Andre is a family medicine physician.
Like all physicians, he spent many years of hard work and very little play to earn his career. And like many physicians, Andre loves his job.
Unlike most physicians, however, Andre only works six months of the year. What does he do the rest of the time? He surfs, backpacks around the world, and well... enjoys his life.
After reading this story, I can almost guarantee that you will react in one of two ways—either you'll be shaking your head, silently admonishing these young millennial physicians who don't take medicine seriously, or you'll be going green with envy, wondering how you can do the same.
Regardless of your response, Andre will continue doing what he loves, seamlessly blending his passion for medicine with his passion for life. As a locum, he's joined the ranks of a new breed of doctors who've let go of the antiquated idea that doctors must work themselves into the ground to make a difference. Instead, these doctors have decided to create a new set of rules—they reject the status quo and design lifestyles that fit their medical careers around their lives, not the other way around!
Of course, this option isn't available to (or feasible for) everyone and that's a good thing. Medicine hurtles forward on the backs of passionate and driven physicians whose lives center entirely around the profession. Without them, indeed, medicine would be a shadow of what it is today and our patients would ultimately suffer.
But many of us are suffering too! Most physicians report working at least 40-60 hours a week, with 20% of these clocking up to 80 hours! Assuming a five-day work week, at least 1 in 5 doctors reading this post are working 16 hours a day! That doesn't leave much room for anything else and it's little wonder that physicians are overstressed, overworked, and overwhelmed.
And this problem isn't new. The overworked doctor has become a cultural caricature precisely because doctors have been working under severe conditions for a very long time. With generations of burnt-out doctors telling their terrible tales, it's not surprising that Andre and his newly-minted colleagues are renegotiating the traditionally sour balance between work and play.
All work and no play makes Jack a....
We all know the saying. None of us wants to be the dull boy (or girl) in the room and yet many of us fall into the trap of letting work hijack our lives (at some stage anyway). Ask yourself honestly—when was the last time you blocked out an hour to follow a passion of yours? Fine-tuned a hobby? Spent a day without your phone and immersed yourself completely in a family activity?
If your answer to this is anytime longer than yesterday, I would suggest that you need to take a long, hard look at your work-life balance.
We often advise our patients to remove stress from their lives, but we rarely take our own advice. Most of us don't manage stress very well because our locus of control tends to be a little messed up. But managing stress is about more than just being mindful or having a positive attitude toward stress. Integrating leisure into our daily lives is essential for our well-being. Without some good ol' playtime, we run the risk of descending into hopelessness, developing depression, and just generally feeling lousy (I really don't need to reference this, but I will anyway).
But why is leisure so important to well-being? And why does it feel so good?
In his book, Flow: The Psychology of Happiness, Mihaly Csikszentmihalyi discusses his years of investigation into a psychological phenomenon called flow. A flow state can be loosely described as a fully-absorbing experience—a state that takes you completely and utterly into the moment that you're in.
Csikszentmihalyi investigated the phenomenon of flow by interviewing thousands of people with various backgrounds (chess players, housewives, hikers, tennis players, ballerinas, surgeons, etc.) and came to the conclusion that flow is a universal experience. Every single one of us enters into states of flow—those immersive moments where you are fully and completely absorbed in the activity that you're doing. He (and much of the related research since) argues that achieving a flow state on a regular basis is vital to happiness.
Csikszentmihalyi found that the features and conditions that promote flow states are fairly well-defined:
- Clarity of goals and immediate feedback on the progress: Games and competitive sports utilize this feature to get you hooked. In a competition, you know what you need to achieve and get immediate feedback on whether you are winning or losing.
- Merging yourself with the task: You become one with your activity (for want of a better description)—the pianist merges with her piano and becomes the music she is playing. The effort becomes automatic and there are no mental barriers blocking the process.
- Losing awareness: Losing awareness of yourself, your time, and your surroundings is a common experience in flow, yet afterwards, you feel a stronger connection with everything around you. Time passes very quickly, yet it can feel like the entire world has slowed down around you.
- Activities are intrinsically rewarding and enjoyable: You do an activity for its own sake and not for an external reward. You're okay with failure because the journey, rather than the outcome itself, is your end goal.
An experience of flow is such that you don't notice when you're in it. You recognize it by its conspicuous absence after it ends. Since flow states are mediated by our feel-good neurotransmitters—dopamine, norepinephrine, oxytocin, and serotonin—it is often described as the most addictive state on Earth! And, if you can think back to a time when you've been in flow, the chances are you agree.
But if flow is natural to all of us, why would we bother trying to induce it?
First of all, there is no definitive way of inducing flow (without the help of nootropics) that can be consistently relied upon to achieve the desired results. However, activities that lead to flow states are called autotelic—derived from the Greek words auto (self) and telos (goal)—because they are inherently self-directed and are an end in themselves. You do them because you like doing them, not because you're trying to achieve a certain outcome. Autotelic activities aren’t, necessarily, all fun. Research documents that homemakers often achieve states of flow while cleaning the house, just as many academics report entering flow states as they write their research papers. But, by and large, activities that we enjoy for their own sakes, and which are more likely to help us reach flow states, tend to be those we do simply for fun.
The five leisure blocks
Have you ever heard the (very yuppie) slogan—work hard, play hard? Well, that's exactly what this post is all about! We want you to practice getting into a flow state on a regular basis, as a result of both work and leisure. Both aspects of your life can help you to get into flow, but the key is to vary your experiences on a day-to-day basis so that you can increase your chances of getting into that state (as well as work out which activities tend to get you there more often).
We'll leave it to you to work out how to hit your flow while at work, but we know that squeezing fun time into our busy schedules is way more challenging. That's where the five leisure blocks come in. The concept is very simple—just as we try to break up our work goals into time-managed blocks, we should also be planning our leisure activities based on the regularity with which we need them.
The time periods are easy to remember—hourly, daily, weekly, monthly, quarterly, and yearly.
For each of these time blocks, we can assign an activity (or category of activities) that we could do to help us get into a flow state or (at the very least) help us to relax and enjoy the moment. Take a minute to do the following exercise:
For each of the aforementioned time blocks, list some activities you can assign yourself, which are both feasible and enjoyable for you.
- Hourly: Choose something that takes less than five minutes to do. Achieving flow is unlikely here, but this is more about letting your brain take a break to refresh (e.g., five-minute meditation, doodling, a set of lunges). And note, the hourly activity that may be good for you in the morning might not be as ideal in the afternoon (and vice versa). Similarly, an activity that you can do at work might be different from one that you’ll do at home.
- Daily: No matter how busy you are, there is bound to be at least 15–30 minutes each night (or morning!) that you can commit to a hobby you enjoy. This is when flow is most likely to happen. Don't have a hobby? Master a new one in 20 hours or less (e.g., painting, gardening, crocheting, reading, building miniature boats).
- Weekly: Dedicate at least half a day to one full day a week where you completely switch off from the world. Shut off your phone (or switch to an old-style phone for the day) and completely immerse yourself in an activity with friends and family. Avoid screens. Actually do something (e.g., go on a hike, play golf, take a painting class, spend a day at the beach, invite friends for a barbecue). The world's your oyster!
- Monthly or quarterly: If you can afford it, going away for a mini-break every 1–3 months will do wonders for your well-being. Something as simple as hiring a cabin in the mountains, renting a room at a beach resort that you can drive to, or taking some solo time and attending a themed retreat—whatever it is—don't wait for your yearly holiday to take a trip somewhere. This doesn't need to break the bank. Something close by is perfectly fine. The idea is just to get out of your familiar environment for a couple of days to reset.
- Yearly: This one should be obvious, but way too many people give this one up. Common excuses are: I can't get away from work, I can't afford a trip right now, etc., etc... Whatever your excuse, find a way around it! Protect your yearly break like you would your loved ones. You need this time to recharge for the year ahead so that you can perform at your best.
Even Osler refused to be a slave to his profession. He took time out, daily, too.
Every day do some reading or work apart from your profession. I fully realize, no one more so, how absorbing the profession of medicine is... but you will be a better man and not a worse practitioner for an avocation. I care not what it may be, gardening or farming, literature or history or bibliography, any one of which will bring you into contact with books.—William Osler
If Osler, the father of modern medicine, can find a few minutes everyday to just chill, chances are you can too!
What activities help you to get into flow? Share them below.