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The Physician Philosopher Podcast

TPP 52: Self Coaching Through Physician Mom (or Dad) Guilt

Editor’s Note: For this week only we are offering a free, LIVE masterclass called “How Doctors Can Stop Feeling Trapped in Medicine: 3 Tools to Help Physicians Finally Practice Medicine on Their Terms”.  So, if you are a physician who feels trapped in medicine, make sure to save your seat! The masterclass is only available for one week, and seats are limited. Click here to reserve your seat

Larry Keller

It is my experience that shame is one of the many things that lead to a physician feeling powerless and trapped in medicine.  Often times this shame is a result of feeling like a bad spouse. Or a bad parent.  And, sometimes, it is even the result of feeling like a bad physician.  This shame can look different, but it usually produces the same result. A failure to find work-life balance in medicine.

When physicians feel trapped in medicine they often know that they need to make a change, but they just don’t know how to get started. It is not a coincidence that the tagline for The Physician Philosopher podcast is to “Start before you’re ready. Start by starting. Start now.”

But how do doctors get started when they feel trapped by the mountain of student loan debt they have? Or by the shame of not feeling like a good mom or dad?  Or when they feel completely out of balance and ask to go part-time, but are told by their leadership that the group cannot afford it?

It is easy to see why so many physicians feel undervalued, overworked, and unappreciated. Many are burned out or morally injured in medicine. They have thought about changing jobs, going part-time, and some have even thought about leaving medicine altogether.

However, this all begs the question… Instead of asking what makes them feel trapped, often a more useful question is asking “why do physicians feel trapped?”

Work-Life Imbalance in Medicine

Usually, the answer is that medicine is taking their time away from something else that is important to them. The root of the problem always comes back to a lack of autonomy.  As I often say, “When you say ‘yes’ to one thing, you are saying ‘no’ to something else.”  And – usually – what you are implicitly saying “no” to is something that matters to you.

Like your friends and family.  Your hobbies.  Or exercise and sleep.  You know, the stuff that matters?

And this often produces shame as many of our physician clients in the Alpha Coaching Experience (ACE) struggle with not feeling like a good spouse.  Or a good parent. 

This struggle of feeling like you are being forced to choose between medicine and your family happens a lot.  It is actually really common among the clients we coach in ACE.  

Being a Parent and a Physician

Recently, in our current group of clients inside of ACE, we had a client come on the weekly large group coaching call.  She is an amazing physician.  Yet, she and her family felt upside down in their student loan debt burden.  This required her to work full-time so that she could maintain Public Service Loan Forgiveness as an option.  So, she felt completely burned out and trapped in her situation. 

To compound this problem, she felt like she worked too much, which prevented her from being around her children enough.  They would often clamor for her time and when she had to go back to the hospital, they would ask her why she had to leave.  They’d ask, “Can’t you just stay home with us?” 

The result was that she felt like she was not being a good mom. That her kids deserved more of her time.  Yet, she couldn’t give it to them because she had to work full-time in medicine to pay back all those student loans. 

And in this, we find the power of coaching.   

When we coach our clients in ACE, we spend a LOT of time separating the facts from the story.  We call these “facts” the circumstance and the “story” your thoughts.  This is one of the things we teach in the mindset pillar, which is one of the pillars we will discuss in our upcoming masterclass. 

So, the story this client had been telling herself was that she had a massive student loan debt burden. And that the student loan debt burden – which she must work full-time to have forgiven – was the problem.  That student loan debt burden was preventing her from being a good mom.

Is that really true, though?  Was it really true that she was not a good mom because she couldn’t spend enough time with her kids?

Facts versus Story

First, we spent some time discussing all the ways she was not trapped by her student loans. Yes, we talked about Public Service Loan Forgiveness versus refinancing her student loans.  We also talked about other options she might have.   

Yet, that’s not where the real conversation went.  The real work to be done is in the thought work about her being a “good mom”.  And the resulting lack of work-life balance she felt as a physician mom.   

It turns out that this thought resulted from the fact that she felt like she didn’t currently spend enough time with her kids.  So, I asked her a simple question – how much time would be “enough” time with her kids? Is there such a thing? 

And who gets to decide what “enough” means?  Is it her? Or the kids?

Never Enough

By letting her get her thoughts out, she realized that there was not a magic number of hours she could spend with her kids that would constitute “enough”.  They would always want more hours with her.   

And she produced evidence of that when she had a week off recently where her kids said that they wanted more time with her. Even though she had been off all week, and constantly available. 

This is important because I bet – and she confirmed – that her kids want to spend as much time as they possibly could with her.  Which, to me, sure feels like the opposite story of being a bad mom.

In fact, she was such a good mom that her kids could never get enough time with her.  They loved spending time with her.  Why? Because she was a GREAT mom. 

Yet, that wasn’t the story she had been previously telling herself.  And this is why it is important to separate the facts from the story we tell ourselves.

Telling the Wrong Story

You can see from this doc’s story that she felt like a bad mom because of the story she was telling herself about not spending enough time around her kids. 

Yet, when we separated the facts from the story, she was able to see that her kids wanting more time was not a sign of her being a bad mom. It was a sign that she was an amazing mother. 

This is why it is so important to separate the facts from the story. The most effective way I’ve found to do this is through talking it out with a coach who understands your situation. This is why all of our coaching in ACE is from coaches who are also physicians. 

Yet, you won’t always have a coach around. So, what should you do when something comes up?  

Self-Coaching to Find Work-Life Balance 

You break out pen and paper.  Or ipad and magic pencil.  Whatever your favorite tool is to get your thoughts out.   

Dump all of your thoughts out on paper.  Don’t filter them yet. Just write down everything that comes to mind.   

Once you have done this, go back and be as impartial as you can about what is a fact. In other words, what two lawyers would unanimously agree on in the court of law.  And then separate out what is not. 

You’ll realize by going through this that many of the stories that you tell yourself in life that feel like a fact are, in fact, quite the opposite. They are just a narrative you are telling yourself.   

And this narrative can either produce great shame or great confidence. It all depends on the story you tell yourself about the facts.

What Story Are You Telling Yourself?

After you get your thoughts out, then you get to question the story you are telling yourself.  In the example given today, our client chose to change her narrative. Instead of feeling shame and mom-guilt, she felt confident as she realized how much her kids loved being around her. 

All that changed was the story or the narrative she was telling herself. Instead of being her own worst critic, she started the work of becoming her biggest fan. 

The same work can be done about that bad patient outcome you had which has led you to tell yourself you are a bad doctor. Or that has produced imposter syndrome.   

It is the same work to be done when you feel like a victim who is trapped in medicine.  Are you truly a victim without options in medicine? Or will you choose to be the hero of your story 

So, whether you are battling mom-guilt, imposter syndrome, or work-life imbalance… the work to be done is all the same.  What story will you tell yourself today?  

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