Looking at the heavy-hitters in the medical field never fails to spark in me both a sense of admiration and of dread. Physicians who take time to teach the general public about medicine (Atul Gawande); physicians who devote their lives to the raising up communities (Paul Farmer); physicians who make the most out of their dual degrees (Anoop Raman, see article below). [For some reason, I'm unable to summon up a female physician's name. Whether this is due to my limited knowledge or some deeper challenge that women face, I don't know.]
Hearing their accomplishments makes me reflect on my own and I feel that I pale in comparison. My heart beats a little faster and I imagine that stomach drops an inch or two - anxiety starts to gnaw away at me. My brain starts to list out my every failure and a vicious cycle of feeling sorry for myself begins. A voice inside me says, "I don't work hard enough, I don't care for others enough, and I am certainly not smart enough!". I've been working on squelching this voice through journaling and mindfulness techniques, but I haven't faced it head on.
Because my current rotation is psychiatry, my concerns about comparing myself have been at the forefront of my mind. I recently learned about cognitive-behavior therapy, a technique for addressing distorted thoughts about yourself and breaking the vicious cycle of negativity. It's not enough to simply say to yourself, "Stop it! Stop comparing yourself with others." If this was the case, therapists and doctors could cure everyone within a month or two. "Stop deluding yourself!", "Stop late-night snacking!" And they'd probably stop wars too.
Cognitive-behavior therapy (CBT) is based on a trifecta of thoughts, actions, and emotions. One way of looking at how it works is that our negative thoughts leads to actions (or poor behaviors) that reinforce our emotions of feeling bad about ourselves. CBT, combined often with pharmacotherapy, has been shown to have great success in treating those with anxiety disorders, a group of conditions that include OCD, social anxiety, and PTSD. Here are the general (and very logical) steps involved:
Step 1. Identify and challenge problematic thoughts and beliefs
Step 2. Create pleasant activities that challenge problematic beliefs, like calling a friend for someone who believes no one likes them
Step 3. Extended exposure to anxiety-eliciting stimuli to decrease our panic response
While I'm on this relevant rotation, I'll be trying out some self-CBT in order to work on my bad habit of comparing myself with others. In my last rotation, family medicine taught me about motivational interviewing, a technique for building up motivation in patients to change their habits for the better. By working on both these techniques, I hope that I'll be better at encouraging patients to take good care of themselves!
Few things I've been reading:
http://www.aafp.org/afp/2015/1101/p807.html "Common Questions About Cognitive Behavior Therapy for Psychiatric Disorders"
*Note that it's likely that psychiatric disorders or mental illness is really a spectrum. There's no clear black or white status of yes, you're mentally ill vs. no, you're just maladjusted. We all have positive things to gain about becoming self-aware of our mental health. :)