Some Myths About Stress

Feb 21, 2022

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We all describe our lives and careers as stressful. In so many different phrases we hear it over and over. But what if believing certains things are stressful is nothing more than a myth?

Welcome to the 2nd episode of my brand new podcast, Stress-Less Physician. I’m your host, Dr. Sara Dill. As  a board-certified dermatologist and pediatric dermatologist, I was very familiar with stress. So much so that I took time away from my practice and embarked on a journey to find that elusive “work-life balance”. I longed to find a solution and free myself from a potential lifelong career filled with never-slackening stress. On that journey, I learned that stress is a symptom and thoughts are the root cause. In other words, what we think about situations and circumstances and how we respond to them determine how stressful they are.

Armed with this and more freeing knowledge, I became a life coach for doctors to help others learn what I have. The goal of this podcast is to reach more people with these truths, starting with how we think about things. By the way, if you missed Episode 1, I encourage you to go to my website and listen to it. In that episode, I discuss how to feel better.

What You’ll Learn 

Defining terms around stress

  • Physiological versus emotional
  • A loose definition of stress

Myths and Misunderstandings of Stress

  • Origins
  • A motivator
  • Management of effects rather than cause
  • Inevitability

The Caveat

  • No blame or shame
  • Working toward awareness

Ability and authority to change your response

  • Altering perceptions
  • Observing other people’s responses

Contact Info and Recommended Resources

Book Recommendation by Dr. Sara Dill: 

The Upside of Stress by Kelly McGonigal

Connect with Sara Dill, MD, The Doctor’s Coach


A bit about me…

I’m Sara Dill, MD, board-certified dermatologist and pediatric dermatologist. I went through life getting straight As, following the rules, and getting into the right schools (Harvard, UC San Diego, Brown). I believed the way to be a good and successful doctor was to work hard, always say yes, and put patients (and everyone else) first. 

But while I was successful, I felt perpetually stressed out, overworked and unhappy. I was always looking for that perfect work-life balance, which never appeared. So I became determined to solve this problem. I had worked too long and hard to simply accept being overworked and stressed out for my whole medical career! 

I took a sabbatical from practice and studied life coaching. I completed two life coach training programs, numerous other courses, read 100s of books, and used coaching to transform my own relationship to work.

What I learned was that stress is a symptom. It all has less to do with the actual hours you work than with your thoughts about your work.

With this knowledge, I took control of my life and stopped being just one more overworked and stressed out doctor. So can you! But you don't have to take years and read hundreds of books to figure it out. I did it so you don't have to. And I’m here to help. Using a combination of coaching tools and mindfulness, I coached myself back into a thriving dermatology practice I truly enjoy. With the rest of my time, I coach other physicians on how to stress-less and enjoy their work and life more.

Transcript

I’m Dr. Sara Dill, and this is the Stress Less Physician Podcast, Episode Number Two. Welcome to the Stress Less Physician Podcast. I’m your host, Dr. Sara Dill, MD. Using my unique combination of coaching and mindfulness tools, I will teach you practical ways to reduce your stress level, feel happier at work, and create a better balance between your medical career and personal life. If you are a busy practicing physician who wants to design a life and medical career that feel good to you, you are in the right place.

Hey, everyone, welcome back to the podcast. Today, I wanted to talk about stress. So many of us, myself included, often revert to saying things like, “I’m so stressed out, work is so stressful.” Most of us would describe COVID and this whole global pandemic is extremely stressful and difficult. And I wanted to play around with this idea a little bit and talk about some of the myths of stress that I think are very interesting and useful to think about.

So, I was introduced to this idea that maybe the idea that there are just some things in life that are stressful is a myth. This is what all of coaching sort of boils down to, is the idea that it’s not the circumstances or the facts of our life that are inherently challenging or stressful, but it’s our thoughts about them that create our emotional response to them.

So, before I get started, on the myths of stress today, I wanted to start by defining our terms. And this is actually more challenging than I would have thought. So, stress is defined in a variety of ways. There’s the more scientific definitions of stress, which actually vary widely—a lot of them end up going back to any trigger or any event that creates a fight or flight or freeze response in the body, or perhaps generates stress hormones, would be labeled stress or a stressor.

However, when most of us talk about being stressed out, a lot of the time, what we’re talking about is emotional stress. And part of that might have a physiological response, of an elevated heart rate, elevated blood pressure, shortness of breath, all sorts of things that’s part of the stress response, the fight, flight, freeze response. But in some of the earlier studies, there was also a lumping in of what I would consider more physiological stressors. So, animals being exposed to cold or heat, or other situations that also elicit a physiological stress response. And most of us aren’t talking about being cold when we’re talking about being stressed out. So, I would like to offer that when we’re talking about being stressed, we’re typically talking about a wide range of negative emotional states: feeling anxious, feeling overwhelmed, feeling worried, feeling angry, feeling afraid. So many of those.

There is this idea of beneficial stress that you might see in the literature. There’s also a great book that I love call The Upside of Stress, in which Kelly McGonigal is looking at what is considered sort of positive stress. And it’s interesting, in that, there is this definition of what’s called you stress versus distress. So, you stress is sort of this idea of beneficial stress. So, it’s often when we’re feeling enthusiastic or excited. It also generates a physiological response. But most of us when we’re feeling stressed, aren’t really talking about feeling excited, or happy.

And in Kelly McGonigal, his book, it’s interesting in that she defines stress as “What arises when something you care about is at stake.” She likes this definition, because it includes one’s thoughts, emotions and physical reactions. And she goes on to say that stress and meaning are inextricably linked, that stress doesn’t happen in a vacuum, you don’t stress out about things you don’t care about. And so a lot of her research is really unrefreshing how we think about stress so that it doesn’t create so much negative emotion. So, I haven’t really defined stress, but I’m going to leave it somewhat loosely defined as basically a negative reaction, whether it’s short term or long term, to what we perceive as a stressful event.

So here we go: The four myths of stress and a caveat. Or maybe a better way to phrase it, it’s how we misunderstand stress and the cause of stress in our lives, and the implications of it. So the first myth or misunderstanding that I want to talk about, is that stress comes from our circumstances from the things that happen in our lives. So if this is a myth, then this means that there’s no such thing as a stressor in life, right? We often talk about, well, how do you want to respond to a stressor? What’s the stressor going to be in my new job versus my old job? Maybe that’s a difficult patient, maybe that’s running late. Maybe that’s traffic.

I want to posit, just to sort of get you to start thinking about it. What if stress comes from our thinking about our circumstances, not the circumstances, or facts of our life? This goes back to what I talked about in the first episode, which is the idea that our feelings don’t come from the facts of our life, they come from our thoughts about our life, about the facts of our life, from our thoughts and perceptions about the facts of our life. So, what if the same is true about stress? What if there’s no such thing as just “stress.” But basically, it requires our perception for something to become stressful for us.

This is why I would suggest that different people have different emotional reactions to the same or similar situations. So what stresses me out might not stress you out? For example, I don’t like to be late. I have several dear friends, however, who are very late a lot of the time. I don’t know that they get stressed out by that. If they do, they probably have a different kind of stress reaction. My reaction is impatience, annoyance, frustration. There’s might be… I actually have no idea. I don’t know what their reaction would be. I’m guessing it might be different, or they might not have any stress about it at all, they might just think this is fine. No problem.

So the number one myth of stress that I’d like to suggest that you consider is that feeling stressed does not come from your circumstances, that there’s no such thing as a universal stressor out there that every person would agree is stressful. If you want to really question it, which I would encourage you to do so with anything I discuss or offer on this podcast, would getting chased by a tiger or a lion or some sort of life-threatening situation, be a universal stressor? Maybe that might be close. But what if that Tiger is actually tame? What if you see what you think is a snake but it turns out to be a rope?

Someone might not find that stressful if they knew that, if the tiger was tame, or the so-called snake was a rope. So again, I would just consider the possibility, what if feeling stressed comes from our thoughts and not the situation or facts or events of our lives. That could be really good news, and leads me to myth or misunderstanding number two about stress.

So, number two, is the idea that we need some stress to motivate us to achieve and to perform, or otherwise we would all just sit around and do nothing, maybe watch Netflix, maybe just lounge around, eat stuff. I think a lot of us sort of believe this. I know I certainly did, that somehow, I thought stress was a necessary motivator, it was the best way that I knew how to perform. And that without it, I and others would have no desire or ability or reason to do things, or accomplish things or have big goals.

I think here, it’s very important to draw a distinction between a motivator or having motivation and stress. There’s a difference between stress and desire, between stress and wanting things, between stress and excitement, between stress and creativity. So having goals in life, striving to do stuff, striving to do things, having big plans, trying new things, all of those can be and are independent of feeling stressed. All of those perhaps rely on some motivation or desire or interest or excitement, all positive emotions. The undertaking of big goals can certainly generate some stressful thoughts and stressful feelings in the undertaking and achieving them. Of course, I would argue that this is coming from our thoughts. But what if we don’t need to be stressed out to take action and to achieve and to set goals? I think so many of us are so used to experiencing stress, that we don’t remember what life was like without it.

But if you think about children, you can observe younger children especially, they go and do a lot of things. They’re very interested and excited and enthusiastic about so many things. They come at it though with more of a motivation of play. I’d love to maybe question whether being playful, whether bringing play and curiosity is way more effective and help helpful in creating a life and taking risks and going after things, than needing to feel stressed out about them.

So children often don’t experience a lot of stress, or at least I hope not, at least not a lot of emotional stress as we’re talking about. But they have plenty of energy to explore their interests, to explore the world, and to undertake different tasks to learn and grow. What if the same is true for us adults? What if we can actually function better without experiencing high levels of stress? What if our achievements are not because of how we perceive stress and use that as a sort of negative motivator, the idea of using a stick against ourselves, rather than the carrot? But what if we could actually achieve more, if we were able to do it in a way without experiencing high levels of stress? What if our achievements are in spite of our stress and negative emotions, not because of them? Just something to think about. What if our achievements are in spite of our stress, and negative emotions, not because of them?

The third thing I’d like you to consider as a possible myth or misunderstanding about stress is that the best way to deal with stress is to manage your stress by doing things like relaxing, meditating, exercising, doing self-care, deep breathing, etc. All of these are different tools that are suggested. But I think they’re really sort of missing the point, if we buy into the idea that stress doesn’t come from what’s going on in our life but instead, it comes from our thoughts about what’s going on in our life. So all of these are really stressed management tools, which I completely believe in. I’m a big fan of exercising, breathing, relaxing, taking time off meditating, I do all of those things.

But what if the stress management tools, they’re really designed to relieve the effects of stress but not address the cause? It’s to alleviate the deleterious effects of stress, which again, I’m all for. But what if we did that and addressed the cause, which is our thinking and our perceptions? Because of the cause of stress—again, stress, I’m defining as negative emotions, like anxiety, overwhelm, fear, irritation, anger, what we need to be doing is looking at our thoughts that are the cause of these stressful responses, rather than looking at the results and then trying to alleviate or manage the negative results of having chronic stressful thoughts and feelings.

So again, a more effective approach might involve learning to think differently about situations that you find personally challenging or stressful. So, I would just ask you here, what is the stressful situation for you? What is maybe a repetitively stressful situation? Can you identify it? Let’s start to work on what you think about it. What makes it stressful for you? What’s the flavor of the stress that you experience? Is it anxiety? Is it overwhelm? Is it fear? Is it panic? Maybe it’s just like irritation. Any of those things? And then we can start to work with it rather than doing stress management, in which case, we sort of assume that stress is a given. And what we’re going to have to do is try to manage the effects of stress. And that might be the best that we can do.

And that brings me to the last myth of stress or misunderstanding is that I think a lot of us think that stress is just inevitable, right? It’s part of the world. It’s something that we’re all going to experience and there’s not a lot that we can do about it, except again, learn to manage it better. So I will say, in all honesty, that I’ve been in this coaching world, and self-coaching and getting coached for many years, and I still experience stress, very frequently, I’m a human being. I don’t know that it’s possible to ever completely eliminate a lot of my thinking that generates a stressful response in me, and I’m okay with that.

Because what I have discovered is that I experienced stress a whole lot less, and that I am able to sort of deactivate it and let it go a whole lot more quickly. And I understand what’s causing it and that that is very empowering. So, I can promise you that just starting to consider the fact that what if it’s actually possible to stress less, not through needing to change the world, but through changing your thoughts about the world can be quite empowering. And it can actually work.

So, I would also just offer as another piece of evidence that again, you could notice what stresses you out is probably different than what stresses me out or other people. So something that bothers you and that doesn’t bother other people is very interesting to look at. For example, I’m not afraid of flying. I have friends and family who are anxious fliers, and I know other people who are quite terrified by it. For them, it’s a very stressful experience. But the way I see it is that flying is pretty neutral, right? It’s getting on a plane and taking that plane to another location. Some people love it. Some people hate it. Some people are terrified of it. Some people are indifferent about it, and some people just find flying annoying and sort of a hassle.

So you can notice that we all have different thoughts about it. It does not mean that you have to decide you want to love everything or feel happy about everything. But it does show you that again, this idea that stress is inevitable, is perhaps not totally true. So, the emotional response that someone has, when they think that flying somewhere is based on their thoughts about flying, not the actual plane traveling through space to another location, that can give you a lot of power back over deciding, do I want to start to react and respond differently? So, what are my thoughts that are generating my stress, and how can I start to change them?

And now the caveat, and this is true of everything I will talk about on this podcast, and that I talk about and do with my clients. So often what I’ve noticed is that when people, myself included, start to notice and believe that I’m the creator of my feelings and my results in life by how I am thinking and believing, there can be a tendency to start to blame oneself to think that I should immediately make a better different choice, to wonder, why am I choosing these thoughts? So, I would like to say that it’s not like we’re all choosing to be stressed out. Stress is not a choice that we are making consciously. So there’s no need to blame or shame or regret here.

I know in this podcast I talk a lot about choosing our thoughts and changing our thoughts, and I certainly will. But in the moment the stress arises, however, it’s there, right? This is the same for any negative emotion, if you didn’t choose to feel it consciously. Our stress response is very useful in an evolutionary and survival picture. That’s why we have it. And yet now we often feel chronic stress about things in which survival is not on the line. It’s like an operating system that we need to upgrade.

Stress in the moment, it’s a byproduct. I would suggest, of our subconscious beliefs, or perhaps beliefs that we aren’t yet aware of maybe unconscious, you can’t choose immediately not to believe something, if you currently believe it. So a lot of the work of coaching is to start by bringing things to awareness. What am I thinking here in this situation that is causing me to feel stressed out? What is the feeling of being stressed out for me? For me, it was a lot of anxiety and sort of worry, mostly about making mistakes or things like that. That was a big stressor for me. Not getting it right was probably the thought there that I had a lot: “I’ve made a mistake, I’m not getting it right, I did it wrong.”

So in the moment, when you believe it, you can’t just change it. So you believe it because you think that thought is true. So to learn how to eliminate stress, or at least reduce stress in a significant fashion, you have to start to learn how to challenge your beliefs and to see them differently, to start to disprove them, to start to disbelieve them. And actually, that’s what I’m going to talk about in the next podcast. I’m going to talk about how to believe new things, which is completely possible.

But in the meantime, telling yourself that you are choosing to feel stressed— hopefully you aren’t doing that. It feels sort of blaming to me. In the moment, of course, again, none of us would choose it. Most of us have this belief that stress is just sort of inevitable, right? It’s a part of the world, that there are all these stressors. And the best we can do is try to counteract some of the effects of stress by meditating, doing yoga, taking walks in nature, connecting with people, all of which are amazing things to do and great tools to manage the effects of stress, while we start to work on our thinking that keeps generating our own personal stress response.

And so why does this matter? Is this really such a big deal? You know, is it worth it to do all this work to start to unravel the thoughts that are creating your stress? I think so. It’s been worth it. For me. I think stress is a big deal. Chronic stress, as we know, is linked to many medical conditions. And in my opinion, walking around in life feeling anxious or overwhelmed or irritated or afraid, or whatever other negative emotions are sort of your go-to stress response, I think it’s a big deal. Most of us want to enjoy our lives. Most of us want to enjoy our lives more. Most of us want to feel more contented. Most of us want to maybe feel more excited or safer, or valuable or fulfilled. All of those, I would argue is the opposite of feeling stressed out.

So again, I just want to offer what if it is possible to be less stressed. That’s why I chose the name of the podcast, the Stress Less Physician. Again, I have not met anyone, maybe except for one of my teachers, Byron Katie, who I would label as “stress-free.” However, I can say that having done a lot of this work, having started to really test this idea that it’s not the facts of our life, it’s not the circumstances of our life that are inherently stressful, but our thoughts about them that create our stress response, and that I have the ability and the authority to change my own stress response, especially to those things in practice, or those things in my life that I don’t want to be stressed out about.

I don’t want to be stressed when I go to work, I don’t want to be stressed out by throwing a dinner party, I don’t want to feel stressed all the time about people who believe different things about COVID, or medical care. I don’t want to feel stressed out about running late in clinic. I don’t like running late in clinic, but I would prefer to feel more relaxed about it. I don’t like that sense of anxiety; it actually creates a very negative response. And it tends to make whatever I’m trying to work through worse.

So again, what if it is possible that stress does not come from our circumstances, but how we think about them? What if it is true that most of what we think of is stress in the lay population sort of term is not good for us? There is you stress and this idea of, you know, physiological stress, say, working out with your muscles, breaking them down to build them up stronger. That’s a different kind of stress than I think most of us are talking about. What if it’s not true that we need stress to be a motivator, and otherwise, we just sit around and watch TV? What if it’s possible that we might actually be able to accomplish more and achieve more without feeling stressed out all the time?

What if we don’t have to learn how to deal with stress with exercise, breathing, relaxing, meditation, etc. But that we can actually work on the source of stress, which is our thinking about it. And of course, it’s good to have techniques that can help deal with the results or the effects of stress. But that’s not the only coping skill. And what if stress isn’t a choice until we become aware of the fact that we’re creating the stressful response for ourselves, by the way we’re thinking about a situation.

I just want to offer all that to you. I know it’s a little bit of a different mindset. And it goes against a lot of what most of us sort of think and believe, and what certainly gets talked about in the media, on Facebook groups, etc. And again, never take anything that I say as truth, I’m pretty sure you wouldn’t anyways, I just want to offer it to you just play around with it wonder about it. How do I feel when I think about the idea that maybe it’s possible to stress less, maybe I don’t have to respond to what other people would agree with me as a stressful situation, and perceive it as stressful? What if I were able to switch the way I think about things to not perceive them as stressful?

So again, you can notice that what you find stressful, other people don’t find stressful. That, to me, is very interesting. Even being in almost the same job at times where I was unhappy, and someone else was happy, was very curious, right? Like, what do they think about this job, where they’re happy and thriving and enjoying it? What am I thinking that’s making me feel anxious and overwhelmed and overworked? That’s where we start to work with it with coaching. So again, don’t blame yourself. Don’t tell yourself, you should already know this, or you shouldn’t be so stressed out. Anytime we do that, we actually lose a lot of access to our thoughts and our ability to really shift how we perceive the world. So you always want to come at this with curiosity.

And again, and this is where I’m happy to help or where self-coaching comes in, is really noticing, maybe when do I feel stressed? What are those situations? Can I detail them out very factually? Get to know your own particular stressors. And again, start to question what you’re thinking about those situations or those people or whatever. Why do you find it stressful? What is it about that that’s stressful? And sometimes you’ll notice that it’s not always helpful to talk to other people about it, because they might just reinforce your belief that that is very stressful, and there’s no way around it. So again, getting curious again playful just starting to wonder, I wonder if it’s possible.

Feel free to shoot me an email if you have any questions. And again, if you want to head on over to my website, saradill.com I offer several free consultation calls. If you want to get some personalized help with this, or continue this discussion, love talking about this. I’ll talk to you soon.

If you are a busy practicing physician ready to start feeling less stressed, enjoy work more, and learn how to create a more balanced and sustainable medical practice and life, sign up for a consult call with me at Saradill.com That’s S-A-R-A- D- I- L-L.com. It would be my privilege and pleasure to work with you.

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