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How I Broke the Cycle of Stress

How I Broke the Cycle of Stress

A technique called “goal diversification” turned out to be surprisingly effective

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Most of us can likely relate to this experience: you put all that you have into your work for prolonged periods of time and feel physically and mentally exhausted by the end. This common phenomenon is known simply as

, a natural reaction to facing increasing demands without the necessary resources to meet them. In moderation, stress on our bodies and minds can elicit beneficial responses that enhance well-being, such as increased
memory formation
. However, as most of us know, there is often an imperceptibly fine line between advantageous stress and toxic stress from being exposed to too much for too long. Sadly, we often cannot control the balance between the two.

Whether it is on social media or our go-to news channels, we hear a lot about

stress and deteriorating well-being
in our country. In fact, this reality has become so pervasive that some of us probably normalize much of it, writing off the downstream effects of stress as just part of modernity. For adults working in fields associated with
above-average levels of psychosocial stress
, a vicious cycle can manifest wherein
chronic stress breaks us down, drains us of our resilience, narrows our perception of what makes life worth living, and leaves us feeling hollow. This whole process is often encapsulated in a single word:

For some: burnout, schm-urnout! Critics of this concept tend to point out how nebulous it sounds even when someone offers up the definition. A different, more integrated way of understanding the long-term effects of chronic stress on the whole person is a principle called

allostatic load
. While there is
a lot that happens
to our bodies when we experience prolonged stress, the central idea of allostatic load theory is that, if you apply enough force for long enough on someone without destroying her, you will fundamentally change the way she functions and responds to future stressors through a process called


As a medical student, I see this problem of maladaptation frequently, both in trainees and trained physicians. Research demonstrates this trend in the alarming number of physicians who

quit practicing medicine
every year. I think it is because we are so deeply focused on trying to carry out a complex mission of providing care to patients. In our efforts to do this, we often focus on one large goal after another, not allowing ourselves to have much latitude. Whether it is taking a
standardized examination
or meeting documentation requirements, setting and pursuing less diverse goals like this is problematic: any barriers to goal attainment will cause much
more stress
than it would if we had other irons in the fire.

Recently, major news sources and professional organizations have cited emerging evidence of

epidemic levels
of burnout among physicians in the United States. While this is
not unique
to physicians, there is perhaps a pronounced susceptibility in this population because of how purpose-discordant tasks like navigating
electronic medical records
hinder progress toward meaningful goals like direct patient care. While much work is being done to
these systems-level processes, not enough is being done to examine what goals are not being achieved and why they exist on a cultural level.

Doing what is in the best interest of the patient is at the heart of the

Hippocratic Oath
, which represents a major theme in
physician culture
. The oft-overlooked connection between personal well-being and quality of patient care has an empirical basis: physicians who experience chronic stress and burnout are more likely to make
that result in disease, disability or death. What is ironic is that physicians who push themselves to deliver the best care possible may be doing so at the expense of this goal!

So, what do we do about this?

We are making strides toward rectifying

issues ingrained in health care systems
, but progress toward shifting the culture to uphold our mission of optimal care is less robust. Research in positive psychology and organizational dynamics has shown that goal diversification is associated with
subjective well-being
. This means the act of setting and pursuing different kinds of goals that are meaningful to you is associated with less stress, which decreases the
of allostatic load on the body and mind. Studies on intervention strategies to promote goal diversification have included
mindfulness meditation
hope building
and active


Hope theory
describes how thinking about one’s motivation and perceived capability of attaining a goal and about the pathways leading to that goal influence how we set and go after what is important to us. It also suggests that goals, especially smaller ones, can
serve as pathways
to other larger goals. This theoretical framework is further supported by research showing that goal setting
promotes behavioral change
, which can
improve well-being
even in the context of major depression. Moreover, the act of setting goals, particularly those that are diverse and of high personal value, increases productivity at work, which may subsequently help alleviate stress by
decreasing the demands
of one’s work environment.

One of the most significant hurdles in health care is that clinical practice generally has a

substantial workload and numerous legal constraints
that force clinicians to stick to a script. So, if the current practice environment largely opposes personal goal setting and goal diversity, how do we work around this?
National research on health care quality
offers some ideas: decreasing daily workplace activity, adopting collaborative care models and allowing employees to work on quality improvement projects. A common thread in all of these ideas is that health care providers can focus on more than just the same repetitive goals, which allows them to feel that they are fulfilling their professional purpose more often. Additionally, this method can
limit stress
and prevent much of the maladaptation that comes with it.

People can break their cycles of stress and even flourish outside of the work they regularly do by incorporating new and different goals in their day-to-days. Our best shot at getting ahead of the problems stress produces in our country is to look at where our finite energy is going and ask the tough questions: “Why?” and “At what cost?” We are not machines; it is not sustainable for us to push ourselves at the cost of our well-being. Whether it is in medicine or any other field, we must ensure that our cultures nurture goal diversity and being more than just your work because, at the end of the day, stress occurs when we feel that we lack the resources to meet the demands around us.

The views expressed are those of the author(s) and are not necessarily those of Scientific American.


Key Ideas

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The Stress We Encounter Daily

The Stress We Encounter Daily

A moderate amount of stress is beneficial for us but chronic, and toxic stress has the opposite effect of deteriorating our well-being.

Our current lifestyles provide us with above-average levels of psychological stress, which slowly drains us of our willpower and resilience, and makes us feeling hollow and unfulfilled.

We have a word for it: Burnout.





The long-term effect of chronic stress is described as allostatic load. This is a fairly common form of chronic stress response of the body if it isn’t completely destroyed.

Prolonged stress makes the mind and body function in a different, sub-optimal way called maladaptation.



Pseudo Work And Stress

Many professionals have reported epidemic levels of burnout due to an abundance of stress-inducing activities that are not productive or necessary.

Chronic stress and burnout also result in errors, accidents, disability and even death.



Stress Relievers

Research in positive psychology shows that setting and pursuing a variety of goals that are meaningful to us is associated with less stress.

This includes being present in the moment and self-reflection activities like writing a journal.



Hope Theory

This is about concentrating on your internal motivation, and perceived capability to attain a certain goal. It makes us achieve small goals, as we are motivated towards taking the small steps which eventually lead to our larger goals.

Remember that we are not machines, and we cannot sacrifice our well-being for someone else’s bottom line, or any artificial target.




The Relationship Between Goals And Burning Out

The Relationship Between Goals And Burning Out

Effective goal-setting underlies the fundamental aspect of your motivation and keeps stressful situations at bay.

If you don’t set goals in positive, attainable ways, you may fall i...

Reorganizing Your Goal Hierarchy

As losing resources is more likely to cause burnout than gaining resources is to mitigate it, dealing with the negative aspects is more beneficial than using positive “band-aid” fixes. You want to drive down uncertainty and inefficiency to ensure that you aren’t doing unnecessary tasks and minimize your emotional exhaustion. To do that:

  1. Create a chart and place your major goal at its top, followed by layers of very specific subgoals needed to attain the major goal.
  2. Find and fix the inefficiencies in your goal hierarchy.
  3. Determine the attainability of each goal.

Burnout Symptoms And Signs Of Exhaustion

  • Chronic fatigue
  • Insomnia
  • Impaired concentration/ forgetfulness
  • Loss of appetite
  • Anxiety
  • Increased illness
  • Physical symptoms
  • Chest pain
  • Shortness of breath
  • Dizziness
  • Gastrointestinal pain
  • Depression
  • Interpersonal problems.

4 more ideas

The Pressure Of Time

Most leaders have familiar approaches to managing time: setting goals, planning, delegating, tracking commitments, and creating to-do lists. While these approaches do help in self-organization, the...

Sustainable Productivity

Instead of increasing the number of productive hours, we can focus on getting the right things done in a timely way. We also need to restore and balance ourselves, our colleagues, family and environment, instead of a neurotic or pathological focus on deadlines.

Find out what's truly important to us and use the finite resource of time wisely.

Phantom Workload

Phantom workload looks like real work but results in massive unproductivity and even conflict in an organization. The pressure to meet unrealistic expectations causes a vicious cycle of further workload.

Leaders need to take a hard look at what is being avoided or not addressed. Facing difficult tasks that were 'swept under the carpet' earlier strengthens them further to make hard decisions and face difficult people and situations.

Understand your limitations

Burnout occurs when job demands consistently outweigh the resources available. The first thing you need to do is to set proper limits.

When you limit your time spent on specific tasks,...

Learn to say no

 ... especially to projects and clients that suck the creativity out of you.

When your mental resources are limited, you need to make sure they’re going to the right tasks. Burnout decimates your motivation, making working on projects you’re uninterested in an agonizing process.

Finding a creative outlet

Find a completely unrelated creative outlet: look for a creative task with lower stakes to help ease you back into things and re-ignite your creativity and motivation.

What are the things in your own life that you enjoy but aren’t necessarily “productive”?