"Right Way" Energy

Do you get stuck in “right way” energy?

Today I'm sharing a little bit of my own anxious internal environment and talking about “right way” energy. IT’s that internal voice that tells you that there is only one right way to do things. We'll talk about where this kind of energy comes from, what it creates for us in our lives, and what it keeps us from having in our lives.

 This is a don't miss episode so be sure to tune in.

Transcript

00:00
Hello my friend and welcome to another episode. As always I am so glad that you're here and tuning in and choosing to connect with yourself, connect with your life and your struggles, and I hope that in listening to this podcast you feel a sense of community. Even though most of us are going to be listening to podcasts on our own.

00:26
I really try to highlight some of my own experience, some of my clients' experience, some of what I have seen in the world and what I hear from others. And in so doing, I hope that you find some richness and some connection within that, because for so much of what we do in medicine, we often will feel alone. And I think especially when we struggle with habits of...

00:53
perfectionism and people pleasing and lack of boundaries that are all contributing to burnout as we practice in a broken healthcare system, the isolation is real. So I just wanted to call that out that I love sharing the podcast with you and I love hearing from others. I don't think I've said this out loud on the podcast, but most of the clients that come to me for one-on-one coaching actually have been listening to the podcast and actually feel quite connected to me.

01:23
before we even get on any calls together. And so whether or not you plan to get any coaching yourself, I just want to call out that I love the sense of community that's already here. OK, enough on that. Today we are talking about what I'm going to call from now on right way energy, as in there's a right way to do this, and therefore there are wrong ways to do this. And this one really comes out of my own

01:53
experience, my own sort of internal dialogue. And thankfully, I think I've shed a lot of the right way energy that has existed in my life. But I still feel moments of it. And I'll tell you a very silly example of where this often pops up for me in my current day to day, which is that for a really long time, if I found out that I was, like, let's say out of a grocery item that we need for this week. Or.

02:22
or you know some some little tiny household thing and It's during the middle of the week and not at the end of the week when I usually do my usual kind of shopping It will be stuck in my brain that I have to stop and get that item Or else right the right thing to do is for mom to stop and you know get that on the way home or on the way to work or you know, make some kind of special trip and

02:51
That thought pattern comes up over and over and over again. And it comes up in such a way that I'm like, oh, gosh, I have to go to the store. I have to go to the store and get it. And as I have been noticing when that idea pops up and how inconvenient it would be to go to the store to get that thing, if I notice it, I often find.

03:18
that I will let go of that thought and I will come up with some other idea of like, oh, you know what, no problem, we have this thing. This thing is close enough, it'll taste fine, like it'll be no big deal or, oh no, like we totally have enough of that soap or that we have enough toilet paper, we're gonna be totally fine, we'll make it work. And then I can let go of that thought, but I still get that initial thought of, oh no, I gotta go get something. And,

03:47
for much of my adult life, like I would have gone to go get the thing and I would have been kind of hassled and harried and you know, feeling some things. And so this happened to me this morning that I was thinking, oh God, I've got to go to the store. And I sat back and paused and I was like, you know what? This is a kind of energy that comes up over and over in my life and it comes up, I know, in the life of my clients because I've talked to them about it.

04:13
And it shows up. This is a very silly example of grocery shopping, but it shows up in our professional lives. It shows up in our families and our relationships. And so we're going to talk about it today and dive in a little deeper as to why this happens, what it creates for us, and what it keeps us from doing. So let's dive in. So let's start by exploring a little bit of where this came from.

04:43
Again, like many things, you may have had this tendency before you came into medical school. Because frankly, when you are a high achiever, you often learn quite clearly along the path, whether that's in your early family and upbringing, or just along the trajectory of high school and college and being pre-med, you will learn that there is a quote unquote right path.

05:13
I remember when I was in high school and college, I thought the right path to get into medical school was first high school, right? Then college, then medical school. That's the only pathway I knew. Now, of course, when I got into medical school, then I saw all these other people who mostly had been out for at least a year. They had done something after college for at least a year. They were a little bit older.

05:42
They were a little bit more mature. They were totally fine. They had taken a different path. But all I knew was, this is the right way. Clearly, that's wrong. But I just showed that to highlight where we can get really stuck in an idea of there is one right way to do this. So we may have come out of that.

06:07
Many of us may have come out of anxious households or households where there were some OCD traits. And again, some of those tendencies may have served us because they probably kept us working hard, studying, really sort of drilling in to memorize things. It may have been useful, but it may not be creating good things for you right now.

06:34
So that might have led us into medical school, but what happened during medical school and residency? Protocols, algorithms, you know, this is how this organ works, this is how this physiology works, this is where this anatomy is, right? This is the right way. There is so much of that going on in medical school, and once you are out in practice,

07:03
you can often see how that one way of thinking about it is not accurate anymore, right? That does happen. It's not helpful to think that there's only one set of tools that can address a particular concern, right? You may have had it drilled in, like these are the starting blood pressure medicines and you have to go in this order. This is the right way.

07:30
You may run into patients who don't want to go the right way for whatever reason. They don't want to do step one, two, three, right? They only want to jump to step three. That may be appropriate. But because we come out of that training of this is the one right way, it may be very difficult for us to be flexible, even though there may be very legitimate reasons why we want to go a different way. Think about algorithms that we learn.

07:58
Think about code drills. Now in some of those settings, it is really important, and it is evidence-based to go in a certain order. And the reason that we do those drills, like think of code drills, think about learning ACLS protocols and such. The idea there is to take the thinking out of it. So you can just automatically go from step to step to step.

08:24
according to what the evidence shows for the best way to resuscitate a dead body. That may be the right way, and that's okay, but when we train in that environment, we will often internalize that there is one right way for everything. When I think about my work that I do in obesity medicine, certainly there were things that I learned of, okay, we have to pay attention to this, this, this, and this.

08:53
And kind of the old-fashioned thinking was that we would always, always, always start with changing nutrition, changing exercise. We might later think about adding support from nutritionists or coach. We might later think about adding support from medications. But where the rubber meets the road, when I'm meeting somebody for the first time, they may have done none of that.

09:21
And it may be totally appropriate to go with medications to reduce the barriers for them to do that other stuff. Just to say that if I have it stuck in my brain that there's only one right way to do things, I am not going to be as helpful and as supportive in helping my patients have success. But again,

09:48
were sort of drilled into this right-way mentality. Think about teachers that you had during medical school, during residency. And some of them might have been fairly rigid as well, right? This is the way that you do this. I remember learning to do paracervical blocks. Now, I probably learned five different ways to do them. And each teacher insisted that their way was the correct way based on the anatomy.

10:17
based on the effectiveness. There cannot be five one right ways, right? And when I'm teaching residents how to do a parable cervical block, I'm very clear with them, you know? This is the way that I've learned this is most effective. And, you know, based on the anatomy, this is how I tend to do it, but you're going to learn to do it a bunch of different ways and you're going to need to decide.

10:46
What works best for you?

10:50
let's break up that right way mentality unless we know very, very clearly that there is only one right way to do things, which I think there's probably a small number of things, but I want us to see how the training has led us to have these beliefs and how that shows up for us. So we're gonna dive next into kind of how that might show up for us.

11:19
When we think there is one right way to do things, we will have repetitive thoughts, and thoughts that we think over and over again basically become our internal beliefs, whether we hold them as sacred truths or they're just thoughts we have over and over again.

11:41
When we have thought patterns over and over again that there's one right way to do things, we will really struggle with a lot of negative emotions, especially when things are challenging. So that might be that you know there's one right way to treat hypertension, right? And it involves step A, B, C, D. And then you have a patient who again, doesn't wanna do A, B, C, D, they will agree to C.

12:11
Right, they will agree to not the first line treatment and that's what they're willing to do. Now, if I stay stuck in my, there's one right way to do this, I'm gonna be annoyed, frustrated, irritable, because that patient is getting in the way of me being able to treat their hypertension correctly. Now, I'm not saying that

12:41
our evidence and our guidelines are not important. What I am saying is that in the practice of medicine or in things to do with your children, your relationships, again, in dealing with other human beings, we may need to be more flexible, but if we repetitively think over and over again, there's one right way to do things, we are gonna have a lot of negative emotions when other humans don't respond to us that way or won't do that.

13:11
one right way, right? So I want you to think about where this comes up for you in your life. It may be patient interactions. It may be some process or policy that happens in your clinic or your hospital where you think that the right way is this. And what happens in practice is something else. Now again, there are going to be situations where there are

13:39
is something that is a good idea, a good policy, clearly evidence-based, and other people aren't following it, or there's inadequate staffing or resources, that absolutely does happen. And I'm not saying that that's okay, we need to just not care. But I think there's a lot of situations where there is room for flexibility, and we get stuck in a lot of negative thoughts and emotions about how things ought to be done.

14:10
And then we are swimming in this soup of negativity, which is absolutely contributing to our sense of burnout and exhaustion. So let's agree to take some of these things that really there is a right way to treat condition X. Let's take that out of it where we know that there's only sort of one right thing to do. And let's think about things that are much more general. So.

14:37
You know, a late arrival policy, a last minute cancellation policy, forms that are dropped off, you know, things that are there absolutely no one right way to do it. There may be a policy or there may be a way that we want to do it. And that's not being followed.

14:58
If somebody's making a reasonable choice, but I'm upset that they're not doing it the right way, I'm gonna create a lot of negative energy for myself. All right, I'm not gonna dive into the tangent on forms and late arrivals, because that's not the point here. But I just want you to think about where does this pop up for you? Does this happen with patients? Does this happen with staff? Does it happen at home? Is there a...

15:27
right way for your kids to clean their room, and that's not the way that they do it, right? We might be getting into a lot of that energy. I see some of that energy, you know, in my house where I have a way that I clean dishes, and that's different from my husband's way. But as my kids are learning how to do it, they are getting different messages from two parents who think that their way is right way, and don't think that the other parent's way is the right way.

15:58
I see that and I'm trying to let go of it. Because frankly, I don't wanna create rigidity and tightness and control in my kids when it comes to tasks like cleaning, which aren't usually that pleasant anyway, right? I don't wanna create more negativity in those relationships because there is no one right way to do this. Now, there are some...

16:23
sloppy ways to do dishes, like where the dishes don't actually get clean. I think a lot of experts would argue that their way is the correct way to do dishes, but let's just accept that there are a number of ways to get dishes clean. It depends on how we define clean. It depends on what resources we have. We can have some flexibility there because clean dishes really aren't going to be a life and death issue. Even if they're dirty, we're probably not going to catch botulism and die.

16:53
from dirty dishes. OK, let's let our anxiety go there. All right. I want to think next about, so we've talked about where does this tendency come from? Sorry. What does it create for us in terms of our internal state, our thoughts and our emotions, a lot of negative emotions that come out of right-weight energy, controlling anger, frustration?

17:20
But let's also talk about what does this create for us in our life when it comes to our actions, our relationships. I would argue that right-way energy often leads to a lot of ineffectiveness or inefficiency if you're used to using the word efficiency. Slight tangent here. So efficiency is being able to do things correctly, quickly.

17:50
Effectiveness is doing the right things, doing them so that they get done. There's less of an emphasis on the timeliness and more on the right people doing the right work. I don't want to speed up and see more and more and more patients quickly.

18:19
That is a marker of efficiency. Effectiveness is, is the right person doing the right work, right? If I have a highly effective team, I may end up spending little time with the patient, but all of that time is going to be highly focused on the patient and the patient care, and less time on administrative burdens, for example. It's more effective also for, let's say, a nurse to be going through lab results and really only pulling attention

18:49
the physician or the provider, if there's something abnormal and that needs to be attended to. Most of our systems are not highly effective. Okay, but we're not gonna dwell on that for today, but just to say that we want to be highly effective, and when we're stuck in right way energy, thinking there's one right way to do it and I know how to do it, we are often going to be very ineffective for a few different reasons.

19:18
One is that we become the bottleneck. If I am the clinical leader, as it were, I as the physician am kind of the top of the pyramid, if you will, in terms of being able to make decisions and direct care, if I am very stuck in right-way energy, then

19:44
that people around me don't get to make any decisions. And so everything has to funnel through me rather than people practicing to the highest levels of their license being empowered to make some decisions based on protocols and discussions that we've had about this is the way that we solve this problem in our clinical space. There may be.

20:10
protocols that would be really helpful to be in place, for example, for your nursing staff to be able to address abnormal pap smear results. If they are empowered to be able to look at ASCCP guidelines, for example, and help direct the care, they may be able to do a very quick check-in. Hey, we got this result back. I checked the algorithm. It means that she needs to go and have a colposcopy, so we're going to blah, blah, blah.

20:39
They can still check in with you, but you are no longer the one who has to go and do all of the parts, including review the guidelines and determine the next steps and everything. We become a bottleneck in a not good way. What else goes on? We lose the trust that is necessary for effective teams. So our team members will not trust us

21:08
we do not trust them. So when we're stuck in right way energy, like this is the only way to do it, if other people can't do it our way because they're not inside our brain or they don't have the deep seated knowledge that we have or whatever it is, they will always be not doing it right and they will not wanna do the task, they will not be empowered.

21:35
They will not want to lift it from you because they don't want to get yelled at. You will not trust them because they can never get it right. This lack of trust is a huge issue. And I would argue that as teams have become bloated and swollen and the team members are swapped in and out and there's high turnover, there is so little trust and that really affects the effectiveness.

22:04
affects the effectiveness of the clinical teams. If you don't know who you're working with, you don't know what they're capable of, they don't know how you like to do things, you are not going to work that great together. Yes, you can probably pull together and run a code because that's a very algorithmic thing. But you don't know your working style for those non-critical emergency situations. That creates mistrust.

22:34
So it's a problem. We also, when we're stuck in right-way energy, we'll be thinking that we have to do it all ourselves, because we don't trust others to do it. We are the bottleneck. We slow everything down. We will have this huge pile of work that we need to get through, that other people are counting on. We feel high degrees of pressure usually in order to get it done, but we aren't effective.

23:03
It's really a problem, right? Of course that contributes to overwhelm and burnout, and that's absolutely a part of some of the systemic problems, right? Is that physicians and clinicians are becoming exhausted by always having to be the decision makers because that's how clinical teams are set up for liability purposes. You know, the EMR took away a lot of the, you know, the sort of normal triaging that was typically done by.

23:31
RNs in the past, who are no longer empowered to do much of that. Creates exhaustion. The other thing is that you won't accept help if you are stuck in right-way energy. So people are going to be less inclined to ask to help you, because again, they don't want to be yelled at. They don't want to hear over and over again how they're doing it wrong, and they're never going to be able to do it right. But you also.

24:00
will not trust that others are capable of helping you. And that's a problem, because there's too much for us to do. We need help. We absolutely need help with the work that we're doing. And if we stay stuck in that right-way energy, we're not going to get the help that we deserve. And we need to be effective to be practicing to the top of our licenses. That is absolutely a problem.

24:29
With all of this, ultimately, we will have a tremendous lack of flexibility, a strong sense of rigidity and controlling energy that is a negative sort of feeling. It's a tight, highly wound up feeling that makes it really hard to relax, really hard to enjoy your off time. And it just dramatically increases your workload.

24:58
right way thinking that there's one right way to do it creates a internal mental environment where you are so much more creative and flexible and that creates lightness in your life. Now we aren't going to be inventing new surgical techniques and just doing whatever. We aren't going to be not following guidelines to the best of our ability but

25:27
we will know that there are situations where we need to think creatively and act differently. Again, you know, that's not going to happen in a routine surgery. Don't go and make up a new way to do an appendectomy when there is a proven safe way to do it. I don't know if that's a good example or not, but when we've got a patient, right, who is not willing to take lysinepro because all of their relatives had terrible cough.

25:56
and they're not willing to take hydrochlorothiazide because they don't wanna pee all day, but they would take amlodipine, even though it's not first line. It's more important for me to treat their blood pressure and get them on board with the regimen that they're gonna go with, than to choose that first line treatment and they walk out and they won't do anything, right? That flexibility, that creativity matters, and it can be life saving.

26:28
When we are creative and flexible at home, as opposed to right way energy, we get more buy-in from the people that we care about and we have more loving, open, collaborative relationships, because people trust that we will assume the best of them. If my kids can see that there's more than one way to clean the dishes, there's more than one way to keep the house tidy, that's all good.

26:54
If we're stuck in right way energy, then they're never gonna do it right because they haven't been on the planet for 43 years, right? And they don't wanna stop reading and clean the house. They don't understand why that might be important, right? Or mow the lawn or any of those things. When we are out of right way energy, there's room for collaboration and creativity and connection, and that is always gonna be more important in our home relationships.

27:22
than having a perfectly mown lawn done the right way or a perfectly clean house cleaned the right way.

27:31
The OCD parts, and I'm not belittling anything related to a true OCD diagnosis. I'm simply talking about the parts of us that have different degrees of anxiety and OCD tendencies. They need to stand down here. They need to relax. And in order to do that, it takes noticing, where am I getting stuck in right-way energy, and being willing to be flexible and creative and try something new.

28:00
You don't always need to do it that way. You might learn that there's a new way to do it that you like it better. You might learn that substituting this ingredient tastes better anyway, or I don't know, fixes some other problem, right? There are lots and lots of ways where we can benefit from getting out of right way energy. And so I invite you again to sit and think, where is this showing up?

28:26
Tackle the easy stuff first, right? Think about where this shows up, that it's not highly emotionally charged, but it would add some lightness and add some goodness to let go of weird energy that you have thinking that you have to do this in a certain way.

28:45
My friends, that's what I have for you today. Thank you as always for listening. If you would like to help support the show, there is a link down at the bottom that says support the show, and you can choose to make a very tiny, tiny monthly contribution, like two or three dollars. And that helps to offset the cost of the podcast. It is such a thing that brings a smile to my face when I see that listeners are contributing because...

29:14
It just helps me to know that this means something to you. And again, it's a little tiny thing that you can do to help be a part of this community. And I appreciate it so, so much. All right, take care. Have a great day. And I'll see you next week. Bye.