My Fellow…

Art of Learning

One of the best books on learning I have ever read…

Topic of a future book club…

Tension Relaxation Model

Relaxation

• Should be the default (in crappy jobs, it is not)

Relaxation to Type I Tension

Gamification

The more an activity looks like a game, the more enjoyable it becomes.

Flow by

Autotelic Activity-intrinsic rather than extrinsic

• 1. Setting goals.
  • One must have clear goals to strive for.
  • They also learn to define the challenges, and a system of action in a specific direction to reach a larger goal.
  • Make as many subgoals as needed
• 2. Becoming immersed in the activity.
  • The person grows deeply involved in whatever they are doing, balancing expectations and demands with one’s capacity to act, ensuring neither stagnation, nor gross disappointment.
• 3. Pay attention to what is happening.
  
• 4. Track Progress
  • Concentration leads to involvement, which can only be maintained by constant inputs of attention. Athletes are aware that in a race even a momentary lapse can spell complete defeat.
  • The same pitfalls threaten anyone who participates in a complex system: to stay in it, he must keep investing psychic energy.
  • Create Mechanisms to track progress
• 5. Develop the skills needed to make progress
• 6. Learning to enjoy immediate experience.
• The outcome of having an autotelic self—of learning to set goals, to develop skills, to be sensitive to feedback, to know how to concentrate and get involved—is that one can enjoy life even when objective circumstances are brutish and nasty. Being in control of the mind means that literally anything that happens can be a source of joy.
• To achieve this control, however, requires determination and discipline. Optimal experience is not the result of a hedonistic, lotus-eating approach to life. A relaxed, laissez-faire attitude is not a sufficient defense against chaos.
• 7. Keep Raising the Stakes
• [from Graham Mann] and [Dan Silvestre]

Flow into Chaos from “Flow”

1. Unselfconscious self-assurance. Face the challenges believing you are able to change the outcome. But recognize you might not succeed because of factors outside your control
2. To focus your attention on the world. Shift your attention away from yourself so you won’t focus on your internal struggles. And focusing on the external allows you to find a better way to adapt to the problem
3. To discover new solutions. Don’t focus your attention on the new obstacles to achieve your goals. Evaluate the problem more broadly. Take the time to explore alternative goals that are more appropriate for the time being [Dan Silvestre]

Relaxation to Type II Tension (Threat)

Mindset

Almost entirely Mindset related

Meditation is a blocker

Chade-Meng Ten's Joy on Demand

Ultra-Rapid Meditation

• Find Your Breath
• Find Your Feet
• Find Your Heart
• Find Your Joy
• Lauria's and my BTSF
• Podcast 182 – Kettlebells for the Brain – Meditation from SMACC 2016
• EMCrit Wee – Vipassana Meditation

But also Situational Arousal in excess of the capacity of your training and psychological reserve

Threat to Burnout

The suitcase you carry home – Anticipation/Rumination

Haybron's Model of Happiness (Brief Introduction to Happiness) = Burnout Blockers

from: Happiness, A Very Brief Introduction

See also, Will Schoder's amazing Youtube Video

•  Security
  • Material Security
    • Happiness plateaus (not life satisfaction) at ~90,000 in 2020 money
  • Project Security
  • Time Security
• Outlook–Mindset!!!!
  • Events only effect us through our interpretations of them
  • Acceptance
    • Acceptance lives between Stimulus & Action
  • Positivity
• Autonomy
  • Independence, Choice, Individualism, Relatedness
  • Your actions are self-endorsed
  • Autonomy Supportive environments walk the line between cold & controlling and chaotic & permissive environments
• Relationships (Relatedness)
• Skilled & Meaningful Work (Competence)
  • Mastery but also feeling of Growth
  • Training
  • Also needs meaning

More Stuff

Soft Zone vs. Hard Zone

Somebody interrupts or says something dumb

Do you respond with ease & humor

Or do you lose your crap?

Waitkin contrasts these two scenarios with you in the soft zone or the hard zone

Evidence on Threat/Challenge Dichotomy

Additional New Information

More on EMCrit

Additional Resources

Now on to the Podcast

• Author
• Recent Posts

Scott Weingart, MD FCCM

Editor-in-Chief, at EMCrit.org

An ED Intensivist from NY.
Professor
Nassau University Medical Center
No conflicts of interest (coi).

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