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  • The Reflective Doc

Discovering a New Path Forward

Updated: Feb 12

I listened to a podcast today (Life Kit on NPR) featuring the poet Maggie Smith, whose most recent collection, Keep Moving, was published last fall. It’s a terrific podcast, and I can’t wait for my copy of her book to arrive. She shared the phrase “trying on hope” to describe her reason for writing the series of essays included in the book. It is such a lovely phrase, and I respected her brave exploration of its application as she suffered through the painful process of divorce.


It reminded me of the work I do with patients struggling against persistent anxiety and self-criticism. My goal is to help them learn how to “try on” a more confident self. We work together first to identify the automatic negative thoughts, such as “I will never get this right.” This uncovering is not easy. Curiosity and self-compassion are incredibly important during this phase, and each small step forward should be identified as the remarkable growth it demonstrates. Next, we begin the process of shifting away from the deeply treaded pathway of prior thinking, seeking a new future where more neutral, or even positive, expectations frequently exist.


For example, as an exercise, I ask them to imagine hiring a personal trainer. On the morning of an anxiety-inducing event, such as a job interview or public speech, this individual arrives and begins a steady commentary. Which version would be most motivating? “This could end terribly! You will probably make a fool of yourself. There is no way you will succeed.” Or, “You are prepared. You may enjoy yourself, or you may not, but nothing disastrous will occur.” Or perhaps “OMG, you are amazing! You are going to be offered the job on the spot by a hiring manager in tears because you are JUST THAT PERFECT!”


If you are like most, the third example sounds a bit grandiose, and I understand that. But think about how imaginative we can be when we are predicting negative outcomes. A creative mind is a beautiful thing, but we have to use it in ways that serve us. I encourage you to try practicing the fabulous opposite of your worried thought. “I’m about to give a lecture and the students are going to think I’m terrible,” becomes “I will DEFINITELY receive a standing ovation because my lecture will be LIFE CHANGING and the students will storm the stage to congratulate me on my incredible knowledge and insight.” (The all-caps portions are where I raise my voice and eyebrows in wonderment).


We, as humans, are blessed with highly protective brains (thank you, evolution), working hard to keep us safe and anticipating danger. This leads to much suffering, however, if those fearful thoughts go into overdrive. We can learn, instead, to harness this predictive power, bolster our confidence and increase positive anticipation. There is a reason professional athletes utilize detailed imagery of top performances before they hit the field. Your brain cannot fully differentiate between a mental rehearsal and the real deal. On the flip side, have you ever felt exhausted at the end of the a long day of worrying? You have been putting your brain through those imagined negative experiences, and it is traumatized.


Maintaining awareness of our critical internal voice is an ongoing process. Like the frequent recommendation of lifestyle change to achieve sustained weight loss, we need a daily practice of recognizing our “junk food thoughts.” These may motivate us through fear for a short time—“I can’t fail today, I would be humiliated.” However, just as that handful of candy gives you only a brief energy boost followed by a sugar crash, over the long term these types of thoughts are not without a hefty cost to our confidence and our willingness to try again.


None of us are free of self-criticism, and initially it takes a lot of attention to make the change, even to neutral thoughts. And it’s ok if you doubt these new thoughts. You don’t need to believe them right away, you just need to give it a try. We can all benefit from the grandiosity exercise, myself included (“This essay is horrendous,” can become “This essay is absolutely INCREDIBLE. How can I hide from the paparazzi now?”) Ideally, however, we can just get to neutral (“Maybe one person will enjoy this essay.”) and start from there.



(Photo: Pat Grossman)


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