Beware of looking for goals: look for a way of life. Decide how you want to live and then see what you can do to make a living within that way of life. ~Hunter S. Thompson
The Math of Self-Reflection
My clinical supervisor once gave me a powerful equation to help reflect on just how crappy it can feel to be confronted with uncertainty and ambiguity, two of the inevitable realities of life. Think about a spectrum: on one end is what he calls our “ego ideals,” in this context the goals that we are so often admonished to make ever clearer, SMARTer, and unfortunately more commanding of our attention and emotional energy, especially around the New Year. On the other end of the spectrum is “realistic expectations,” or the practical limitations imposed upon us by our environment and individuality. He said that the degree of discomfort we feel is equal to the degree of discrepancy between our ego ideals and our realistic expectations. The wider the gap, the worse we feel. The task is to bring the two ends of the spectrum closer to each other in our thoughts and our behavior (from both ends, as it were), which leads, one hopes, to a greater sense of well-being and contentment, and of ideals and expectations that work in harmony.
Some of this equation’s implications have been studied in veterinary medicine as an outgrowth of human medical training and throughout the history of psychiatry (see further reading). The research centers around discovering and measuring one’s “tolerance” for both uncertainty (future-oriented worries) and ambiguity (present-oriented problems). Researchers are starting to ask just how comfortable we are with not knowing, how important to our self-worth it is to appear and act as the “expert,” and whether we find simple or complex problems more interesting.
As veterinary professionals, we work in situations rich in ambiguity and grapple with plans and decisions equally rich in uncertainty: managing patients with multiple diagnoses, winning the trust of owners with complicated circumstances, sorting through conflicting or paradoxical findings, the need to make decisions with less than 100% of the facts, the individual differences in how patients respond to treatment, and gaining a client’s trust when we are unsure of a prognosis, to name but a few.
We all know the standard prescriptions: more self-care, build resilience, and so on. Those will not help us here. To simplify our dilemma, we can think about treating ambiguity and uncertainty as either problems to overcome, or realities to embrace. I suggest that the more we apply the latter option, the more we increase our tolerance of the unknown, and eventually our ability to move toward our fear of it in order to grow. We might be surprised one day to notice that the goals have achieved themselves, for we ourselves have changed. We have learned to move and feel freedom within our limitations while striving to expand them. We are OK with not being “OK” all the time.
The Goal and the Way
Regardless of the level of formality we bring to the idea of goal-setting and personal and professional improvement, contaminated as it has become by the emergence of whole industries profiting on our deepest fears about the unknown (but that’s another rant), we might agree on one point: goals are changes that we can’t see yet. That’s what makes them so painful and scary to work on. No matter how convinced our brains might be that a course of action is right, we still must make our bodies do the movements of that course as our confidence and motivation inevitably wax and wane. In my clinical experience, there comes a point where a client has talked about the issue enough and needs to go away and try out their changes in real time and actually have experiences. There is a saying in the recovery community: “you can’t think your way into a new way of acting, but you can act your way into a new way of thinking.” Sometimes the only (and therefore best) reason to do anything is so you don’t have to think about it anymore. Do something on the outside to make a change on the inside. In the practice of cognitive behavioral therapy, the phrase is “motivation follows action.”
This is only to remind us that what we want for ourselves is sometimes just the state of mind that we’ve referred to as “OK.” We want to feel competent, successful, respected, and safe. How we move ourselves back toward that state when our environment throws us out of it often has its answers in moving our bodies (see practical suggestions), or changing our sensory environment in some way, or making ourselves speak out loud a truth we’re afraid to tell. It’s in behaving how we’d like to be, not how we are, even and especially if we don’t feel it. It’s a sign that we’re building strength and nurturing a way of being that allows goal-directed change to happen.
So, whatever your goals are as a new year begins, maybe think about ways to embrace both ambiguity and uncertainty, to hold onto the desire to make changes, and to find relief in movement when we can’t see the change. These suggestions are applicable to professionally related goals, but feel free to translate them to all areas of life, in hopes of bringing our ideals and our realities a little bit closer to each other.
Sitting with the Ambiguity
- Speak your doubts freely with clients. Honesty always builds trust (see Reminder below).
- Try out this conversation guide for help with the tough ones.
- Don’t apologize for not knowing something.
- Don’t apologize for how you feel.
- Don’t demand such apologies from others.
Moving into the Uncertainty
- Let the client participate in creating the treatment plan.
- Speak your doubts freely with peers. Include them in your thought process. (see Reminder, again…)
- If you have to make a decision with insufficient information, don’t do it alone.
- When you feel stuck, get up and walk.
- Notice how your body feels before, during, and after your shift. If it takes more energy and attention out of you than it gives back space for, that’s a sign of unhappiness.
- Be open to the possibility that what you thought was the “ideal” doesn’t fit with what your body is telling you, and that radical change (like leaving a job) is on the table.