20070125

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Information about 20070125
Education

Published on January 15, 2008

Author: Sever

Source: authorstream.com

Why doctors are so unhappy?:  Why doctors are so unhappy? 林思偕 長庚兒童醫院兒童過敏氣喘風濕科 Research on happiness(1):  Research on happiness(1) How to gain, how to keep, how to recover happiness is in fact for most men at all times the secret motive for all they do( William James,1902). People who are happy perceive the world as safer (Johnson & Tversky, 1983), make decisions more easily (Isen & Means, 1983), rate job applicants more favorably (Baron, 1987), are more cooperative (Forgas, 1998), and report greater satisfaction with their whole lives (Schwarz & Clore, 1983). When your mood is gloomy and your thinking preoccupied, life as a whole seems depressing. Let your mood brighten and your thinking broadens and becomes more playful and creative (Fredrickson, 1998, 2000). Your relationships, your self-image, and your hopes for the future also seem more promising. Research on happiness(2):  Research on happiness(2) Feel-good, do-good phenomenon (Salovey, 1990). --When we feel happy we are more willing to help others. In study after study, a mood-boosting experience (finding money, succeeding on a challenging task, recalling a happy event) made people more likely to give money, pick up someone's dropped papers, volunteer time, and so forth. Psychology throughout its history has more often focused on negative emotions. 1.they can make our lives miserable and drive us to seek help; 2. Guilty of being happy. Nowadays, researchers are becoming increasingly interested in subjective well-being, assessed either as feelings of happiness (sometimes defined as a high ratio of positive to negative feelings) or as a sense of satisfaction with life. "Positive psychology" is on the rise. Research on happiness(3):  Research on happiness(3) It may come as a disappointment, but the effect of dramatically positive events is similarly temporary. Once their rush of euphoria wears off, state lottery winners typically find their overall happiness unchanged (Brickman & others, 1978). Other research confirms that there is much more to well-being than being well-off. Many people (including most new collegians) believe they would be happier if they had more money. They probably would be--temporarily. But in the long run, increased affluence hardly affects happiness. Wealth is like health: Its utter absence breeds misery, yet having it is no guarantee of happiness. The Adaptation-Level Principle: Happiness Is Relative to Our Prior Experience :  The Adaptation-Level Principle: Happiness Is Relative to Our Prior Experience The adaptation-level phenomenon describes our tendency to judge various stimuli relative to those we have previously experienced. We adjust our “neutral levels”---based on our experience. We then notice and react to variations up or down from these levels. Satisfaction and dissatisfaction, success and failure--all are relative to our recent experience. "Satisfaction has a short half-life." as Richard Ryan (1999) says. “Whoever said money can't buy happiness isn't spending it right”? Studies from Lottery winners and people with 4-limb paralysis show quite the opposite. Seeking happiness through material achievement requires an ever-increasing abundance of things. The Relative Deprivation Principle: Happiness Is Relative to Others' Attainments:  The Relative Deprivation Principle: Happiness Is Relative to Others' Attainments Happiness is relative not only to our past experience but also to our comparisons with others. "Beggars do not envy millionaires, though of course they will envy other beggars who are more successful," noted Bertrand Russell (1930) You cannot, therefore, get away from envy by means of success alone, for there will always be in history or legend some person even more successful than you are By "counting our blessings" when we compare ourselves with those less fortunate, we can, however, increase our satisfaction. "I cried because I had no shoes," states a Persian saying, "until I met a man who had no feet." Predictors of Happiness(1):  Predictors of Happiness(1) Many studies indicate that religiously active people tend to report greater happiness and life satisfaction. Is happiness then conducive to faith? Or does faith enhance happiness? People feel happier if mentally engaged by work or active leisure than if passively vegetating. Ironically, the less expensive a leisure activity is, the more absorbed and happy people often are while doing it. People are happier gardening than sitting on a power boat. They're happier when talking to friends than when watching TV. Happy are those whose work and leisure absorb them, enabling them to "flow" unself-consciously in focused activity. (Csikszentmihalyi,1990) From the study of 254 identical and fraternal twins, 50 percent of the difference among people's happiness ratings is heritable. Even identical twins raised apart are often similarly happy.(David Lykken and Auke Tellegen,1996) Predictors of Happiness(2):  Predictors of Happiness(2) The very happy people were highly social, and had stronger romantic and other social relationships than less happy groups. They were more extraverted, more agreeable, and less neurotic, and scored lower on several psychopathology scales of the Minnesota Multiphasic Personality Inventory. Compared with the less happy groups, the happiest respondents did not exercise significantly more, participate in religious activities significantly more, or experience more objectively defined good events. No variable was sufficient for happiness, but good social relations were necessary. Members of the happiest group experienced positive, but not ecstatic, feelings most of the time, and they reported occasional negative moods. This suggests that very happy people do have a functioning emotion system that can react appropriately to life events. Today's physicians are not “happy campers.”:  Today's physicians are not “happy campers.” We are born into total disorientation and must literally learn everything, including happiness. A growing number of physicians proffer that they would choose another vocation if they had it to do over again, the problem seems to be getting steadily worse. Recent data suggest that female physicians are at greater risk for suicide(Silvermann MM,2000). Drug abuse is no more prevalent among physicians,while divorce rate is actually lower than other comparable socioeconomic groups or professionals.(Avery DM,2000; Rollman BL,1997) Psychiatric illness, especially depression, is thought to be more common. (Hendrie,1990) Much of this discussion attributes responsibility for this trend to the predisposition of the individuals who enter the medical profession. Physician distress and tribulation are not new:  Physician distress and tribulation are not new The first law of medicine, non primum nocere or “first do no harm,” is known to all in the medical profession. The second but less-known law of medicine, Docktor auxiliore sui or “physician heal thyself,” also has its roots in antiquity. There is evidence that physician vulnerability to stress has more to do with the personality traits that are possessed by those who enter the medical profession than the practice of medicine per se. (Sotile WM,2002 and McCranie EW,1988) Although it was once thought that certain specialists, such as anesthesiologists and psychiatrists, were more susceptible to suicide and substance abuse, it is now recognized that such differences between medical specialties are exaggerated. The cause lies more with the personality and emotional makeup of the individual than with the specialty that is chosen. For instance, it is more the personality of physicians who choose psychiatry than it is the practice of psychiatry that explains their inordinately high divorce rate. (Rollman BL,1997) Being happy is not an inherent natural event:  Being happy is not an inherent natural event Society tends to focus on negatives; Negativity has its origin in infancy. Children learn most of their behavioral characteristics from their parents, and because of their rather obsessive-compulsive personality traits, physicians sometimes take parenting to the next level. Winners always find a way to incorporate a positive spin: Thomas Edison; Theodore Roosevelt “Far better it is to dare mighty things, to win glorious triumphs, even though checkered by failure, than to take rank with those poor spirits who neither enjoy much nor suffer much, because they live in the gray twilight that knows not victory nor defeat.” “You cannot steal second base with one foot still on first! ” Fear of failure and negativity can be very detrimental to self-esteem, as well as actual achievement. The “missing tile” syndrome:  The “missing tile” syndrome we tend to focus on minor imperfections and frailties and miss the big picture. Whenever we look at an otherwise attractive, decorative ceiling, all we see is the missing tile; there are hundreds of tiles, yet we always focus on that single area! We should be focusing on what is there and good rather than what is missing or wrong: ‘Twixt the optimist and pessimist, The difference is droll; The optimist sees the doughnut, But the pessimist sees the hole. —W. McLandburgh (1915) 其為政也,善因禍而為福, 轉敗而為功—史記管仲列傳 Physician’s obsessive-compulsive personality trait:  Physician’s obsessive-compulsive personality trait Selection bias: it requires foregoing considerable pleasure and postponing fun just to get into graduate schools, especially competitive medical schools. Medicine is particularly unique in this predisposition because this quirky personality trait is actually nurtured by the process of becoming a doctor so that, by the time you finish the rigors of training, the obsessive-compulsive characteristic is an indelible part of who you are. Adjectives such as dedicated, conscientious, committed, and even sacrificial characterize medical school admission criteria rather than such characteristics as warm, gentle, friendly, agreeable, and adaptable. Obsessive-compulsive disorder:  Obsessive-compulsive disorder “Next year, after I don't have anatomy, biochemistry and microbiology, I'll relax a little more.” “Next year, when I'm not on call every third night and working up patients all night, I can enjoy the family and the weekend.” “Next year when I am the Chief Resident, I won't have be in clinic so late every day.” “Next year when I am not the junior partner, we can take that vacation we have always wanted.” “Next year when we get a new partner, I can start going to the beach with you on weekends.” And finally, “Next year …,” and you die. The worst part about this scenario is that the longer it goes on, the more adept we become at explaining our postponements. It is purely rationalization. This competition or dilemma of the family versus medicine actually accelerates and worsens the obsessive-compulsive disorder because, when that part of our lives becomes stressful, unpleasant, or frustrating, we then tend to gravitate to the office where we receive rewards and where we unquestionably do best. Driven versus called:  Driven versus called Ego versus self-esteem:  Ego versus self-esteem Self-esteem: what you really think of yourself; Ego : your perception of what other people think of you. Marilyn Monroe,and Dion Sanders, are victims of enormous ego but a pitiful lack of self-esteem. There is a line in Shakespeare's Hamlet that defines the concept of self-esteem beautifully: “This above all: to thine own self be true, and it must follow as the night the day, thou canst not then be false to any man.” 古之所謂豪傑之士者,必有過人之節。人情有所不能忍者,匹夫見辱,撥劍而起,挺身而鬥,此不足為勇也。天下有大勇者,卒然臨之而不驚,無故加之而不怒。此其所挾持者甚大,而其志甚遠也。 -- 蘇軾「留侯論」 Issue of integrity-君子慎其獨:  Issue of integrity-君子慎其獨 Integrity is an integral part of self-esteem. With integrity, the “right” decision is already in place before the situation even arises. That is, morality is totally independent of emotions and conditions. People with good integrity embody impeccable honesty. “Besides, it was so close, no one would have ever known the difference.” But “I would have!” For people with integrity, the decision does not depend on the circumstance; the proper choice has been made well before and independent of any situation that arises. It is not a question of who is right but rather what is right. Integrity is a prerequisite for good self-esteem and an essential part of it. 一個人不能事奉兩個主;不是惡這個愛那個,就是重這個輕那個。你們不能又事奉神,又事奉瑪門 (馬太福音6:24-27) Perception versus reality:  Perception versus reality Happiness in life is 90% perception and only about 10% reality. This is especially true for sentiment, particularly love and affection, and the primary reason for this is our incredible intelligence. The greatest pleasure that is associated with a new fancy car, boat, or a child's special Christmas gift is the day before it actually became a reality. Infatuation is a perfect example of this phenomenon. Happiness is not dependent on tangible, material things. Many people appear to have “everything,” yet nothing seems to please them; many others with so little are ecstatic. “Your altitude in life is more dependent on your attitude than it is your aptitude” (Zig Ziglar ,1992). Rewards are equal to service -施比受有福:  Rewards are equal to service -施比受有福 You are undeniably the center of your own little world. It is entirely normal when you look at a group photograph to look first for yourself. humans learn to be sentient beings, and this is dependent on other people. We learn early on how to win affection. Although being loved is essential, it is prudent to point out that the truly greatest pleasure in life is in loving, not being loved. Love is not truly love until it is given away. All parents and grandparents know the “pure” pleasure of giving. The absence of prerequisites and stipulations is what distinguishes agape from philos and eros; agape is totally unselfish and unconditional. The ancient sages were absolutely right: “Tis better to give than receive.” Affection represents “learned behavior.” Practice makes perfect :  Practice makes perfect The habits towards unhappiness are not ingrained personality patterns, and can be changed. People can learn to manage their grief and stress and let it not overwhelm them. Developing a positive attitude requires considerable practice: You become what you think about. “I am sick and tired of this, and I am sick and tired of that.” “I am sick of …” becomes a self-fulfilling prophecy in that you actually do become sick and tired. Perception is far more powerful than reality. The ability to practice appreciation and love are using more neocortical, prefrontal functions. Happiness is an exercise for smart people. A New way to think:  A New way to think Necessitating-- When every request is translated into a demand, ask : What can realistically happen if I don’t do this? Is there a room for negotiation? Deficiency-focusing-- ask what’s right in the situation? How can the obstacles be overcome? Gaining perspectives on mistakes by placing them in the proper context. Low self-esteem- ask: what did I contribute? Or what abilities did I show? Not to ignore limitations but to recognize growing skill and abilities. Inner Dialogue Mental rehearsal Expressive fantacies Medicine as a profession :  Medicine as a profession Medicine is one of life's most rewarding vocations. The practice of medicine is testimony that rewards really are equal to service rendered. Essentially, all physicians would readily agree that the greatest reward from the practice of medicine is the inner personal pleasure of healing the sick. “Doctor, you saved my life” still conveys the same immeasurable, intrinsic value. It is almost never accompanied by an audience, fanfare, visible recognition, and sometimes not even gratitude; it does not need to be. You know! Can any other profession grant such fantastic rewards? Priceless! Beyond Jogging-Physician self care:  Beyond Jogging-Physician self care Have goals and objectives that have been established by you. –stay focused Set priorities for how you are going to spend your time,money and energy. Give yourself permissions to enjoy life without guilt Make sure your life includes diversity-what makes you tick? Make a commitment to continued growth. –be persistent Conclusions:  Conclusions Happiness is an attitude, not an event. We need to examine our lives and define our own mission, our own purpose. We should not allow ourselves to be lured astray by life’s meaningless titles,goals, and trivialities. We can learn to be happy; but remember it will require considerable practice. We come into the world naked, and we will exit naked; all that “noise” in between is really irrelevant. We need to enjoy the journey, not merely focus on arriving the destination. Each of us is in control of our destiny, only to remember “ We have met the enemy, and he is us.”

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