Wellness

Making My Happiness

Being happy is a skill; you have to practice and make it a habit.

I used to believe happiness was something you earned. Happiness was an emotion you felt after some good fortune happened to you or after you achieved a goal. Once you achieve all your goals, then you get to be happy.

As a pre-medical college student, I thought to myself, “I’ll be happy when I get accepted to medical school.” As a pre-clerkship medical student, it turned into “I’ll be happy when I do well on USMLE Step 1.” During clerkships, I moved on to “I’ll be happy when I match in one of my top 3 programs.” As a resident, I found myself postponing happiness even further by thinking “I’ll be happy when I’m an attending and I actually have more money and time.” That last one got pushed even further into the distance as I debated whether I wanted to pursue a fellowship, as if a fellowship would just delay the start of my happiness even more. This is how I saw happiness on the grand scale of my life.

How did I try to find happiness on a day-to-day basis? It was when I finished a project, the end of a shift, when the waiting room was cleared out (which was almost never), my next day off, the end of a relentless intensive care unit rotation when I could finally go back to my “home” in the emergency department, or the countdown of days until my next vacation. Between each of these “accomplishments” there was happiness, but it was fleeting. When I was far away from reaching any of these “things that made me happy,” I felt exhausted and frustrated that I was working so hard and wasn’t fulfilled. Burnout was a foreign concept I never thought could happen to me, but quickly realized I wasn’t as resilient as I thought.

Success doesn’t fuel happiness - happiness fuels success.

It turns out happiness is a cause of good things in life, and it itself promotes even more happiness. Positive psychology, an evidence-based science that focuses on studying human thoughts, feelings, and behaviors with a focus on strengths,1 has found that a positive mindset can raise productivity levels, boost well-being, and that happiness promotes success, not the other way around. It can even be contagious; individuals with happy friends and significant others are more likely to be happy in the future.Research has shown that doctors specifically who were primed to have a “positive effect” performed better at problem-solving and were better at selecting the correct diagnosis, with less anchoring bias than their peers.1,3

You are responsible for your own happiness.

How can we apply this to our lives to reduce burnout and promote resiliency? First, we have to stop relying on purely external factors to validate our own happiness. Good news is that research has shown us that “the good life” can be taught.You already have the tools to improve your own well-being and happiness, both with external actions and internal thoughts. 

External

  • Gratitude is one factor that contributes to happiness. The more we cultivate it, the happier we will be.4 Giving hugs and physical affection can also boost overall well-being.5 People who intentionally cultivate a positive mood to match an outward emotion they need to display, genuinely experience the positive mood.6 People who perform acts of kindness toward others not only get a boost in well-being, they are also more accepted by their peers.7
  • Volunteering on behalf of a cause you believe in improves your well-being and life satisfaction and may even reduce symptoms of depression.8
  • Giving by spending on other people results in greater happiness for the giver.9 In fact, spending money on experiences also provides a boost to happiness rather than spending money on material possessions.10
  • Building a strong social network improves your well-being. The more social support you have, the happier you are. Work on building positive and supportive relationships.

Internal

  • Improve your mood with meditation, finding something to look forward to (a movie, a meal), exercising, and spending your money in ways that make you feel fulfilled.
  • Find meaning and purpose in what you do by being engaged in what you do. You can have the best job in the world, but if you can’t find the meaning in it, you won’t enjoy it.
  • Be optimistic by looking for the positivity in your world. Bad things are temporary and not universal. Burnout is the result of a pessimistic attitude toward your job with negative thoughts such as, “This isn’t getting me anywhere. I can’t handle this. It’s never going to get any better.”
  • Think of failure as an opportunity for growth by creating the local and temporary mindset (“I/it will get better”). Remember: You will fail at something. Give yourself the opportunity to move up not despite the setbacks, but because of them.
  • Believe that your actions have a direct effect on your outcomes.11

Your Wellness Challenge
Being happy is a skill; you have to practice it and make it a habit. Shawn Achor created a “21 Day Challenge,” suggesting picking one of the following 5 habits to do 21 days in a row in order to improve feelings of happiness and optimism.12 (In fact, doing all 5 can take as little as 30 minutes a day.)

  1. Improve your optimism: Write down 3 new things you are grateful for every day.
  2. Scan the world for positivity: Write for a few minutes a day describing a positive experience you had that day.
  3. Increase feelings of social support and commit kindness: Write a message (email, Twitter, Facebook, carrier pigeon) at the start of every day thanking or praising a member of your team.
  4. Undo the negative effects of multitasking and decrease stress: Meditate for a few minutes a day, only focusing on your breathing.
  5. Train your brain that your behavior matters: Exercise for 10 minutes a day.

With as high as 70% burnout rates in emergency medicine,13 we need to focus on how to reduce emotional exhaustion. Happiness can help us to become more resilient and improve well-being, which subsequently can also promote success and further happiness. 


References
1. Estrada C, Isen A, Young M. Positive affect influences creative problem solving and reported source of practice satisfaction in physicians. Motiv Emot. 1994;18(4):285-299.
2. Fowler J, Christakis N. Dynamic spread of happiness in a large social network: longitudinal analysis over 20 years in the Framingham Heart Study. BMJ. 2008;337a2338.
3. Estrada C, Isen A, Young M. Positive affect facilitates integration of information and decreases anchoring in reasoning among physicians. Organ Behav Hum Decis Process. 1997;72(1):117-135.
4. Seligman M, Steen T, Park N, Peterson C. Positive Psychology Progress: Empirical Validation of Interventions. Am Psychol. 2005;60(5):410-421.
5. Barraza J, Zak P. Empathy toward Strangers Triggers Oxytocin Release and Subsequent Generosity. Ann NY Acad Sci. 2009;1167:182-189.
6. Scott B, Barnes C. A Multilevel Field Investigation of Emotional Labor, Affect, Work Withdrawal, and Gender. Acad Manage J. 2011;54(1):116-136.
7. Layous K, Nelson S, Oberle E, Schonert-Reichl K, Lyubomirsky S. Kindness Counts: Prompting Prosocial Behavior in Preadolescents Boosts Peer Acceptance and Well-Being. PLoS One. 2012;7(12).
8. Jenkinson C, Dickens A, Jones K, et al. Is volunteering a public health intervention? A systematic review and meta-analysis of the health and survival of volunteers. BMC Public Health. 2013;13:773.
9. Dunn E, Aknin L, Norton M. Spending Money on Others Promotes Happiness. Science. 2008;319(5870):1687-1688.
10. Howell R, Hill G. The mediators of experiential purchases: Determining the impact of psychological needs satisfaction and social comparison. J Posit Psychol. 2009;4(6):511-522.
11. Achor S. The Happiness Advantage: The Seven Principles That Fuel Success and Performance at Work. London: Virgin; 2010.
12. Achor S. Positive Intelligence. HBR. 2012;January-February.
13. Shanafelt T, Boone S, Tan L, et al. Burnout and Satisfaction With Work-Life Balance Among US Physicians Relative to the General US Population. Arch Intern Med. 2012;172(18):1377-1385.

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