Shownotes
In this episode, I'll be talking about the hidden ways that we can sabotage our clinical growth. I'll take you through 4 psychological defenses that can actually keep us stuck in our clinical practice. At the end, I'll leave you with 5 strategies that will help you overcome these traps of the ego and ultimately help you move into growth, as a person and as a clinician.
Outcome Measures 2.0: I'm building a web-based tool (called Clinio360) that will help physical therapists get below the surface of what makes their patients tick, click here to Join the Journey!
As promised in the episode, here are a couple of links that will help you learn more and implement these changes:
- Wilson & Gilbert Psychological Immune System
- Understanding My Ego Traps Worksheet
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Transcripts
Welcome to the unleash, your best clinical self podcast.
Speaker:I'm your host, Andrew Koppejan.
Speaker:If you're a physiotherapist or other movement professional,
Speaker:who feels like you're stuck in a rut, then my podcast is for you.
Speaker:This podcast is focused on helping you move from frustration to flow
Speaker:in your clinical practice and each episode I'll share strategies,
Speaker:approaches, and my latest thinking on how to improve your clinical
Speaker:performance and keep loving what you do.
Speaker:This is episode number 63 and in this episode, I'm going to be talking
Speaker:about the hidden ways that we can sabotage our clinical growth.
Speaker:I'll also walk through 4 psychological defenses that can actually keep
Speaker:us stuck in our clinical practice.
Speaker:Before I dive in, though, I want to let you know that I have a newsletter
Speaker:where I write about topics relating to improving clinical performance
Speaker:and achieving clinical flow head over to 360 clinician.com to sign up.
Speaker:I want to start off with a little story that was from when I was very young
Speaker:and I got thinking about this story.
Speaker:We were doing some reminiscing with family and I, and when I was around
Speaker:seven or eight years old, for some reason, I don't know why, but I was
Speaker:convinced that the word couple could mean two or three, not just two.
Speaker:And so even though I have older siblings that would correct me, I
Speaker:was very adamant that I was correct.
Speaker:And I just think back to that time.
Speaker:I'm like, I'm not sure how I really wrap that around my head but it
Speaker:wasn't really open for discussion.
Speaker:In my mind it was settled and thankfully I moved past that and got a little bit
Speaker:better command of the English language.
Speaker:I was thinking about this story when I thought about how often I can be blind
Speaker:to learning something new because of my need to protect my sense of self and my
Speaker:sense of feeling that I'm right about it.
Speaker:It wasn't until I was exposed to a concept called the psychological immune system.
Speaker:That I began to understand why I avoided uncomfortable learning experiences.
Speaker:And this concept of the psychological immune system was first introduced by
Speaker:psychologist, Wilson and Gilbert, in their research around decision-making.
Speaker:They shared about this concept of the immune system in that article
Speaker:and I can put it in the show notes and they said the physiological immune
Speaker:system is one that fights threats to physical health and people have
Speaker:a psychological immune system that fights threats to emotional wellbeing.
Speaker:I think it's a, it's an interesting concept and one that I think helps
Speaker:explain some of the ways that we will try to protect ourselves from threatening
Speaker:events and experiences in our life.
Speaker:But the rub is that learning and growth can actually be very challenging,
Speaker:uncomfortable and even at times, threatening to our sense of self.
Speaker:Our psychological defense system helps maintain our sense
Speaker:of equilibrium emotionally.
Speaker:But it can actually work against us when we're trying
Speaker:to look at learning and growth.
Speaker:If it, sees some of these events as threatening to our sense of wellbeing.
Speaker:So this concept has really helped give me some language and a framework to
Speaker:understand how I've protected my own ego at the expense of my growth at times.
Speaker:When our ego feels threatened, it's easy to deceive ourselves.
Speaker:We can misplace blame and we can trivialize new information.
Speaker:But it's in our effort to actually defend our ego and protect ourselves,
Speaker:we actually miss opportunities for learning and growing as clinicians.
Speaker:I think that there's always this balance that we have to achieve right.
Speaker:On one side we have self protection and on the other side we have growth
Speaker:and our ego is always working to say, okay am I feeling threatened right now?
Speaker:Or do I feel safe?
Speaker:And this sort of oscillating between these two ends of the scale, I think
Speaker:that it's when we can get a better sense of how to manage our own sense
Speaker:of self so that we can actually move into some of these learning situations
Speaker:that may feel a little uncomfortable.
Speaker:We can actually be open to that rather than shutting that down
Speaker:and trying to protect ourselves.
Speaker:And so there are some traps of the ego that I've identified in my own
Speaker:life and I wanted to share with you and hopefully you find this helpful.
Speaker:But I think there are quite a number of ways that we can sabotage ourselves.
Speaker:Whether that's conscious or subconscious, and I think these different ways
Speaker:that we try to protect our ego and maintain that internal equilibrium.
Speaker:So here's four that, I found for my own clinical experience that I've
Speaker:realized can actually work against me.
Speaker:The first trap I've discovered is just isolating myself from outside help.
Speaker:I find that when I'm my ego defenses are active it's hard to reach
Speaker:out to somebody else for help.
Speaker:I thought back to when I was a student.
Speaker:And there's always this expectation as a student that you would ask for help.
Speaker:There was definitely a safety in the role of being a student, that you could ask
Speaker:questions and that was expected of you.
Speaker:But the longer that you end up being out of practice the harder it
Speaker:becomes to have that beginner's mind.
Speaker:That place where we can actually be humble and we can accept this idea of
Speaker:not knowing but also having that courage and openness to ask for help from others.
Speaker:Trap number two is avoiding learning because of the
Speaker:challenge to my sense of self.
Speaker:I've thought about this.
Speaker:When I think about topics that I maybe need to learn more about, I have
Speaker:this intention to look it up but then oftentimes I don't follow through on it.
Speaker:And it's something that we can think, oh, well, I'm busy and so I don't have time.
Speaker:But I also noticed that there are times when it's not about a time
Speaker:issue it's more actually about my ego.
Speaker:And sometimes when we look things up, it actually requires us to confront
Speaker:our lack of knowledge about a topic.
Speaker:I think part of it too, with this psychological defenses, is that
Speaker:they can oftentimes be unconscious.
Speaker:We can remain largely unaware of how they're operating in the background.
Speaker:I think back to a clinical case that I had a while ago where the patient
Speaker:was complaining of a persistent shin pain and I was treating
Speaker:actually other areas of the body.
Speaker:And so I put off looking at this area for this patient and
Speaker:really it was something that I should have put more attention to.
Speaker:I think that I would have referred her out for further workup and imaging
Speaker:because of some of the symptoms this patient was complaining about.
Speaker:I was disappointed with myself that I wasn't more prompt with my referral.
Speaker:I felt my anxiety increase and I felt my sense of competence
Speaker:in some ways be threatened.
Speaker:And I knew that I needed to do a thorough case review and really think through how
Speaker:to avoid this in the future and how I could have approached it differently.
Speaker:I actually found myself really struggling to go deeper with this
Speaker:topic and spending the time on it because it forced me to confront this
Speaker:ego threatening experience to me.
Speaker:And so it can be helpful to look back at cases in your caseload to look
Speaker:at okay, well, are there situations that I'm actually avoiding looking
Speaker:up something or I'm learning about something because of the fact that it
Speaker:actually makes me feel uncomfortable.
Speaker:I have to face the fact that I didn't know something about that topic.
Speaker:Trap number three is avoiding acknowledging our limitations.
Speaker:Something that I've noticed myself is this tendency to avoid referring to another
Speaker:provider, especially when it's, you know, could potentially effect my ego.
Speaker:Sometimes it's hard to acknowledge and accept that I may actually not be
Speaker:the best person to solve that person's problems and they need another type
Speaker:of treatment or another provider to provide a different perspective.
Speaker:Confronting that reality can definitely be an a front to the ego and can
Speaker:threaten the psychological immune system.
Speaker:Now, knowing when to refer to another provider can be a challenging decision
Speaker:and there's a lot that goes into it.
Speaker:But I think it's important to look at okay, well, what's the
Speaker:reason for avoiding the referral.
Speaker:Is it because of the fact that it is a threatening my
Speaker:psychological immune system?
Speaker:Or is it because I am just giving up too easily.
Speaker:Whatever it is, I think really looking at that reason for avoiding referral
Speaker:will help to give some clarity in terms of what's actually holding
Speaker:you back from taking that next step.
Speaker:Trap number four is distracting ourselves with shiny objects.
Speaker:I've found that it's really easy to distract myself with new information
Speaker:or experiences and really falling prey to the shiny object syndrome.
Speaker:We learn new information or take a course on a new topic.
Speaker:In some ways it doesn't threaten our sense of self it's, new it's fresh.
Speaker:We're not really having to go back and look at how we've performed or look
Speaker:at the gaps in our existing knowledge.
Speaker:I think that learning new information is good but it's not growth producing if it's
Speaker:an avoidance response to placate our ego.
Speaker:I think it's a lot more exciting and dopamine producing when we're
Speaker:exposed to new ideas and information.
Speaker:Working through a past patient case where we've missed a diagnosis is
Speaker:going to be a lot more important and a lot more growth oriented.
Speaker:I spent a number of years practicing piano, and I was often working on
Speaker:classical piano pieces for months on end.
Speaker:Oftentimes I just got tired of working through a section of music and I wanted
Speaker:something new and exciting to work on.
Speaker:The crux of it was that I needed to spend the time focusing on the stuff I needed
Speaker:to work on, because that was really what was going to help me move forward in terms
Speaker:of be able to master that piece of music.
Speaker:Another shiny object distraction is consuming social media content.
Speaker:A situation where we feel like, oh, I just need a new exercise or
Speaker:I need something new to go with.
Speaker:I think that a lot of times we have to be honest in terms of these are just
Speaker:small dopamine hits that help us feel good and they really are a distraction
Speaker:from maybe something that we do actually need to dig into a little more.
Speaker:So in brief, we have four traps of the ego that I've just talked through.
Speaker:The first is we isolate ourselves, we avoid asking for help.
Speaker:Number two is we can ignore what we need to actually focus on and we
Speaker:avoid learning things that are really going to help improve our growth.
Speaker:The third is we avoid referring out because it is a threat to our ego and
Speaker:then four is distracting ourselves by moving on to new information when in
Speaker:reality, we should actually be focusing on what we're already looking at.
Speaker:So the thing is, that if we engage in these traps of the ego on a regular
Speaker:basis, I can definitely stunt and stagnate our professional growth.
Speaker:When we look at our egos and our psychological immune system
Speaker:it can be challenging work.
Speaker:Because we're dealing with motions and established beliefs and really some of the
Speaker:things that can even impact our sense of who we are as people and our identities.
Speaker:With all of that said I do believe that it is necessary work to engage in,
Speaker:especially if you are committed to a deeper growth and improvement in terms of
Speaker:your skill and ability to help patients.
Speaker:Alright let's dive in to some ways that you can start to navigate the
Speaker:psychological immune system and give less power to our ego protective strategies.
Speaker:First off, I think it's important to understand your ego protective traps
Speaker:or the patterns that you fall into.
Speaker:Getting comfortable with understanding what's going on
Speaker:inside is really important.
Speaker:I've found that writing things down can be such a powerful way to bring
Speaker:clarity to what's actually going on.
Speaker:Sometimes things can feel really confusing and messy.
Speaker:I found that just journaling and writing this stuff down can really help
Speaker:to bring clarity and perspective to some of the emotions and thoughts that
Speaker:are swirling around in my own head.
Speaker:What I've done is I've put a little a worksheet together that you can head
Speaker:over to the blog to check out and it's just really meant to be a starting
Speaker:point to get some things down on paper.
Speaker:And it's a place where you can identify the feelings, are you
Speaker:feeling discomfort, overwhelmed?
Speaker:What's triggering this ego response?
Speaker:What's the response that I'm defaulting to?
Speaker:What do I feel most comfortable in terms of trying to get
Speaker:myself out of the situation?
Speaker:Am I trying to isolate myself?
Speaker:Am I trying to ignore it?
Speaker:Am I trying to avoid by trying to distract.
Speaker:Then I have another column that's how can I respond instead?
Speaker:Is there something that I can do to reach out?
Speaker:Can I lean into this topic?
Speaker:Can I refer out?
Speaker:Is that going to be the best thing here for that patient?
Speaker:Is there a way that I can stay present rather than just distracting myself with
Speaker:new information or with social media.
Speaker:The second strategy is to start to get comfortable with
Speaker:discomfort and vulnerability.
Speaker:And I think an important, but often really hard step is embracing that
Speaker:discomfort and vulnerability that's present when our psychological
Speaker:immune system has been activated.
Speaker:The challenge is that negative and threatening events can really challenge
Speaker:our perception of ourselves and how competent we feel about ourselves.
Speaker:And what's interesting is the research shows that negative and threatening
Speaker:events can actually increase the energy we put into analyzing our situations more
Speaker:than neutral or positive experiences.
Speaker:I think it actually can act as a catalyst for deeper learning and growth when we
Speaker:can bring that increased attention during those stressful or threatening times.
Speaker:Instead of seeing these triggering events as something to run from or
Speaker:avoid, I'd encourage you to try to reframe them as opportunities for growth.
Speaker:I find for myself, this really helps me to better cope with the discomfort
Speaker:that those situations can often bring.
Speaker:Just trying to remind myself that okay, this discomfort may be temporary but the
Speaker:growth and personal development I can engage in here by facing these challenges
Speaker:can actually be really long lasting.
Speaker:So just what I've been trying to do is just really trying to reframe how I look
Speaker:at these experiences and just recognizing what's temporary and what's really my
Speaker:outcome or goal that I'm looking for.
Speaker:Number three is to actually challenge the self-talk.
Speaker:And in one of my previous episodes, I talk about the importance of
Speaker:self-talk and how that affects our ability to perform well clinically.
Speaker:Oftentimes we end up dealing with various cognitive distortions like all or nothing
Speaker:thinking or overgeneralization can actually keep us isolated and can prevent
Speaker:us from taking a growth focused action.
Speaker:So I'd encourage you to check out some of my previous episodes where
Speaker:you can learn more about that.
Speaker:The fourth strategy is to be your own coach.
Speaker:And I've found that whenever I've encountered clinical situations where
Speaker:my ego is being challenged and maybe my defense mechanisms start to kick in.
Speaker:I found that it's actually helpful to take on this role of being my own coach.
Speaker:I'll explain a little bit more of what I mean by that, but it's really a
Speaker:process where I take a step back from the situation and try to create a little
Speaker:bit more emotional space to allow for deeper reflection and processing.
Speaker:Here's some steps that I've jotted down that I found myself going through when
Speaker:I'm trying to take on being my own coach.
Speaker:So first off is, I try to acknowledge my own discomfort.
Speaker:It's important and this is what I try to do for myself as I
Speaker:acknowledged that, okay, discomfort and threat to the ego is real.
Speaker:And I want to acknowledge that for myself.
Speaker:I'm not trying to minimize the experience.
Speaker:And I find that first step really just helps me to not just try to stuff
Speaker:under the rug, minimize what I'm going through, but just to acknowledge,
Speaker:okay, this is yeah, this is real right.
Speaker:That first step I find is a really good place to, to get
Speaker:grounded in what's going on.
Speaker:Then second step is to recognize my own ego driven action.
Speaker:So I want to then reflect on, okay, well, what am I trying to do here?
Speaker:What's my default to keep things in balance.
Speaker:Do I want to isolate, do I want to avoid, ignore, distract?
Speaker:Typically, I find it's actually pretty easy to identify what that is because
Speaker:it's the action that I feel will be the easiest and the fastest to get
Speaker:out of this state of discomfort.
Speaker:Then number three then I'll do is I'll review how that threat impacts my ego.
Speaker:I've found that understanding what the threat can mean to
Speaker:my ego is really helpful.
Speaker:So if it's exploring a clinical case where I missed the diagnosis, what
Speaker:is it that I'm saying about myself?
Speaker:Am I telling myself that I'm incompetent?
Speaker:That I'm no good.
Speaker:How does this situation threaten my identity as a person or
Speaker:in my role as a clinician?
Speaker:Taking that next step to say, okay, what is this threatening situation?
Speaker:How is that impacting my sense of identity, who I see myself, the
Speaker:role that I'm playing as a physio.
Speaker:Really looking at that and then what I do is I, then I challenged
Speaker:myself with a small growth action.
Speaker:Something that's small and doable just feels a lot less daunting and less
Speaker:threatening to actually take action.
Speaker:I think the nice thing with small action and something I'd talk
Speaker:about with my patients is it just requires less motivation.
Speaker:And I think, okay, what's that initial action that will get me
Speaker:comfortable with moving into a place of learning and growth.
Speaker:For example, it might be just taking a look at one chart note for a
Speaker:case that I really need to look at.
Speaker:Or it might be sending an email to a colleague to just set up
Speaker:a time to connect by phone.
Speaker:Or it might be printing off a journal article that I've been
Speaker:holding off on because of the fact that it threatens my sense of
Speaker:understanding around a particular topic.
Speaker:The last part is to just celebrate that small action.
Speaker:From some of the stuff that I've read around motivation and habit building
Speaker:is a small win helps us feel good and we do more of what we feel good doing.
Speaker:So those little steps there are really meant to help you coach yourself and
Speaker:that's what I've found helpful in my own practice to be able to move past this
Speaker:place of being stuck when it comes to kicking in those ego defense mechanisms.
Speaker:The last strategy is to expand your sense of self.
Speaker:In my reading around psychological immune system, I came across this
Speaker:theory in psychology called a theory of positive affirmation.
Speaker:It really talks about how when we can define our sense of self worth outside of
Speaker:an area of threat, it actually bolsters our sense of self and protects us from a
Speaker:threatening information and situations.
Speaker:Really, what it does, it allows us to respond in healthier ways and we haven't
Speaker:put all our eggs in one basket in terms of in our role where we're feeling threatened
Speaker:and we can start to see ourselves having multiple roles that really aren't being
Speaker:threatened by that particular situation.
Speaker:So it really means looking at our value of who we are outside of our clinical work.
Speaker:What roles do we have outside?
Speaker:Like, The role of a spouse, or a friend, or a parent, mentor.
Speaker:Exploring those roles, I think can really be helpful to start to have a
Speaker:more robust sense of self that isn't going to be terribly disrupted when we
Speaker:have a threatening situation affect us.
Speaker:I think the other thing too, is that we can also look at engaging in activities
Speaker:that reinforce values that we have unrelated to the threatening event.
Speaker:So in essence we're getting that robust, multidimensional understanding
Speaker:of ourselves, that means that the threatening experience just
Speaker:has less weight in our lives.
Speaker:I hope those strategies are helpful.
Speaker:I'll just do a quick review here before I sign off.
Speaker:In terms of ways to get unstuck around avoiding learning and growth
Speaker:because of our ego protective system.
Speaker:I think it's important to look at what traps we tend to fall into
Speaker:most frequently or most comfortably.
Speaker:Getting some stuff down on paper can really be a helpful
Speaker:way to better understand that.
Speaker:I talked about the importance of embracing discomfort and vulnerability.
Speaker:And really trying to reframe some of these situations as
Speaker:opportunities for learning and growth.
Speaker:Talked then about the importance of challenging our self-talk and
Speaker:then being our own coach and really supporting ourselves and having a
Speaker:bit of a process to be able to create some space emotionally so that we can
Speaker:actually understand how we can respond in a more growth oriented fashion.
Speaker:Lastly, I talked about the idea of expanding our sense of self looking at
Speaker:the roles that we play outside of our clinical work, as well as activities that
Speaker:we can engage in outside of our clinical work that can help to give us a little
Speaker:more multidimensional understanding of ourselves so we aren't as negatively
Speaker:impacted by situations that we may perceive as threatening or challenging.
Speaker:Thanks for hanging out with me today and hearing about how to improve your
Speaker:clinical performance, make sure to subscribe on iTunes or Spotify to
Speaker:stay up to date on future episodes.
Speaker:If you have enjoyed the podcast, I definitely appreciate if you could
Speaker:leave a review on iTunes, just to let other people know about the podcast.
Speaker:Here's to less frustration, more flow and better clinical results.
