Self-compassion

Dear Colleagues,

Physician burnout has continued to preoccupy us this year. All professional medical organizations are dedicating energy, individually and collectively, to better supporting physicians in identifying precursors of burnout, providing professional development in this area, and fostering resident wellness. Members have told us that the CFPC must continue to advocate for better infrastructure support for the complex care they provide; many think that without this, the effect of physician wellness initiatives will be minimal.

We live in a very dynamic environment—boundaries between personal and professional life are porous, leading to overwork¹; and electronic tools and wide access to information (“Dr Google”) leads to intolerance of uncertainty and expectations of immediate service. How can we ever manage and cope in such an environment?

I want to conclude 2018 with a column on this topic, from a position of strength, and remind us about self-compassion as an important component of resilience. Think for a moment about a time when a colleague or friend might have confided in you after experiencing a setback. You might have recognized defensiveness, self-blame, or blame directed at others, and would likely have responded in a supportive manner, providing hope and a balanced approach to the situation.

People who have developed self-compassion have internalized this approach. Typically, they are kind to themselves; they recognize and accept failure as a shared human experience, and they take a balanced approach to emotional setbacks.^2,3 Reflection is an important attitude to help us become more compassionate toward ourselves. Those who practise self-compassion tend to have a growth mindset. They view personality traits and attitudes as malleable and focus on “better” rather than on a predetermined notion of good or perfect. They develop the capacity to view their professional and personal lives as a trajectory, with opportunities to make course corrections if and when necessary. There is emerging evidence that self-compassion (kindness, understanding, no fixed negative judgment) helps navigate potential social disapproval and fosters authenticity and optimism.² In turn, these positive attributes create an emotional climate where one is more willing to take chances and accept potential risks.

Serena Chen suggests asking oneself 3 questions on a regular basis in relation to this: “Am I being kind and understanding to myself? Do I acknowledge shortcomings and failure as experiences shared by everyone? Am I keeping my negative feelings in perspective?”²

McKee and Wiens suggest paying attention to the following areas: First, curb the urge to overwork, as the cycle of trying to get on top of things can result in more stress, isolation, and feeling overwhelmed. The authors recommend practising mindfulness, spending time with loved ones, and dare I say it, getting more sleep. Second, stop beating yourself up. Acknowledge how you feel and recognize that others would likely feel the same in a similar situation. The authors also believe that giving empathy appropriately shifts the focus from the self to others, and that this is also helpful. Some of their recommendations are to build friendships with people you like at work, value people for who they are, coach people, and put your customers, patients, and clients at the centre of your conversation. The authors do caution about “caring too much” and of the need to pay attention to one’s limits.¹

What I retain of this exploration around self-compassion is that with practice and perspective we can do better, both professionally and personally. I hope that you will have the chance over the next few weeks to reconnect with family and friends and to recharge during your well-deserved time off. On behalf of all of us at the CFPC and the CFPC’s Foundation for Advancing Family Medicine, I wish you the very best for the holiday season and 2019.

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