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  • The Reflective Doc

Breaking My Own Rules

The lead up to this holiday season has been challenging. Faced with the continued risk of COVID, planning gatherings, booking travel, and shopping indoors carry a particularly rife cost/benefit equation. Our family has just been trying to endure the late fall viruses slyly eluding our out-of-shape immune systems.

Never one to do things last minute, this year I recognize an almost obsessive commitment to finishing the shopping early, perhaps a talisman to secure a joyful holiday. Consciously, I realize each gift hastily hidden throughout my home cannot assure a peaceful or meaningful season, or begin to make up for the losses my children have faced these past two years. However, imagining an excited smile on their faces, rather than the disappointment of stymied experiences, spurs me on.

I know that I am not alone in the struggle to feel the joy of the season. I find myself missing those who are no longer here, and feeling guilty for not fully appreciating the opportunity to wake each day. However, I’m trying to treat myself gently, to avoid heaping self-criticism on top of the other challenging tasks of the day.

Anyone who has been reading the news these past two years knows that working mothers are struggling, especially those in health care. A recent study by Dr. Elena Frank, PhD and colleagues looked specifically at the difference between male and female physician parents during the pandemic. Compared to their male physician spouses, these physician moms were significantly more likely to carry childcare or schooling responsibilities, reduce their work hours, experience more family-work conflict, and suffer from depressive and anxiety symptoms, compared to prior to the pandemic.

All of these have been true in my household, and it has been a bumpy ride at times. Part of the impetus to write has been my guilt at limiting my psychiatry practice, despite the growing need for mental health treatment. I have also been working exclusively from home, hiding in my makeshift office and hoping my children, when home from school for many months, didn’t play, or something worse, too loudly in the next room. One thing I realized recently, however, was that the harshest critic of my response to recent events has been, in fact, me.

When I started paying closer attention to my thoughts, I noticed a daily tally of my activities, carefully categorized by how they aligned with the arbitrary rules I created. This then lead to an overall grade by the evening, reflecting either a “good” or a “bad” day.

For example: If I saw multiple patients, wrote a full essay, exercised, cooked a real dinner—i.e. yes to vegetables, no to frozen fish sticks—and engaged meaningfully with my kids, it was a successful day. Alternatively, one with few clinical duties, stale Halloween candy in lieu of lunch, and no exercise? Clearly a failure.

Not only was this list kept every day, it also became the arbiter of my worth as a human being. If only goal oriented, “healthy” behaviors counted, though, most of the fun actually happened in between these moments. Tickle attacks, silly dance parties, random conversations with my kids about the habitat of a gecko didn’t occur if I was laser focused on a constructive task.

Listening to many of these experiences reflected in my patients’ laments, I recognize the universal presence of self-criticism in these modern times. We cannot help but compare ourselves to others, and when the expanse of representation available online is far beyond the numbers with whom we can truly connect—suggested at 150 individuals by the British anthropologist, Robin Dunbar, PhD—we soon become overwhelmed.

Short of fully unplugging from our social media accounts, we need to find a way to buffer ourselves from the onslaught of lives we “should” be living. We must be vigilant in taking stock of our own responses to online and in-person interactions, and curate an environment that not only supports us, but also challenges us to learn and grow toward a life with depth.

I don’t have a prescription for finding meaning and engagement in life, but I know I won’t find it by scrutinizing every day for failures and lost opportunities. Instead I will continue to attempt a mindful approach to each day, trying to accept what is, learning to release what should be, and seeking self-worth not through productivity and success, but through love and purpose, one moment at a time.

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