LESSONS LEARNED THE HARD WAY:

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LESSONS LEARNED THE HARD WAY

• A Personal Story of Denial, Illness and Recovery

Presented by Marsha W. Snyder, MD. Center for
Physician Success and Wellbeing Bethlehem, PA.
USA Saturday, Sept.5, 2009 Adelaide, Australia
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Questions

• Estimating by percentages, draw a pie chart of
  how your time is divided in a typical week.

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Questions

• If money and location were no object, what would
  be your ideal job? Give details.
• Identify your two greatest passions in life
  (things that get you excited and are
  energy-generating)

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Professional Demands Side of Stress in Healthcare
Professionals

• Long work hours
• Lack of sleep
• Constant life and death decisions
• Constant responsibility for the care of others
• Poor life balance
• Poor self-care

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My Unique Demands

• Single parent of two young children both
  diagnosed with autism
• Living 50 miles away from my workplace for the
  first 4 years I worked there
• Chairman of department, taking over from a doctor
  who had died with AIDS

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Although I was aware of feeling tired, had normal
PEs and lacked awareness of stress or lack of
life balance.

• DECADE LONG DENIAL!!

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Denial and Its Consequences

• -- ITS JUST STRESS
• -- I SHOULD BE ABLE TO MANAGE ALL THIS STRESS.
  I NEED TO DO BETTER.
• -- PEOPLE MUST THINK I CANT DO MY JOB. THEY
  THINK IM SLACKING OFF.
• --Self-care not taught to doctors. Self-neglect
  is glorified

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Consequences

• Burnout distorts our perception of our personal
  resources I am unable to change my circumstances
  or make them better
• Self-alienation distances us from our values,
  purpose and priorities Keeping up the doctor
  image
• Social withdrawal distances us from our support
  systems No one will understand no one can help

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Perfectionism

• Reinforced and exacerbated by medical training
• Creates perception that nothing I ever do is good
  enough to justify a feeling of self-satisfaction
• Reinforces low self-esteem as well as chronic
  disappointment in others

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The Result

• By early 2001 I felt burned out I cant go on
  like this
• Chronic job and life dissatisfaction
• Feeling trapped and overwhelmed
• Disconnect of values and desires from day-to-day
  reality
• Chronic discontentWhy am I so unhappy?

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Descent into Illness

• December, 2001
• 2002-2003couldnt walk or work
• Couldnt get a diagnosis
• The doctor as patient

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What happened to Dr. Snyder???

• Loss of identity and control
• Loss of direction and sense of purpose
• Loss of loves

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The Consequences A Model to Conceptualize the
Self
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Essential SelfCenter ofpassion, true desires,
and purpose--
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Dissonances Hurts, long hours, education,
sleeplessness, death, isolation, etc.
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Bounded Self the rigid, inflexible, outer
veneer the face we show to the worldHow we get
stuckThe doctor
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We live our lives, make decisions, to reinforce
this hard outer veneer

• Outer image very important
• Dependence on approval and acceptance of others
• Denial of personal problems (physically and
  emotionally)
• Our work becomes our identity
• Whose value system?

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Crisis causes cracks in the outer veneer Robs us
of our identity, but can lead us back to our
essentialness.
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Self- discovery and Self-control---The baby steps
forwardSelf-knowledge

• 1) Trusting yourself and the world around you
  your world is what you choose to see and create.
  Our focus and intention create a benevolent
  universe

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Visioning

• 2) Identifying what you most desire to be and
  accomplish. Using your gifts toward a mighty
  goal. What gets you excited?

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Taking Responsibility

• Transforming your vision into intentions and
  actionable steps.

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Celebrating

• Acknowledge and rejoice in each small victory.
  Developing a new found gratitude
• for your bountiful gifts and opportunities

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Letting Go

• Dealing with frustrations and upsets through
  positive, authentic communication with self and
  others. Learning and growing from frustrations
  and roadblocks.

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Discovery of Noble Purpose SERVICE TO OTHERS

• I use my strengths and talents in service to
  others while taking care of myself and setting
  healthy limits
• Listening to the true callings of the heart and
  pursuing them in order to improve the human
  condition and serve others
• Medicine as a passion to heal and lessen suffering

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Self-awareness and self-focus are not
selfish!Knowing yourself is essential for career
and life satisfaction
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Self-awarenessSelf-discovery and self-control

• Recognition of ones emotions and their impact on
  others
• To accurately assess ones strengths and
  weaknessesself-respect and self-love
• To live life in concert with ones values,
  passion and purpose
• Ability to set realistic goals and
  expectationsreleasing perfectionism

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Looking back on the questions you addressed at
the outset of todays programWhat percentage of
your pie chart in question one includes your
ideals and passions from questions 2 and 3?
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Defining your own passion, purpose and personal
goals as a physician

• Your personal visionWhat do I really want?
• Steps you will take to achieve your own goals and
  vision
• Learning and growing from battles lost
• Make decisions and take action
• Celebrating successes
• Remaining grounded in your own goals in spite of
  distractions

Tuesday, April 8,2008
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Make Decisions and Take Action

• If you always do what youve always done youll
  get what youve always had
• Success and fulfillment requires solid decision
  making and positive action
• Clarify what you need and take positive steps to
  achieve your goals and desires
• CAUTION AHEAD!! Need for continuity

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Focus on What You Want Not What You Dont Have

• Regard negative emotions as information about
  what you dont want
• Know yourself, your talents, needs, priorities
  and values
• Develop a positive vision for your life based on
  them
• Focus on positive change

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Manage Perfectionism

• Set realistic goals for yourself and others
• Learn to say no to requests that are
  unreasonable or exhausting
• Accept mistakes and negative events as the path
  to learning and success
• Let go of the need to control everything and do
  it yourself.

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Self-empowerment

• Knowing you have the freedom to choose how to act
  in, and respond to, difficult situations
• Know what you want, know your values, and make
  choices based upon them
• Realize that at any time you have the ability to
  make changes in your life
• Reclaim your sense of purpose and passion and
  build your life around them

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Healing, purpose, service

• When we are self-aware, living our passion and
  purpose, we are healed and can be healers for our
  patients.

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The Value of Connection