Have a Little (Self)-Compassion Free

Bethany T. Samuelson Bannow, MD
Assistant professor of medicine at Oregon Health & Science University

While the COVID-19 pandemic brought unprecedented attention to the problem of burnout among health care workers, for working parents and many others, burnout is far from a new issue. Still, the response to burnout from health care institutions has been felt, by many, to be unsatisfying. Repeated exhortations to be more “resilient” when health care workers are, by definition, extraordinarily resilient can be discouraging.

The reality of modern health care is that it is phenomenally stressful. As hematologists, we see people with severe or even terminal illness regularly. We are being asked to cover larger patient populations or even stretch out of our areas of clinical focus and expertise because of staffing shortages. To make matters worse, one in five physicians reported they will likely leave their current practice within two years, and one in three reported they will reduce work hours in the next 12 months.¹

Much has been published about strategies to reduce provider burnout, although many of them are impractical for a lot of us. While we wait for systems-level changes to improve the health care work environments,² there are a few things we can do to reduce burnout and emotional exhaustion.

In January 2022 I made one of the better decisions of my professional life and hired a physician coach. (Admittedly, this is a privilege in and of itself, but there is evidence it can improve quality of life.³) Allow me to share some of the simple and effective strategies she has taught me.

The first and best thing I learned is to practice self-​compassion. As physicians and health care workers, we are taught and expected to (and absolutely should) practice compassion for our patients. Many of us encounter them on the worst days of their lives, and we have all witnessed the effect that stress has on their well-being and ability to function and cope with other stressors. Yet as physicians we are often expected (and expect of ourselves) to function perfectly, regardless of how much stress we are under, what physical and mental illnesses we are suffering with, or how long we have had to go without rest, sleep, food, or even a bathroom break. Aiming for perfection in such high-stakes settings seems to make sense, but doctors are human, too, and we do make mistakes. As it turns out, how we handle those mistakes makes all the difference between whether we make the same mistake again later or learn from it, move on, and do better next time.

So how does one practice self-compassion? One randomized, controlled trial using a three-week intervention based on the following principles demonstrated greater optimism and self-efficacy and decreased rumination in participants who received the intervention compared to controls.⁴

1. Notice your own suffering. Most health care providers are trained to ignore our own fatigue, pain, emotions, and even physical needs in the interest of focusing on the job at hand. While I recognize this is sometimes unavoidable, taking a moment, when we have it, to acknowledge the difficulty of what we are facing is far healthier and more effective than ignoring our own needs or trying to forget they exist.
2. Notice how you talk to yourself. I’m not talking about muttering to ourselves as we go about our days (although many of us are guilty of that from time to time), but rather the things you say to yourself about yourself. When you do make a mistake, like responding to someone in a less than kind way, what do you tell yourself? That you are hopeless? A failure? That you always do things wrong? If that kind of talk is unfamiliar to you, fantastic! If it is all too familiar, as it is for many high-achieving professionals, rest assured it is a pattern that can be changed. Noticing how you talk to yourself empowers you to change it.
3. Start speaking more compassionately to yourself. Instead of beating yourself up or ruminating over mistakes, think about how you would talk to a good friend in the same situation. You would probably reassure them that everybody makes mistakes sometimes, remind them that they are under a lot of stress and pressure while being expected to function at a very high level, and encourage them that they will do better next time.

If all this still feels a little too “woo-woo” for you, consider this: Practicing self-compassion and using this kind of self-talk actually makes us better! Self-compassion fosters a growth mindset instead of a fixed mindset, which leaves us to believe we can do better, which leads us to actually do better. One study demonstrated that students who were taught to practice self-compassion after doing poorly on a difficult vocabulary test studied more than students who were given an external ego boost or who were told nothing, and they did better on their next test.⁵ If we truly want to do better, the best strategy might actually be to offer ourselves compassion and encouragement to try again, differently.

I hope that the next time you make a mistake, are a little too short with a friend, partner, or child, or don’t handle a work situation with quite the professionalism you’d like, you are able to take a breath and practice some self-compassion. You’ll do better next time.

Bethany T. Samuelson Bannow, MD
Associate Editor

References

1. Henry TA. Medicine’s great resignation? 1 in 5 doctors plan to exit in 2 years. Published January 18, 2022. Accessed June 13, 2022. https://www.ama-assn.org/practice-management/physician-health/medicine-s-great-resignation-1-5-doctors-plan-exit-2-years.
2. Sinsky CA, Brown RL, Stillman MJ, Linzer M. COVID-related stress and work intentions in a sample of US health care workers. Mayo Clin Proc Innov Qual Outcomes. 2021;5(6):1165-1173.
3. Dyrbye LN, Shanafelt TD, Gill PR, Satele DV, West CP. Effect of a professional coaching intervention on the well-being and distress of physicians: a pilot randomized clinical trial. JAMA Intern Med. 2019;179(10):1406-1414.
4. Smeets E, Neff K, Alberts H, Peters M. Meeting suffering with kindness: effects of a brief self-compassion intervention for female college students. J Clin Psychol. 2014;70(9):794-807.
5. Breines JG, Chen S. Self-compassion increases self-improvement motivation. Pers Soc Psychol Bull. 2012;38(9):1133-1143.

The content of the Editor's Corner is the opinion of the author and does not represent the official position of the American Society of Hematology unless so stated.

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