This is my commentary on #twitter #movements. Before I go I want to preface this with a statement: I love humans. We're amazing creative & powerful beings. I'm fascinated by human behaviour and the hidden motivations underlying our basic need to belong. 1/
I've observed some movements taking off on Twitter. Some for #MedEd, raising awareness, knowledge sharing, inspiration and sharing failings, wounds & triumphs. Generally they support creative expression in 280 characters. Awesome! 2/
As these movements gain momentum, more people want to join in b/c #belonging. I'm seeing a disturbing trend of sharing experiences of patients/clients to promote how deep & human they are. Some are purely intended, some not. 3/
Where's the line between sharing testimonials for self-promotion & desire to contribute meaningfully to a conversation that doesn't compromise confidentiality & personal ethics? Wait, there's more. 4/
Here's the thing. One of the biggest businesses in medicine currently is #burnout prevention. Everyone's fed up: it's harming healthcare professionals, patients & destroying the system (good for forced innovation... oops sidetracked). Burnout causes are multifactorial. 5/
Some are external factors like abusive, exclusive & conformity-driven workforce cultures that leave little room for professional creativity, self-expression & performing the duties they actually signed up for before at least a decade of intense education & training. 6/
There are internal factors, such as feeling in control of your life, sense of personal & professional satisfaction. Literature says a lot about emotional exhaustion. I disagree. This falls into the causes of empathic drain/compassion fatigue. That's a thread for another day. 7/
One of the biggest drains of energy that contribute to burnout is not a shitty workplace, lack of self-care, busyness, interpersonal conflict or anything anyone is talking about. Are you still with me?

I'm talking about needing APPROVAL. 8/
Like belonging, approval is a basic human need. If you think about how we're raised, educated & promoted along a career path, it's mainly based on proving one's value based on a set of expectations, KPIs, GPA scores and so on. 9/
Sometimes (too often!) we'll go above & beyond to gain approval from the authority figure holding power that permits us to rise & succeed, according the implied & explicit cultural rules, regulations & standards. Our need for approval is primal & many will do anything for it 10/
such as publicly share confidential information, sensationalise private & personal experiences, self-promote for likes and any other soul sucking actions for a temporary fix of external validation (vs contributing valuable info/insight) b/c we have yet to learn how 11/
to generate the energy of approval for ourselves. Approval doesn't come with conditions based on what others think of us. It's always there, unacknowledged. The moral dilemma that's created from intentionally/unknowingly feeding approval addiction is draining. 12/
because it's sending a message to our very core that we matter only when others show us we do. It's complete BS. There is no amount of external 'likes' & validation that will ever satisfy our need to approve of who we are, where we're at in life & that our life matters. 13/
It's ok -we all have it because we've been conditioned to always seek approval from an authority figure: a parent, colleague, teacher, supervisor, culture, community, society, SoMe movement instead of being shown how to recognise signs of needing approval & to meet them ourselves
Checking in with ourselves before we post or declare something can help us avoid forming a habit that feeds burnout-promoting approval addiction. The energy required to maintain it is exhausting. The unresolved anger or sadness that fills us when we don't get it is draining. 15/
Ethical practice applies beyond the clinic into all our interactions in person & online. I strive to get better at this all the time. I also recognise that what I say about others has a ripple effect, even if they don't know I'm talking about them. 16/
We can honour those who are no longer alive by being mindful about what we share about them, not because we're trying to make ourselves look good or have something clever/profound to share on #SoMe. It's because their lives mattered & they're not able to speak for themselves. 17/
If we're about changing the healthcare culture to prevent burnout, let's make sure we're not perpetuating those practices here in #SoMe land. Inclusion because we each matter shouldn't come with a moral pricetag. Approval is an inside job.
#Wordsmatter
#Everyonematters

FIN
I can see the hypocrisy of tagging people. I'm doing so because I think they'll be interested. I'm thrilled if this starts a conversation or if this gentle rant helps one person to reflect on their habits & seek to form new self-fulfilling & energising ones.
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More from @NatsforDocs

May 24, 2018
I mentor & coach physicians on their wellbeing & how to use their energy wisely.

Just as there are people called to work in healthcare, it's my calling to serve those who help people in their most vulnerable times & phases of life to continually have the capacity to do it.
Somewhere along the journey to becoming a physician, students started believing that they should be able to handle everything they're exposed to & developed messy coping habits that impact on their ability to connect with others & self in healthy ways.
Healers need healers otherwise they will fail to recognise how their own suffering can become a source of wisdom to apply in their work with patients & in supporting their peers/colleagues. Instead, personal suffering or denial of it, can take one's mind into dark places.
Read 10 tweets
May 15, 2018
THREAD:

Being an entrepreneur comes with a sense of freedom & none of the institutional limits on creativity. Yet unless I'm consulting within an organisation or connected to community, it can feel lonely & isolating. Online communities are great for support but it's not enough.
I've seen the negative effects of people investing all their time/energy in networking online & draining group dynamics. I realised that one of my values is to participate in collaborations that involve physical meet ups or at least in the potential of physical meetups. 2/
What can I say? I derive inspiration from in person experiences. So it's not surprising that I notice changes in my thinking patterns & emotional landscape when my interactions are more virtual than physical. It's de-motivating & raises mental health alarm bells 3/
Read 20 tweets
May 11, 2018
#FridayNightMusings
The end of my week involves reflecting on my week and what I've learned from my experiences & conversations with others. Topics in my awareness are gender inequality in medicine, physician burnout, abuse in healthcare & sharing/oversharing our stories 1/
There are those here who strive to inspire peers, provide a space for connection & rally for change through the various discussion threads. It's clear to me that there's a lot of passion & desire to do great things in the world by those who I follow/see in my feed. 2/
I can also feel the collective frustration/anger/angst/sadness/resignation/sympathy/name that heavy emotion when any of our efforts aimed at success & liberation from system constraints appear to be blocked by injustice, abuse, ineffective strategy or poor communication. 3/
Read 17 tweets
May 1, 2018
I’m going to pitch in here. A lot of what’s considered burnout is actually compassion fatigue. Poor understanding of either which affects types of interventions, prevention & support available. Let’s also remember how boys are socialised to be ‘men’.
Depersonalisation: shut down of empathy to cope. Emotional exhaustion: too much empathy & absorbing emotional burden + vicarious trauma thrown in. Both contribute to compassion fatigue-looks like burnout but isn’t.
Burnout is related to untenable/unsustainable work conditions rather than emotional labour. Burnout is the signal that your ideal life doesn’t match your reality & you’re working hard to maintain what you have rather than make choices that move toward ideal. Energy sucking life.
Read 9 tweets
Apr 27, 2018
Some thoughts: There seems to be an assumption in #medicine that patients receive the best care based on best evidence, where evidence usually means quantitative research (my assumption). Yet quality of care is dependent on personal characteristics of each health professional 1/
Knowledge derived from evidence is insufficient to translate into behavioural changes that support the 'best care' intention. Science-based evidence must be channeled through unquantifiable characteristics expressed by each individual health professional to provide best care 2/
These characteristics include: empathy, kindness, unconditional positive regard, non-judgemental attitude, empathic listening, intuition, warmth, encouragement, hope and so on. If we're touting science-based medicine, it must also include practice-based evidence 3/
Read 11 tweets
Apr 18, 2018
Wellbeing preservation in healthcare (within your control)

1. Stable & trusting connections to others
2. Connection to self - meditation, self-reflection, self-examination ie. quiet time
3. Connection to your environment/Nature

#medtwitter #phdchat #MH4Docs #womeninmedicine
1/
4. Connection to your purpose (your Why) & desire to serve wellbeing of others
5. Peer support & group reflective practice w/ agreements to preserve confidentiality, respect, non-judgement & openness
6. Mentoring by someone who has qualities you want/admire & skills you need

2/
7. Therapy with someone who can see in you what you can’t ie. your strengths, growing edges & blind spots)
8. Have a life & interests outside of your profession
9. Trust your intuition by listening to it and following through. If something feels ‘off’ it is.

3/
Read 5 tweets

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