and insidious path to burnout. So, not for the first time, he cried when getting back to his car before driving home, well aware this was spilling over to his family life and personal relationships.
Stopping this endless cycle of expectation, guilt and burnout appeared on the surface easy; the reality as ever was more complex. Financial commitments to family, peer pressure from colleagues, the societal status of being a doctor, family expectations, and the sunk costs of getting this far in a career all played heavily on his mind. But this again was conflicted with the dark decline to worsening mental health and searing unhappiness that was growing daily. He felt trapped and isolated, with the world's weight on his shoulders.
This feeling of being trapped in jobs we hate, slowly burning out and having that sinking feeling of leading a life less than your full potential is commonplace in our society and far more widespread than just in healthcare. Most of us have experienced this in our lives at some point. Adam Kay's book and TV dramatisation of 'This is going to hurt' is a fantastic exploration of the issues around this.
But what if it is impossible to quit the day job, throw in the towel and move on? Please seek professional medical advice if you are suffering from significant mental health issues through the issues I raise here. If this affects you but has not yet led to mental health problems, we can use several changes in mindset to try and help.
1 - 'Get to' versus 'Have to'
Often when we are in a situation of feeling trapped, we tell ourselves we have to do something. We have to earn enough money, we have to do mundane tasks, and we have to stay until a certain time. One shift in thinking that can help is the shift from telling yourself you have to do something to you get to do something. This applies to small and large tasks alike.
In Ed Deci's great book 'Why We Do What we Do' he describes the difference between internal and external motivation. External motivation is often good for short-term goals. But to develop long-term internal motivation, we need a combination of autonomy, connectedness with those around us and mastery of our work. Although a subtle shift moving from 'have to' to 'get to' gives us more autonomy and improves our internal motivation.
A good example here is how we approach a daily commute. If we have to commute, it becomes an emotional drain contributing to tiredness and lack of job satisfaction. On the other hand, suppose we ‘get to’ commute, which frees up our time to listen to uplifting podcasts and educational audiobooks. In that case, this can become a time in our day to improve mastery of a topic, improving both autonomy and mastery.
2 - Change in Mindset
When we feel trapped, we can feel like we need to have all the right answers and deliver our job in the way we have been told. This is even worse for those of us who are self-confessed perfectionists.
Two key ideas which can help here are the Pareto Principle. Pareto discovered the 80:20 law of economics that 80% of the wealth belongs to 80% of the population. This applies to many areas of business, time management and finance, e.g. 20% of clients bring 80% income, 20% of the exercise in the gym brings 80% of the results etc. Likely, 20% of the work tasks bring 80% of the stress, and 20% of your interaction brings 80% of the results. What 20% of areas could you concentrate on to improve 80% of the results?
The second idea comes from my most recommended book of all time, Carol Dweck's 'Mindset'. In it, she develops the idea that there are those with a fixed mindset who have a fixed way of looking at things and require external validation; and those with a growth mindset who see everything as a learning opportunity and seek out mistakes and negative feedback as a way of growing and developing. Going back to Ben, if he could see every encounter to develop feedback and learn from it, it is likely that going back to the idea of internal motivation; he would be more connected to those around him and gain a fast track to mastery of his work.
3 - Search for Meaning
But I know what you're thinking. 'This is all very good inside the theories and books, but my life is different'. It is worth considering the case of Victor Frankl.
In any difficult situation, it can be easy to focus solely on the negative and lose sight of what's truly important. However, as Victor Frankl discovered during his time in Nazi concentration camps, searching for meaning can be a powerful motivator. When faced with unimaginable suffering, Frankl looked for ways to bring hope and compassion to his fellow prisoners. As a result, he maintained his sense of humanity despite the atrocities around him. His experience shows that even in the darkest times, finding meaning and motivation is possible. We can get through even the most difficult situations by keeping our eyes open for opportunities to make a difference.
Going back to Ben, the answer clearly has two paths: to leave and find an alternative path or stay on the current one and try and build resilience. The path may be difficult and winding, but adopting some changes in mindset may move the needle to make things bearable in the short term.
Actionable steps:
- Take a small task and concentrate on making it a ‘get to’ vs ‘have to’ task - this will give you a higher level of appreciation and a feeling of autonomy.
- Take a deep dive into your tasks, time management, and colleague interactions. What 20% of encounters are giving you 80% of the results? Could you double down on them?
- In what areas do you have a fixed mindset? Where do you seek external approval and validation for doing well? Could you adopt a more growth-based mindset where you seek negative feedback, learn from mistakes and grow from it? Better still, could you make this part of your identity as someone who always does this?
- What meaning do you draw from your difficult job? Could you give that a higher meaning? Career progression? A place to learn new skills? Somewhere that provides for your family? If you draw a higher meaning, you will likely be more motivated to do the job and more resilient.
Good luck on your journey!
Diarmaid
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