Realistic optimism: a key to burnout prevention

Work can often feel like a series of crises, piling on top of each other and burying us underneath. It can feel like there's no way out! But it doesn't have to be this way. Resilient people tend to face the same world, the same challenges in a day, with realistic optimism. In this video, from our Resilience Masterclass: 10 Critical Skills course, you'll learn to recognize the tendency to frame experiences from a pessimistic perspective and, instead, develop an optimistic (yet realistic) approach to your environment.

Burnout among healthcare professionals is all too common. This course will teach you how to recognize burnout in a healthcare setting and build resilience against it. You’ll learn how to establish a resilience network around you, explore work stressors, and learn tactics to mitigate them. The time-tested strategies you’ll discover will empower you in the face of any challenge that crosses your path!

We all experience it, the Sisyphean experience of heading into work every day, truly wondering if we're making any difference whatsoever. We go at a dizzying pace, always running from one crisis to another, but always seeming to be losing ground. More complications, more interpersonal rifts, more complaints, more disasters.

And the outside world, well, the outside world is on fire, figuratively, and literally. So much of every component of our lives, feels out of control and careening in the wrong direction. Then a pandemic hits and it goes from bad to really, really bad. In such situations, we fall so easily into a mindset of helplessness, defeatism, and nihilism.

This is one of the cornerstones of burnout, the sense of quote, "What's the use, nothing I'm doing has any impact." So we respond with defense mechanisms. We limit our engagement and our enthusiasm. Quick on the heels of nihilism comes cynicism and dark humor, often dark, dark humor, humor that anyone on the outside looking in, would think was ghastly.

And we seek escape, often through indulgence and unhealthy activities. But it doesn't have to be this way. Resilient people tend to face the same world, the same horrors of the day with a realistic optimism. That is, a belief that things are moving and will move in the right direction. A belief that they can influence this direction, that they can make a difference.

They're not being Pollyannas, who fail to account for the hard stuff. They acknowledge and accept the difficult components of their day, their work, their environments, their relationships, their world. But, approach them with a sense that some good can come out of even the roughest of circumstances.

To paraphrase comic Jerry Seinfeld, speaking recently about New Yorkers in the COVID-19 pandemic, they're like ants, who have just had their anthill kicked over, and who immediately set about rebuilding it. Doing so doggedly. Doing so until it's all rebuilt, perhaps even better than before. This takes a shift in one's mental map.

That is, the way one views his or her existence, and the world around him or her. It takes accepting that bad things do happen, even terrible things, but that such outcomes are not immutable, and that they can be influenced and improved upon. So how do you do it? How do you shift to realistic optimism? Here are a few exercises to try.

One, consider some deeply challenging circumstances of your current existence. Start off by admitting, this is hard. But, remind yourself, I am going to get through this. Write down the components of said circumstances. Write down the worst case scenarios associated with the entity, now counter this by writing down more positive potential outcomes.

They don't have to be perfect outcomes, just better. And write down ideas on how you may influence the outcomes in the better direction, towards the better outcomes. What you're doing is training your mind to search for alternative pathways, to alternative assumptions, to active participation rather than passive surrender.

Sometimes, you won't have any viable solutions, so then narrow your scope. In your microcosm, is there anything you can do to effect a more palatable outcome? If not, are there more positive ways that you can respond to it? Are there silver linings? Are there lessons to be learned? Are there relationships that can be strengthened?

For example, over time as a neurosurgeon, I've tended to become very close with my systems trauma specialists, because with frightening frequency, we struggle together to save victims of horrible accidents. Sometimes unsuccessfully. The closeness not only affects a better personal experience, but makes us a better team that will perform at even higher levels of efficiency, and efficacy for the next victim.

Yes, we can't save every patient. But with every patient, we get better at what we do, and we have more close colleagues to commiserate with. Do the same exercise with your resilience group. Set up some dire scenarios and map out the many possible outcomes. Acknowledge that there won't be perfect solutions, just a hierarchy of worst to best Now, diagram positive influences.

Solicit alternative pathways. Commit to always looking for the best possible outcomes, and ramifications of all stressful situations. In a group, wonderful ideas will come fast and furious, and the positive spin will become contagious. Exercise two. Counteract stress induced negative thought patterns. It's all well and good to find silver linings when we have time, and a quiet environment to contemplate these things.

But in the thick of our busy days, all we do is run from one scenario to another, often multitasking while we do so. During these high stress times, we're often bombarded by mind chatter, and it's often negative. This mind chatter is laying the path for nihilism, assuming that everything connected with a situation is going, and is going to go wrong.

So, actively challenge this mind chatter. Don't let it run on and on, tell it, "Hey, settle down there. It doesn't have to be that way. We can do something here something positive. Maybe it won't be quite as bad as you're saying. You never know. We may even hit a home run." Again, we're not advocating assuming the best will always happen, but countering the assumption that the worst is definitely always going to happen.

This takes energy and effort upfront, but you will reign in that chatter, and soon will find that it spontaneously is seeking out the positive angles. Now, with your resilience team, roleplay stressful scenarios, and then solicit the participants and the audience for their mind chatter during the scenario. Discuss as a group what's behind negative chatter, and ways to influence it more towards the positive. Exercise three.

Tackle one piece at a time. Identify a major problem with your system, and explore its many facets. Recognize that an ultimate solution may not be at all within your scope, but consider what small piece of it you may be able to influence for the better. For example, interdisciplinary relations at your healthcare system may be a royal mess. Perhaps a strike is looming.

Instead of wallowing in a sense of helplessness, saying, "Oh man, if the nurses walk out, the whole place just shuts down." Why not focus on treating the nursing colleagues in your immediate sphere as well as you possibly can? Complimenting them on their efforts, offering assistance in their duties, giving them a sympathetic ear.

This moves you away from passive victimhood to active intervention. It's a product of realistic optimism. This activity lends itself again to group discussion. Take on executive level problems facing your organization, realizing you may not be in a position to solve them. But come up with a list of ways that you individually or as a group can contribute to a better outcome.

Exercise four. Envision and articulate a desired future. We all get stuck in our own private time warps. We live perpetually in the very present present. That is, things are coming so fast at us we lose track of the way things are going to be, and the way we would like things to be in the future. This is particularly true when facing a crisis. Time stops, and the world revolves solely around that very moment in time.

The effect is the negatives become exaggerated, and we lose track of the positive outcomes that might happen. To counter this, when dealing with a crisis, envision what it will look like next week, or next year, or five years down the line. Often this will defang the crisis, make it seem much more manageable.

But more importantly, envision your own personal future, particularly the future you wish for yourself. Project to next year, and five years down the line and 10 years. Be realistic, but also reach for what you truly want in your life, professionally, personally and socially. Take out some paper and sketch a timeline, a pathway on how to get there.

And create milestones, markers along the way that will reassure you that you're still on your path. Also include where you were five to 10 years ago. This exercise will remind you that there is a pathway to what you want in life, and that you're on it, making ground. It pushes aside the nihilism and the passivity, and encourages you to be an active player in your own life.

It inherently fills you with optimism and appreciation for where you are in your journey, and where it may take you. Reassess this at least every year, and be willing to modify your goals. Time changes us all. Again, do this exercise with your resilience group. Share your desired futures. Useful suggestions will often be generated. Allies will be acquired.

Contacts potentially made. Always encourage an optimistic approach. Nihilism is a principal component of burnout. Don't accept that you're not making a difference. Reframe your perspective, acknowledge that there are many major challenges out there, but believe you can affect them for the positive, at least in a small way.