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The Physician Philosopher Podcast

TPP #21: Choose Curiosity Over Shame

We all have habits and patterns that we live in day by day. Some of these habits are automatic and we don’t even realize we do them.

Larry Keller

When are new to trying to break these habits it can be do easy to become discouraged and not follow through with what we were hoping to do. When this happens it’s so easy to fell shameful and beat ourselves up for our failures.

The good news is, you don’t have to feel any shame! When you “fall off the band wagon” and back into an old habit, it’s not the end of the world. Take the time to get yo know yourself and why you make those choices and feel those feelings.

You’ll be right back at those good habits in no time!

Today You’ll Learn

  • How to break those automatic habits and routines holding you back.
  • Avoiding feelings of shame when you fall back into an old, bad pattern.
  • How to get to know yourself and why you do the things you do.
  • How to allow an urge without giving in to it.
  • And more!

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We all have things that we're working on. Things that we're trying to be better about. So whether you are trying to lose weight or save money, how you treat yourself when you fall back into your old patterns, your old routines has everything to do with whether you're going to accomplish your goal or not keep listening to find out why you should choose curiosity over time.

This is The Physician Philosopher Podcast. I'm Dr. Jimmy Turner, an anesthesiologist, personal finance blogger, and life coach for doctors. The Physician Philosopher Podcast teaches you how to create the life that you deserve. One thought at a time. Start before you're ready. Start by starting. Start now.

Hey. Hey. Hey, everyone. Welcome to episode number 21 of The Physician Philosopher Podcast, where we take an uncurated and unapologetic look into physician life. Before we dive into the show, I want to mention an awesome opportunity that I really don't want you to miss out on. The Alpha Coaching Experience, our premier coaching program meant specifically to help doctors find balance and create the life that you want and deserve, that's going to be opening up February 13th. It only opens up two to three times per year. However, you don't have to wait to say that you're interested. The waitlist for the Alpha Coaching Experience is open right now, and in fact, if you sign up for that waitlist, there is going to be a $500 discount off the pricing for coaching, when the enrollment opens. So by signing up, you're just simply saying that you want to learn more about the Alpha Coaching Experience and what that offers.

This online coaching program does include coaching on a variety of topics, including life and career coaching, for busy and burned out doctors or those thinking about making a career change. It also includes money and business coaching for those considering starting an online physician side gig or side hustle, entrepreneurial effort. So if you're a doctor who feels overwhelmed by all the responsibilities you have as a partner, a parent and a physician, maybe you're burned out and looking for options, or you just want to see what's causing all the buzz with this physician coaching stuff. The Alpha Coaching Experience waitlist is open right now. Make sure to sign up so that you can get your exclusive discount when enrollment opens. You can sign up for the waitlist by going to thephysicianphilosopher.com/waitlist, or by clicking the link that's in the show notes or the description on your podcast player for this episode.

All right. Today's thought is this. When you were trying to make a change in habits and slip back into your old routine, choose curiosity over shame. What in the world does that mean? Well, our human brains are really interesting. We make goals to become better all the time and through brute force or white knuckling, we try to lose weight, spend less money, save more money. We try to stop drinking alcohol, get off our cell phone, stop biting our nails, pray more, be more spiritual, or whatever's going on for you. In order to change any of these things, we have to change our habits and eventually we have to change our identity. So I'm going to talk to you more about this in a show in the future, about changing your identity and your habits and how to go about doing that.

For this episode, I want to talk about what we do when we are trying to change our ways and we fall back into our old routines, our old patterns, the way that we've always done things. Really when this happens, the most common thing that people do is that we shame ourselves. Do you shame yourself when you're trying to lose weight or exercise more and you skipped an exercise or you eat what you promised you wouldn't? Or do we try to improve the process when we fall off the horse? Do we try to take a tactic towards curiosity? As an example, I had a client who had previously decided that he was going to start eating better. Consciously, he made that decision to have a healthier lifestyle for both him and his family. Yet every time his food of choice was put in front of him, and if I recall correctly, it was pizza, I think, or ice cream, he felt like he couldn't help, but eat it.

It wasn't even a choice. It was just automatic, pizza put in front of him, therefore he ate it. Part of this also came from many of his baseline thoughts on food. He had this background, for example, where many of us come from actually, this idea that you have to clear your plate for dinner. So he'd make himself a big plate and he'd clear his plate. He also felt like many of the food choices that he made weren't really choices. They were just automatic. They were decisions that were made without seemingly any thought involved. Now, that's not exactly true. And it's interesting there too. I'll just throw a little snippet out there from something I've learned from other books about habits and about eating, is interestingly, smaller plates lead to smaller portions and smaller eating. But when you come from this big plate, clear your plate mentality, he was set up in this way that he was going to keep eating.

Now that's not the way that it really works. This automatic part of it, at least. There is a thought in there, but it happens so fast that we don't even realize it. This is the way that it is for many of the things in our life. When you snap at your kids or your partner, your spouse, oftentimes you're like, "There's no thought in there. I was just really mad, and so I snapped." That's not really true. But it happened so fast. It does seem automatic. There is a thought back there, an identity, a thing that sets you off to eat the food or snap at the kid. The way that you dive into that is by looking at things and making some progress with intentional choices. For eating food, we worked on making intentional choices with this client's food choices.

It turns out that when we are trying to break automatic habits, one thing that helps with this is deciding more than 24 hours in advance, what you're going to eat for dinner so that the choice doesn't seem so automatic. You're making intentional by deciding in advance. So you make the dinner choice, well in advance and now you're less dependent on that urge to eat whatever's put in front of you. That's the way it works. Same thing for alcohol, same thing for being on your phone, biting your nails, saving money, spending money. Any process where you have an urge, a desire, and then a reward, which is usually dopamine by the way, anytime that process is going on, the way that you start to deal with that is by doing two things. I'm just going to mention them in this episode. That's not what this episode is about.

But the first is to allow the urge, to know that it's there, without giving into it, to notice it. The second thing is to be intentional about your decisions in the future. So tomorrow, we're going to have this for dinner. This is how much I'm going to eat. This is why, and I'm going to set up all the parameters for it. Now, when you do that and you make things intentional, you don't get that same hit of dopamine that you get when someone slides a plate of food in front of you and you just start pounding away at it. Because there were some intentional process put to it, and some intentional decisions made about why you're eating, what you're eating.

So after all, this is the process that really happens in the back of our minds, that goes on all the time. In a way, if you're going to put this in a phrase, this is really about habit formation. Whether we're trying to create a good habit or break a bad habit, it all happens in similar ways. The problem is this. That process takes time. So what do we do when we're in the learning process, we make some progress, but then we fall into one of our old patterns, routines, our old ways? We fall off the horse, as they say. That's what this show is all about. Because I found in time that we can talk about creating intentional plans and techniques and tools to help you accomplish your goals, but inevitably, you're going to be human and you're going to have a human brain. That is going to lead to situations where you fall back into your old ways.

If you don't have a healthy way of dealing with that, then it inevitably is going to just make you fall back into your old ways and your chance of progress going forward is just next to nothing. Actually, this is what happens too, with procedures. This is what happens too with bad outcomes with patients, where we choose to shame ourselves for those things instead of looking at the facts and making sure that the story that we're telling ourselves is fair. Instead, we often shame ourselves and determine that we must be a terrible doctor because X, Y, or Z happened. So let's take our friend who was trying to eat better earlier as an example, and just to truly point out this idea of choosing curiosity over shame. Let's say that he's trying to work on not eating dessert with dinner each night.

He's previously eaten dessert every night for dinner for the last two months, and now he's making the decision that he doesn't want to eat dessert anymore. That's where he wants to start. So he makes a decision not to do this except on Friday nights. But last night was a Wednesday and some friends stopped by and he definitely ate some apple pie that they brought and some ice cream. This is the moment of truth. This is the scenario where it's not a Friday, he decided intentionally he wasn't going to eat dessert except on Fridays, and he just ate dessert on Wednesday. This is how it would normally work. This is how most people operate. The first thing that happens of course, is that he ate the pie and the ice cream, not on a Friday, and has a thought, "I can't believe that I did that. I can't believe that I ate that apple pie when I decided I wasn't going to do this anymore. I am a terrible person. I'm not making my goals. I'm setting a horrible example for my kids. Oh man."

I just feel shame when I say all that, even into a microphone right now, but certainly the person going through this would feel shame. That shame makes us ruminate on our decisions. This person's going to beat themselves up, judge themselves, question their resolve. You know what ends up happening after you have that shame cycle where you just shame yourself and ruminate on how terrible you are, is that you end up eating more apple pie and more ice cream. So you end up doing the very thing that made you shame yourself in the first place. It's a cycle. This happens. Think about it. With cell phones, alcohol, biting your nails. I mean, anything. This is what happens. You have a bad patient outcome. You shame yourself into thinking you're a terrible doctor, living in that mind space, there's a higher chance that you're going to provide worse care to patients going forward. It's not a helpful space to be in.

This, my friend, is what happens when we choose shame. It is a useless, judgmental feeling. It assumes that we need to be perfect and that when we're not, and we don't live up to that, it pushes us to accept that we are a failure. Shame is not helpful ever. We can't change, so we should just give up. That's what you do when you have shame, right? Now, this is different than having a moment of pause and thinking and regret and saying, "Ah, I shouldn't done that. Let's figure out what we should do going forward." That's different. I'm talking about just shame, where you are beating yourself up. This really sets up an either or fallacy. That's what shame does. Where we're either holding to our new habit or we're failure. There's no ground in between to learn. There's no learning process. We're either successful or not. It's an either or a fallacy.

When we think like that, then we tend to do what's called overgeneralization, where we take that failure, that shame is now teaching us that we've become, and we over-generalize that to everything. "Well, I'm just a terrible dad. I'm just a terrible husband. I'm just a terrible wife. I'm a terrible mom." Whatever your situation is, and then you take that shame and over-generalize it to the rest of your life. "I had one bad patient outcome. Therefore, I am a bad doctor." That's ludicrous. You're ignoring other 99% of good patient outcomes that you've had because shame is that powerful. It will let you take one moment, one example, one instance of difficulty failure, bad outcome, and let you define yourself through it. It is toxic.

It's not perfection that separates the elite from the average. It's consistency. It's not about getting it right every single time. It's just about being more consistent in the direction that we're trying to go with each passing day. Even the elite forget to work out, meditate, write daily, create, eat healthy on occasion. I know registered dieticians that don't eat healthy all the time. I certainly know people that are crazy fit that skip exercises every once in a while. I know pastors who drink too much or forget to pray because we're human. This is exactly the idea that James Clear, the author of Atomic Habits, gets at when he says, and I love this quote. He says, "Every action you take is a vote for the type of person you wish to become. No single instance will transform your beliefs, but as the votes built up, so does the evidence of your identity."

Now I want to read that one part again. No single instance will transform your beliefs. What he's saying is every day, in every action that we take, we're casting a vote for the type of person that we want to be, our identity. Now, as long as the votes casted add up more for the person we're trying to be, then they do against it. As long as we're consistently working in progress towards that goal, we're on the right track. Now, no single instance determines whether you're a success or failure. You are more than the sum of your mistakes. You're more than the sum of your successes. Essentially, what I'm trying to say is that the sum of your successes are just pointing you in a direction that you're trying to head. You just want those sum of your successes to outweigh the sum of your failures. Making one decision that goes against the habits you're trying to build is just one instance. It's one moment. It is a single vote, but we have a chance to vote differently the next moment, the next day, for the rest of our lives.

So when you fall off the horse, recognize that's just a moment to reflect on what happened and how do we do that? How do we reflect on it so that we continue to cast votes for the person that we're trying to become? Well, my friends, instead of choosing shame, which leads to inaction and overgeneralization and terrible outcomes, we have another choice. Instead of choosing shame, we can choose curiosity. Instead of shaming ourselves with how bad we are and how we can't believe we slipped into our old routines or choices. We had that pizza, or we had the apple pie and the ice cream on a Wednesday night when it wasn't a Friday, and we decided we weren't going to have dessert outside of Fridays. Instead of getting mad that you had the unhealthy meal, shaming yourself because you looked at pornography again, regretting the money you spent, the money that you said you didn't intend to spend or hating yourself because you had the third or fourth drink, when you said you stop at two.

No matter what we're talking about. It can be any of these subject matters. Things that we're trying to work on, bad habits, we're trying to break good habits that we're trying to form. Instead of choosing shame, you can choose curiosity. You can recognize that you're a human with a brain, having a human experience. That's often something that I'll tell myself. "I'm just a human, having a human experience." We take an uncurated look on this podcast, and so I'll tell you. The other day, I totally felt overwhelmed by about 50 different things that were going on, went upstairs and my wife pointed out something else that I needed to be working on. I honestly... I just felt overwhelmed. I snapped at her. I snapped at my wife, Kristen. No excuse for it. I own that. It was my thoughts that led to my actions. It wasn't a proud moment for me, but you know what? I got a chance to reflect on that and to have a moment to say...

Instead of taking that moment and saying, "Jimmy, you're such a terrible husband. I can't believe that you just snapped at your wife like that." I took that moment, and instead of embracing shame, I took curiosity and said, "Hey, I'm human. I'm fallible. I make mistakes all the time. Welcome to humanity. How can I learn from this? What can I do, going back to Kristen, when I apologize? To explain what was going on in my head, why I shouldn't have done what I did, and how I can be better. How we as a couple can be better going forward when moments like this happen." And it was positive. It was great. It was actually super helpful after the fact and afterwards, our marriage was stronger because of it. I'm a human, having a human experience. I cast a vote in the wrong direction in that moment, but then following up, I cast a vote in the right direction several times for the next few days.

So recognize that you're human. That's one way to start. Another way to start is to recognize that you can ask questions about what happened to lead to that outcome. What was going on at the time? What were the triggers or circumstances, like our apple pie, ice cream eating client that we're talking about earlier? What was going on? People came over, they brought ice cream and apple pie. What were the triggers or the circumstances? What thoughts were you thinking that made it easier to slip into your old routine? Like, "Oh, it's just one piece." It's just some ice cream. Yeah. I'm just going to make this one exception."? What could you have done differently? What could you do differently next time? Is another way to ask that. So basically you're preparing your brain for, "Okay. Hey, this isn't the only time it's ever going to happen. What can I do differently next time? How can I learn from this experience?"

What you'll notice is, instead of taking shame, which makes things about an individual and how terrible we are, curiosity wants to fix the system. It wants to make a process improvement. It wants to make things better next time through the resources that we have. Shame is an individualized hate moment, moment filled with hate, I should say. Whereas curiosity is an opportunity to improve the process going forward. Instead of choosing shame, you can think, "Huh, that's interesting. I wonder why I did that." In other words, you can learn from this experience instead of judging it. So shame works towards an action, curiosity works differently. I gave you that model earlier. The apple pie shame after having the thought of how, "I can't believe I did that." Then all the inaction or rumination and the tendency to go and eat more apple pie and ice cream after. In fact, that's what shame does that. It leads to inaction and bad results.

This is how curiosity works. Same circumstance, apple pie and ice cream. Instead of shaming himself, he could have said, "Huh, I wonder why I did that. Maybe it's because we had friends over. I wonder what I could do next time." It's a curiosity approach. Looking at ways to politely decline dessert maybe, the actions that come out of that, allowing urges without giving into them, explaining to people, without the people pleasing that might've been behind, that you're only going to eat dessert on Fridays. You'll save it for Friday. Thinking about creative solutions basically. That will allow you, through curiosity, to have progress toward the goal, even though you had the apple pie and the ice cream on Wednesday that you didn't mean to have. Now, why should we do this? Why should we choose curiosity over shame? I want to end the show by going over some of this because I think it's so important.

There are a couple of really big reasons why we as doctors should choose curiosity over shame. Number one is that self compassion is so important. Unfortunately, self-compassion is also something that many doctors lack. We expect perfection. We expect ourselves to live up to the standards that we've set, and when we don't, we shame ourselves so much. We have so little self compassion for ourselves. Despite what the outside world thinks, we can often have a very low view of ourselves. I know lots of doctors that when they get in a coaching session, are brought to tears because of what they actually think of themselves. The world may think that you're arrogant or prideful, that you accomplish all these amazing things, you're paid so much money, that you're successful in every possible way of defining that word. When it comes down to it, when you're honest and vulnerable, you hate yourself. You think low of yourself. You're lonely. You're miring yourself and shame and regret for decisions that you've made.

I'll just give you an example of this. I used to have a quote on my desk, back in our old house when I first started residency, and this is what it said. It's by Henry Ward Beecher. If you like this quote, I'm not hating on you, but I can tell you right now that I'm not a fan of it anymore because of the lack of self-compassion that it had for me. But this is the mentality that medicine produces. This is what Henry Ward Beecher said, "Hold yourself responsible for a higher standard than anybody else expects of you. Never excuse yourself. Never pity yourself. Be a hard master to yourself and be lenient to everyone else." So this is all about high responsibility, no excuses, no pity, be a hard master. I think Beecher's quote is crap. I'm going to say right now. I used to love this quote because I had this idea of being lenient to other people, but having incredibly high standards for yourself. Oh man, I did.

You know where that led? It led to me having lots of very strong opinions about how big of a failure I was, even though everybody else in the world saw me as nothing but a raging success, winning awards, publishing, building a successful business, as a dad, as a husband. That's what everyone else saw, and my opinion of myself was total garbage. I thought so lowly of myself because I was a hard master. I didn't have any pity. I didn't excuse myself. I think that I'm still a big fan of having leniency on other people, but I want to be a person that seeks to become better. Who seeks curiosity and who avoids shame. Now, that doesn't mean avoid negative feelings. I'm willing to feel disappointment or failure or work through a lot of hard feelings that actually work towards progress. Shame isn't one of them. Shame is an indulgent emotion that gets you nowhere, and that's what happens when you, I have this unreasonable expectation about mistakes and perfection.

Instead, I now want to choose curiosity. I want to have self compassion towards myself when I make mistakes, and I encourage my clients to do the same thing. All the podcast listeners that are listening right now, have compassion on yourself when you make mistakes. That one single instance does not mean you're a bad doctor, it does not mean you're a bad partner, a bad parent. It doesn't mean you're bad at whatever realm that thing happened in. You happen to be a human, having a human experience, who cast a vote in a direction different than the one that you've decided to become. Guess what? Tomorrow's a new day, you have the opportunity to be curious about how to improve that process, to have some self-compassion to forgive yourself and then to move forward. That part, my friends, is infinitely more important than the mistake you made.

The second reason is what I've hinted at earlier. Shame leads to inaction and getting stuck in our old routines. Curiosity, on the other hand, encourages progress. So curiosity is that systematic approach that makes the system better. The way that I like to think about this is the story in the 1970s Tenerife accident, as March of 1977 killed around 600 passengers because two pilots were involved in a system that didn't allow people to question the head pilot. The pilot of the plane was God, and you were not allowed to question them. Through that investigation and realizing that it was the culture that led to the accident that killed 600 people, the airline industry inserted what's called crew resource management, which is a tool system that allows people to look at the system without pointing fingers at individuals. That's what shame does.

Shame points the finger at you and makes you feel terrible about who you are, so you don't do anything. You don't change. You just stay how you are because you're a failure. Crew resource management, looking at the system, being curious about what happened and why and what can be done better the next time, that systems-based approach is what can allow us to move forward even though there were mistakes. Similar to burnout and moral injury, we can focus on individual doctors and blame them and tell them, "You need to go meditate more." Nothing's going to change. Nothing's going to change. It's not the doctor's fault. Or medicine could pursue curiosity about our systematic and systemic problems and make burnout and moral injury better by improving the system that is currently burning out the doctor.

So choosing curiosity over shame has a variety of applications, but it is always better to do this than to choose shame. So the next time that you do something you said you wouldn't do, or you're not making the progress that you want towards a goal that you set, you slip back into your old routine or old habits, don't shame yourself into inaction. Instead, choose curiosity about the human experience you're having and how you might improve upon things the next time. So today's thought is this, when you're trying to make a change in habits and slip back into your old routine, choose curiosity over shame. Until next time my friends, start before you're ready. Start by starting. Start now.

My dad, Dr. Jimmy Turner, is a physician, first personal finance blogger, and a life coach for doctors. However, he is not your physician or your life coach. He also isn't a financial advisor, financial planner or accountant. Anything discussed in this podcast is for general education and entertainment purposes only. Life coaching is not a substitute for therapy, medicine, or medical treatment. However, if you're a doctor looking for a life coach, you can reach out to my dad at [email protected]

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