EPISODE: 34
The Lost Art of Control:
A Doctor Mom’s Guide to
Reclaiming Power
InspiredMomMDs.com/34
Feeling powerless in medicine or motherhood? In Ep 34, learn how to take back control as a physician mom and reignite your agency with practical, empowering tools.
Episode 34: The Lost Art of Control: A Doctor Mom’s Guide to Reclaiming Power
How can having the sense of control be so elusive?
Somewhere along the way in this career in medicine and in the role of a mom, autonomy slips, or it’s seemingly taken away.
And that matters – quite a lot.
It feels disheartening to not control what matters most. This can lead to chronic stress and the massive fall out from how stress hurts the mind and body.
But there is hope.
A loss of control over some areas of life does not mean the ability, confidence and drive is lost.
There is still a fire in you that wants to be set free.
You can step back into the ring and take back agency.
When you have it, it is gloriously rewarding.
This episode will discuss 2 common thieves of control.
Loss of Control is Incredibly Frustrating for a Physician Mom
Slowly losing control over important matters at work and home leads to feelings of helplessness or hopelessness. The solution is to understand the psychology and even some neuroscience behind these conditions.
Today I will help shine light on how the brain gets stuck in a swirl of lost agency.
Once you understand it, you can diagnose it, and then tackle it.
Recall that agency means you can produce desired results by your actions. Good outcomes are more likely and bad outcomes less so because of this control over one’s actions.
It gives you power to change what can be changed.
But sometimes it doesn’t feel that way – that it’s not very clear that change is even possible.
Loss of control can be fueled by several things, but I want to discuss today 2 common ones that you can reverse: learned helplessness and defensive pessimism.
Learned Helplessness is Endemic in the Physician Mom Population
I have a story about learned helplessness that many will relate to. I used a fictitious character so I could compile true events from multiple doctors.
Dr. Jones had just spent a significant amount of time with a young patient, diagnosing a complex medical condition. She’d carefully explained the treatment plan to the parents and answered their questions patiently. She was confident that she had provided the best possible care.
However, when she turned her attention to the insurance paperwork, she hit a roadblock. The insurance company had denied coverage for a crucial medication, citing a technicality in the patient’s policy. Frustrated and disheartened, she spent hours on the phone with the insurance company, only to be met with automated systems and unhelpful representatives.
Each failed attempt to resolve the issue only deepened her sense of frustration and helplessness. She felt like she was fighting a losing battle, a tiny individual against a giant, impersonal corporation.
For some, this story can lead to learned helplessness – they give in and let the insurance companies win.
But, not for Dr. Jones. In that moment of despair, a spark ignited within her. She realized that she couldn’t let the system dictate her ability to provide quality care. She resolved to challenge the bureaucracy.
She took back control – WITH ACTION!
Dr. Jones, fueled by a newfound determination, began to explore her options. She researched patient advocacy organizations and sought advice from colleagues who had faced similar challenges. She learned about the importance of clear and concise documentation, and she meticulously documented every interaction with the insurance company.
With renewed vigor, she crafted a detailed appeal letter, citing relevant medical guidelines and emphasizing the patient’s urgent need for the medication. She followed up with phone calls, emails, and even a visit to the insurance company’s local office.
It was a lot of work. But, through her persistence and advocacy, Dr. Jones was finally able to secure the necessary approval for the medication. This victory not only benefited her patient, of course, but also empowered her to take control of her own career and fight for what she believed in. She realized that strengthening her internal sense of control could win over external control of the insurance company.
Martin Seligman, a renowned psychologist, is credited with pioneering the concept of learned helplessness. In 1967, his experiments on dogs demonstrated this phenomenon. Dogs were placed in harnesses and subjected to electric shocks. Initially, they tried to escape, but when they realized their efforts were futile, they eventually stopped trying, even when given the opportunity to escape.
Now, humans can also come to believe they are also helpless to change their situation. And, strikingly, even when opportunities to escape arise, an individual may choose to stay. Wow. This is where Dr. Jones languished for a bit.
It’s like saying here’s an open door to escape this cruddy situation, but you’re too tired and defeated to stand up and walk.
Seligman’s research highlights the importance of perceived control and the negative impact of repeated failures or setbacks.
Fast forward to 2013 when the same renowned psychologist and his colleague, Steven Maier, published a manuscript about the neuroscience of learned helplessness.
And guess what they found; helplessness isn’t in fact learned!
They showed that “Passivity in response to shock is not learned. It is the default, unlearned response to prolonged aversive events and this default system is mediated by serotonin in a very specific part of the brain, the dorsal raphe nucleus, which in turn inhibits escape.”
The good news is that one can overcome this default setting of passivity by learning and strengthening personal control. And that control needs to be internal or come from within – like your fire or spark.
Understand that control starts with you, not waiting for someone else to influence the situation. I will go through some ways to regain control in a couple minutes, right after I tell you my story about defensive pessimism.
Defensive Pessimism is a Byproduct of a Mom Doc’s Loss of Control
Defensive pessimism can feel like self-sabotage when one feels loss of control over a situation. Here’s what happens. It involves setting low expectations and thinking out worst-case scenarios of an important task or situation. This happens even though past evidence shows success.
I sometimes still feel overwhelmed by my demanding schedule, even after recent years of making it much more sane.
Despite the fact that I do actually get everything done on time, I anticipate far less. I’ll jump to a worst-case outcome like getting behind on podcasting or other time-bound business projects. To get behind means failure!
On those crazy weeks, in my head, I never have enough time to complete all my tasks. But the evidence is that I routinely do get everything done. Is this anxiety driven productivity?
Then the answer is yes. Anxiety about potential failure fuels efforts to do well. The anxiety manifests as thought loops – listing everything that needs to get done, and then finding enough hours in my week to do them. And you know what, that takes time!
Paradoxically, I end up wasting time with the stress over deadlines, and doing things right, than just doing my work. As you may guess, the end result is less productivity.
While defensive pessimism can sometimes be a protective strategy like driving me to succeed, it can also hinder performance and lead to unnecessary stress.
Thankfully, I’ve been gaining experience in how to successfully handle my defensive pessimism! Imagine if I let this go, week after week. It could lead to fatigue, an overall drop in performance, and decreased satisfaction with my career.
The biggest win for me to combat this thought cycle is a reality check.
I first question the validity of my negative thoughts. Are they actually based on facts? Am I just fearful of failure? How have I succeeded (or failed) in the past?
This reality check takes me out of the first-person experience into a 3rd person friend. That friend is much more objective in weighing all the facts and emotions and she comes up with logical answers!
Research shows that defensive pessimism is positively predicted by uncertain personal control over a performance outcome. It is therefore negatively predicted by a general task-focused orientation. So, a sense of less control means more pessimism! And more control is correlated with less pessimism.
That reality check and 3rd person review is my way of regaining control, and thereby decreasing defensive pessimism.
Other ways may include setting realistic goals or breaking big jobs down into bite size, yet effective, parts.
The practice of mindfulness is incredibly effective in grounding yourself and decreasing anxiety organically.
I didn’t mention this, but I will also add in very short meditation breaks during high peaks of stress. One of these is only 2 minutes that I found on my meditation app, Insight Timer, so it’s so easy to incorporate.
I also didn’t mention, I absolutely celebrate the small wins! This is an empowering practice that not only reinforces the control you do have, but spurs confidence to keep going.
I want to quickly bring up self-handicapping, which is a close cousin of defensive pessimism.
This is the process of constructing obstacles to success so that if failure occurs, it wasn’t the person’s fault.
I just pointed this out to my kid the other day. He was dreading a calculus quiz because the content was really tough that week. His solution was to not prepare, and just study in his morning classes before his Calculus period.
I told him, “You know what you’re doing? You’re self-handicapping. If you fail, it’s not your fault because you didn’t study, but if you do really well, then you look like a rockstar!”
He answered, “I know mom, I took Psychology last year,” as he smirked back at me. (Insert eyeroll here.)
Good News: You Can Take Back Control and Agency!
You do have the courage to retake control. Recognizing how the brain sometime lets you sink into learned helplessness, or defensive pessimism brings awareness to the psychology and physiology of what is going on here.
Awareness and recognition are a starting point for taking back control – like a little piece of flint.
And flint can be used to re-ignite your fire.
Regain agency by working on internal control, like reality checks, mindfulness, breaking down large goals into smaller, effective chunks.
There are so many options, it depends on your unique circumstances, right? That’s where working with a colleague, family or even a coach can help to clarify changes that are within your reach.
I would like to end today with Reinhold Niebuhr’s 1930’s version of the Serenity Prayer.
“Give us courage to change what must be changed, serenity to accept what cannot be helped, and the insight to know the one from the other.”
Don’t forget to join me next week for another dose of support and inspiration. Until then, take care of yourselves, and take care of those who matter most.
It’s Time to Take Control and Thrive!
About Cindy Van Praag, MD, NBC-HWC
Wellness Advocate for Physician Moms
Cindy talks about the current climate of practicing medicine while juggling the roles of mom, wife, daughter, and more. She brings a fresh pair of eyes and guidance for common situations physician moms face daily. In Inspired Mom MDs Podcast, Cindy delivers a fresh perspective and actionable steps to take agency and elevate your power. Listen on your favorite podcast app!
