Emotions Distress & Doctoring

Docs underutilize resources for emotional stress


With research showing that burnt-out hospital staff is more prone to unprofessional patient care, a new study in the Archives of Surgery finds that 79 percent of surveyed physicians experienced either a serious adverse patient event and/or a traumatic personal event during the previous year.

But despite the frequency of such stressful occurances–the common predecessor to burnout–physicians fail to use established support resources, according to the study conducted at a large tertiary care academic hospital.

Most physicians (89 percent) said a lack of time prevented them from seeking support, while 68 percent had concerns about confidentiality, and 68 percent thought it would negatively affect their career


With 88 percent of survey respondents choosing fellow physicians as their preferred source of support, the researchers suggest hospitals implement one-on-one peer physician support programs to help physicians effectively manage on-the-job stress.

Similarly, physicians in Ottawa found group counseling eased stress, FierceHealthcare previously reported. The physicians meet every two weeks to talk about stressful experiences at work, such as a difficult patient or a challenging diagnosis.

Hospitals also can use a physician health committee that offers support, emphasizing discussion as a committee, evaluation and treatment to professionals and the use of voluntary medical leave of absence, rather than the punitive culture that physicians worry about.

In addition to peers, support also can come from the top. According to a survey conducted by Physician Wellness Services (PWS) and Cejka Search last fall, healthcare administrators can offer flexible or reduced work hours to help physicians achieve better work/life balance, as well as address conflicts promptly to alleviate disruptive situations.

Integrity is Like a T.V. Dinner

Many see integrity as a description reserved for morally upstanding individuals.  However, integrity is like a T.V. dinner.  Remember T.V. dinners?  The word integrity stems from integer which literally means whole.  Now T.V. dinners have the peas, mystery meat, and potatoes each separated from one another by little boxed partitions.  We do not show integrity when we put each part of us and how we behave in separate containers aka we act differently depending on whether we are at work or with our family etc.  To have integrity is to behave the same no matter whether we are at work, at play, at home, etc.  So integrity is when we behave like a T.V. dinner with the meat, potatoes, and peas all mixed together in one big pile.

Why Emotions Matter: Nursing

Why Emotions Matter: Age, Agitation, and Burnout Among Registered Nurses


Rebecca J. Erickson, PhD
Wendy J. C. Grove, PhD



Knowledge of the emotional demands facing today’s nurses is critical for explaining how work stressors translate into burnout and turnover. Following a brief discussion of how the experience of burnout relates to the nursing shortage, we examine the scope of nurses’ emotional experiences and demonstrate that these experiences may be particularly consequential for understanding the higher levels of burnout reported by younger nurses. Using survey data collected from 843 direct care hospital nurses, we show that, compared to their older counterparts, nurses under 30 years of age were more likely to experience feelings of agitation and less likely to engage in techniques to manage these feelings. Younger nurses also reported significantly higher rates of burnout and this was particularly true among those experiencing higher levels of agitation at work. We conclude by suggesting the need for increased awareness of the emotional demands facing today’s nursing workforce as well as the need for more experienced nurses to serve as emotional mentors to those just entering the profession.


Citation: Erickson, R., Grove, W., (October 29, 2007). “Why Emotions Matter: Age, Agitation, and Burnout Among Registered Nurses” Online Journal of Issues in Nursing. Vol. 13, No. 1.

Practice, Practice, Practice

In today’s encore excerpt – practice. Rather than being the result of genetics or inherent genius, truly outstanding skill in any domain is rarely achieved with less than ten thousand hours of practice over ten years’ time. “For those on their way to greatness [in intellectual or physical endeavors], several themes regarding practice consistently come to light: 1. Practice changes your body. Researchers have recorded a constellation of physical changes (occurring in direct response to practice) in the muscles, nerves, hearts, lungs, and brains of those showing profound increases in skill level in any domain. 2. Skills are specific. Individuals becoming great at one particular skill do not serendipitously become great at other skills. Chess champions can remember hundreds of intricate chess positions in sequence but can have a perfectly ordinary memory for everything else. Physical and intellectual changes are ultraspecific responses to particular skill requirements. 3. The brain drives the brawn. Even among athletes, changes in the brain are arguably the most profound, with a vast increase in precise task knowledge, a shift from conscious analysis to intuitive thinking (saving time and energy), and elaborate self-monitoring mechanisms that allow for constant adjustments in real time. 4. Practice style is crucial. Ordinary practice, where your current skill level is simply being reinforced, is not enough to get better. It takes a special kind of practice to force your mind and body into the kind of change necessary to improve. 5. Short-term intensity cannot replace long-term commitment. Many crucial changes take place over long periods of time. Physiologically, it’s impossible to become great overnight. “Across the board, these last two variables — practice style and practice time — emerged as universal and critical. From Scrabble players to dart players to soccer players to violin players, it was observed that the uppermost achievers not only spent significantly more time in solitary study and drills, but also exhibited a consistent (and persistent) style of preparation that K. Anders Ericsson came to call ‘deliberate practice.’ First introduced in a 1993 Psychological Review article, the notion of deliberate practice went far beyond the simple idea of hard work. It conveyed a method of continual skill improvement. ‘Deliberate practice is a very special form of activity that differs from mere experience and mindless drill,’ explains Ericsson. ‘Unlike playful engagement with peers, deliberate practice is not inherently enjoyable. It … does not involve a mere execution or repetition of already attained skills but repeated attempts to reach beyond one’s current level which is associated with frequent failures.’ … “In other words, it is practice that doesn’t take no for an answer; practice that perseveres; the type of practice where the individual keeps raising the bar of what he or she considers success. … “[Take] Eleanor Maguire’s 1999 brain scans of London cabbies, which revealed greatly enlarged representation in the brain region that controls spatial awareness. The same holds for any specific task being honed; the relevant brain regions adapt accordingly. … “[This type of practice] requires a constant self-critique, a pathological restlessness, a passion to aim consistently just beyond one’s capability so that daily disappointment and failure is actually desired, and a never-ending resolve to dust oneself off and try again and again and again. … “The physiology of this process also requires extraordinary amounts of elapsed time — not just hours and hours of deliberate practice each day, Ericsson found, but also thousands of hours over the course of many years. Interestingly, a number of separate studies have turned up the same common number, concluding that truly outstanding skill in any domain is rarely achieved in less than ten thousand hours of practice over ten years’ time (which comes to an average of three hours per day). From sublime pianists to unusually profound physicists, researchers have been very hard-pressed to find any examples of truly extraordinary performers in any field who reached the top of their game before that ten-thousand-hour mark.” Author: David Shenk Title: The Genius in All of Us Publisher: Anchor Date: Copyright 2010 by David Shenk Pages: 53-57

Physician Mindfulness

Physician meditation, communication improve care

May 1, 2012 | By Debra Beaulieu

Learning “mindful meditation and communication” skills may sound to some doctors like a luxury for which they don’t have time, but new research from the University of Rochester confirms it may be well worth the investment for physicians and their patients.

The study, published in Academic Medicine, is a follow-up to a paper the researchers published in the Journal of the American Medical Association in 2009. For the initial study, Howard Beckman, M.D., clinical professor of Medicine and Family Medicine at the University of Rochester Medical Center, and colleagues enrolled 70 physicians in a mindfulness training program that involved eight weekly sessions, followed by 10 monthly sessions. They found that participants were better equipped to handle psychological distress, fend off burnout and improve their well-being. For the follow-up, the team interviewed 20 of the physicians about their experience with the training.

Highlights from their feedback are as follows:

  • 60 percent said the training helped them become more attentive listeners
  • 50 percent said they were more self-aware and less judgmental in conversations at work and home
  • 75 percent found strong benefits in being able to discuss their personal medical experiences with other doctors in the training program in a setting they felt was safe and free of judgment
  • 70 percent placed a high value on the mindfulness course having a well-defined curriculum that designated time and space to pause and reflect

But to truly improve primary care, the researchers suggested training individual physicians in mindfulness doesn’t go far enough.

“Programs focused on personal awareness and self-development are only part of the solution,” the researchers stated. “Our healthcare delivery systems must implement systematic change at the practice level to create an environment that supports mindful practice, encourages transparent and clear communication among clinicians, staff, patients and families, and reduces professional isolation.”

Expert advice will give you a brain freeze

It turns out that getting expert advice literally shuts out brain down, and it can prevent us from making a truly informed decision.  This fact is important to know when you seek expert advice.

1. Don’t rely on a single expert’s advice, get a second or even a third opinion.

2. Do your own research and determine your potential decision options BEFORE you meet with an expert.

I would have loved to not only know of this research but to also really absorb and embrace its truth before some key experiences in my life with “experts” in fields outside of my expertise.  Yes even doctors can fall into this trap of trusting advice from other “experts”, and I can vividly remember several incidences in which my brain shut down/shut off because I was with an “expert”

Expert Advice Shuts Your Brain Down Article

Doctors experience trauma to their hearts and stress to their souls by Edwin Leap, MD

I was talking to some new friends over lunch recently, at the nationally renowned Hominy Cafe, in Charleston, SC. Any place with a Fried Green Tomato BLT, and Shrimp and Grits for breakfast, has my vote!
To the point: my question to these esteemed emergency medicine educators was this: “Do you ever have irrational fears about the people you love, because of what you do?”
The answer was a resounding “absolutely!”
Like me, they worried when ambulances were dispatched while their children were out with friends. They worried when their spouses drove in heavy traffic. The list went on. And I shook my head in agreement.
I had been contemplating this question for quite a long time. What are the consequences of years in the emergency department? Sure, I know: the consequences are anger, bitterness, frustration, distrust, cynicism. Balanced, fortunately, by compassion, perspective, appreciation for life’s gifts, love of common people and the ability to hang out with heavily tattooed bikers, drunks and former felons without feeling the least bit uncomfortable.
But what I mean is this: what emotional, psychiatric consequences are there? What scars do we carry deep inside? I don’t think we acknowledge this; we certainly don’t address it. But the truth is, our specialty takes us into the heart of terror, into the midst of the worst situations humans can experience. All roads, as we know, lead to the emergency room.
The abused child, the raped woman, the burnt workman, the assaulted senior citizen, the addicted teen, the mother dead by suicide. The new diagnosis of cancer the new diagnosis of HIV or Hepatitis. We see the schizophrenic young man who wanders away, we see the demented husband of 50 years who cannot recognize the love of his life.
We tell loved ones that their dearest is dead. We listen as families wail, and collapse onto the ground in the emotional equivalent of a hurricane, suddenly thrust from normalcy and hope to terrible brokenness and stunning loss.
It’s a common fact of the job. We talk about it a little. We teach students and residents how to break bad news. And we tell them the primacy of their own relationships, and explain the perils of using drugs or alcohol to cope. And then we send them off the way we were sent off; like lambs before lions, to face a life of emotional maelstroms.
I wonder, often, how common PTSD is among our population. Post Traumatic Stress Disorder is in the news a lot. We associated with terrible trauma, with death and the threat of death, with disaster, with terrorism and combat. We shake our heads in sympathy with the young man or woman, shaken by tours of duty in Iraq or Afghanistan, whether or not they actually pulled triggers or even saw death. Their very proximity to those things is sufficient to win our appropriate concern.
And yet. And yet … Day after day, night after night we go into a workplace where we have no control over who or what comes through the door. And we have no way to predict what we might see. Certainly, we might spend a shift in utter boredom (hey, it could happen!). Or we may see something so horrible that it changes us forever. We may leave having been stained with the blood of a police-officer, coughed on by a patient with tuberculosis, or tearful from giving terrible news to someone we knew.
Furthermore, we go back to the same rooms where we saw death, the same floors that were littered with dressings and body fluids, the same conference rooms where we delivered the terrible news.
And we do it for years. Decade after decade we accumulate stories and experiences which, taken singly, would send the average citizen screaming to their counselor or psychiatrist…and not without reason.
But we? We are rich doctors. We are the educated. We are expected to do it, to show up the next day after the horror of the day before. We are not excused because of the terrible things we endure, but instead wear them as a tragic badge of honor, even as we die a little inside from fear, from worry, from taking all of those things and imagining how they might appear in our own lives, or in the lives of our families. From the fear that we will make a mistake in the midst of chaos, and add to the sum-total of pain in the world.
I don’t know how many of us meet the strict criteria of PTSD. But we experience trauma to to our hearts and stress to our souls. If you have ever wondered about this, on the drive home, or in the hours before work. If you have ever contemplated it in the night between patients, in the fog of exhaustion, or decompressed from it on the beach with your family, then you aren’t alone.
I’m writing to say that your fears, your terrors, are common to all of us who serve our tours in the emergency department. And you are allowed to be shaken by them, to be wounded by them.
I hope you will not let them shape you, or break you. But I fear that much of what we call burnout, much of our “bitterness” or “anger,” or “bad attitudes” are simply our attempt to express acceptable emotions over the hard things we see, do and remember ever after. Because for some reason, we are not supposed to be affected no matter how much misery crashes on our lives like tsunamis.
It’s high time our colleagues, our employers, our friends and educators and even our politicians recognized that money, education and title don’t ease the pain, and the fear, that is inherent in our work.
Perhaps, however, the most important step in healing would be for us all to admit to ourselves that it’s a hard job, and that the consequences to our lives run deeper than circadian problems and contract negotiations.
And that even healers, like us, have wounds too deep to fully understand.

What is the question that will change your day?

The other night working in the Emergency Department I was dog tired as I picked up a chart of a patient to see.  After I obtained the pertinent medical information from this patient, I then asked my 94 year old patient, “Where were you during world war 2?”

He proceeded to share a little known story about his time working with General Patton.  The patient told me that even his own grandkids don’t ask nor seem interested in his life experiences.  It was an interesting and amazing patient interaction.  I left that conversation so energized that the last 2 hours of my shift flew by.

Reflecting on this event, reminds me of the power of our ability to choose what perspective we will be in and what powerful question we can ask of ourselves and others.  Perspective: It is amazing to me how quickly I can shift from ‘dog tired’ perspective to ‘wow what an incredible patient and story’ perspective–shifting from falling asleep to being fully awake–better than any cup of caffeine!  Question: It is fun and shocking the power of a question to shift our thoughts and energy levels.  I recently asked at a dinner party: What do you crave?  This one question made for a deep and meaningful and laughter filled discussion.

What is the question that you could ask at work and at home that would energize or change your day for the better?


The Sage & The Saboteur: How to Overcome Your Limiting Beliefs

Do you remember the old cartoons that depicted an angel and a devil on each of your shoulders?  Well it turns out that we have a Sage and the Saboteur in our brains.  The Saboteur is a ‘voice’ or thoughts and feelings that was adaptive in our early development and when we were being chased by Saber Tooth Tigers.  It is an early warning ‘voice’ that may say early on in our lives, “Don’t even try to jump that fence because if you do, you will break your leg.”  However, this ‘voice’ grows up with us and becomes our limiting beliefs voice.  It begins to tell us, “You are not enough.” and “You are a failure.” and “You will never amount to anything.”  Ever heard that voice?  I certainly have, and I continue to hear it AND listen to it.

The other ‘voice’ is that of the Sage.  It tells us things like, “You are enough.” and “It is possible.” and “You can do it.”  It turns out that if we train ourselves to listen to this ‘voice’, our brain runs/functions much better in fact studies have shown over 30-40% better!  When we listen to this positive Sage ‘voice’, our brains are flooded with dopamine and serotonin–chemicals that immediately enhance our brains learning centers allowing us to think more quickly and creatively, solve problems better and see and create new ways of doing things.

If you are like me, you hear the ‘voice’ of the saboteur more than the Sage.  And if you are not hearing the saboteur, it means that you have not become aware of it or it is doing a great job of tricking you into believing that it is speaking the truth
or at least speaking things that are helping you.  The saboteur may have convinced you that without it’s advice you would make stupid choices or become lazy, but nothing is further from the truth.  The saboteur ‘voice’ that says, “Now, that was a stupid thing to do.” often will continue that mantra over and over again creating more sleeplessness and more anxiety whereas the Sage’s approach might be to say, “So you made a mistake, to err is human, and this mistake could be made into an opportunity depending on how you react to it.”

Ok. Interesting.  Now what.  The key to weakening The saboteur ‘voice’ (note: most of us have multiple Saboteur ‘voices’ such as a judger and a pleaser and a controller etc.) is:
1. Don’t fight them/it
2. Simply observe and notice the saboteur thoughts and feelings when they arise
3. Tag or label these thoughts or feelings every time you notice them (some who are in training against the saboteur will keep a journal or jot down a quick note when they notice the saboteur thoughts and feelings aka ‘voice’)

50 No’s & 5 Yes’s: How to Treat Overwhelm?

Overwhelm is a HOT topic.  We all feel overwhelmed at some time in our lives.  Our To-Do lists are stuffed to the gills, and we walk around in a To-Do list haze so overwhelmed that we are so busy listening to the tape playing in our heads of what we need To-Do instead of capturing all the amazing things happening all around us.

Solutions?  Burn the To-Do list?  Maybe.

1. Practice Present Perfect: Our brains are designed to be in the present moment, but our To-Do lists and overwhelm feelings and thoughts are predominantly in the future.  The studies show that by not being focused in the present our brainsare much less efficient so the overwhelm and To-Do lists are actually making us less productive.  How do we practice being more present?  Keep a 3×5 card in your pocket or jot down notes in your smartphone when you are in a moment that you have lost track of time in.  These moments of flow are the present moments that bathe our brain in the chemicals that make us more efficient, more productive, and are the antidote for overwhelm.

2. Purpose:  It is easy to live in the land of overwhelm when we lose site of our purpose.  When was the last time you were truly thrilled? What was your most recent peak experience?  Tapping into these moments will help you focus on doing the things that you were made to do.  The things that you were made to do are those things that thrill you.  Get in touch with your thrilling moments and you will begin to get in touch with your Yes’s.  Now list the 1-5 things that you most love to do at work, at home, etc.  This is your YES list.   These are the To-Do items that you were designed to Do and Be with.

3. Prioritize:  Starting with No’s leads to less overwhelm and more YES.  I recently challenged one of my clients to put together a list of 50 No’s.  50 items that he is going to say no to.  What is on our list of No’s?  Which of these No’s are you going to commit to?  I would love to say No to checking my email on my smartphone when out to dinner…..The NO list is the list that frees us up to say YES.


What Are We Running For?

In the movie Chariots of Fire, there are 2 runners. Harold Abrahams who says that he runs to ‘justify [his] whole existence’ where as Eric Liddell says that he runs because when he runs he feels God’s pleasure.

Why do we run?

Are we on the run to justify our existence? Do we run for acceptance? To make more money? For power? For status? Or do we run to feel His pleasure? How might this running transform our lives?

Running on empty?

In the movie Chariots of Fire, there are 2 runners. Harold Abrahams who says that he runs to ‘justify [his] whole existence’ where as Eric Liddell says that he runs because when he runs he feels God’s pleasure.

Why do we run?

Are we on the run to justify our existence? Do we run for acceptance? To make more money? For power? For status? Or do we run to feel His pleasure? How might this running transform our lives?

Narrative Medicine Helps Physicians Hear Patients’ Deeper Concerns

by Debra Beaulieu

The importance of strong physician-patient communication has been well documented, as have the challenges. But a new tool, called narrative medicine, may offer a way for physicians to better connect to their patients by changing the way they listen to their stories.

“What patients complain about the most is, ‘My doctor doesn’t listen to me,’ or ‘I feel like I’m alone in my illness,'” Rita Charon, executive director of the Columbia University Medical Center’s narrative medicine program in New York City, told HealthDay News. “Narrative medicine is a way for people who take care of sick persons to hear what they say, to understand their concerns, to enter the world of the patients, so as to know what can be done in their care,” she said.

An example of narrative medicine comes from a pediatrician who saw a young boy in her office for a cut on his hand that didn’t appear on the surface to require medical intervention. But having recently attended a training session in narrative medicine, the doctor asked the boy’s mother as to whether there was anything else she wanted to say about the scissors the boy had cut himself with. It turned out that a boarder renting a room in the family’s home who was HIV positive had previously cut himself with the scissors, and the mother was worried her son could have been exposed to the virus.

The idea of narrative medicine is beginning to catch on among practicing physicians. Paul Gross, a physician in the family and social medicine department at Montefiore Medical Center in New York City has worked to help physicians share stories similar to the scenario above through a weekly online magazine called Pulse–Voices from the heart of medicine. Similarly, Columbia University’s College of Physicians and Surgeons Program in Narrative Medicine aims to help doctors, nurses, social workers and therapists to improve the effectiveness of care by developing the capacity for attention, reflection, representation and affiliation with patients and colleagues, Kansas City Public Media reported.

Is Life and The People In It Passing You By?

So often I live my life like the guy in this video.  Rushing around to get done all my to do’s while

not taking notice of those around me, not connecting, and not taking in all that is available in the moments.

This video reminds me to slow down and be mindful of those around me and to stop and take in each and every moment as if it were our last.

The Gecko & The Geek

Our brain is often at war with itself.  The primitive emotional centers (The Gecko) vs. the advanced intellectual centers (The Geek). The Gecko gets us in trouble because it’s only capacity is to react whereas the Geek thinks, then reacts.

The Geko takes over when we are feeling stressed or out of control, and it reacts with fight or flight.  Unfortunately, This does not happen consciously, and The Gecko causes us not to think straight, react instead of act, fight first ask questions later, and put our foot in our mouth.  When stresses pile up and we feel out of control, the Gecko shows up, and we become less productive, effective, and lose our decision-making abilities.  In fact, scientific studies have shown that when we experience too much stress and overwhelm, our performance tanks.  Stressful things like financial loss are actually processed in the same area of the brain that responds to mortal danger aka The Gecko area.  We have all learned often the hard way that we make horrible decisions when we are under financial stress or any type of stress.


How can we be more Geek and less Gecko?

  1. Self-awareness.  Studies show that when you put people under high levels of stress, those who are quickest to recover are those who can identify how they are feeling and express their feelings into words.  Scientists, using brain scans, confirm that people who talk about and/or write about their feelings at the time they are experiencing negative emotions immediately over come these negative thoughts and feelings which improves their well-being and enhances their decision making skills.
  2. Make 2 lists: things you have control over and things that you don’t.  Burn the list that you have no control over–they are out of your control! And focus on the areas that you have control over.  So no news is good news after all.  I have made it a habit of not reading the newspaper and watching the news on TV because it only stresses me out.  Now I know why it stresses me out, and why it has been scientifically shown to be counterproductive.  It fills my brain with things that I have no control over allowing my Gecko to run wild.  So maybe we should change the phrase “G.I.G.O” from Garbage In Garbage Out to Garbage In Gecko Out.

The #1 Way to Show Your Patients that You Care: Acknowledgment

“All the tests are back, and their is nothing wrong with your daughter.”  For years, I would step into a patients room and annouce the good news that there was “nothing wrong with you” thinking that the patient would be so releaved.  I was reminded of the impact of such a statment at work recently.  A physician had brought her daughter in to the Emergency Department for abdominal pain, and at the end of the visit, the nurse went into the room announcing to the physician that there was nothing wrong with her daugher.  The physician became very upset stating, “I would never bring my daughter into the Emergency Room if there was nothing wrong with her!”  With some ‘service recovery’, I was able to calm this physician mom.  But I was reminded again of how the “there is nothing wrong with you” statement must land with my patients.  For the last several years, I have changed my phrasing.  I now acknowledge that clearly there is something wrong but that our technology can’t find out what exactly is causing the pain.  This simple shift of phrase acknowledges and confirms our patients pain, suffering, and anxiety.  It is not about working harder or even spending more time.  It is working smarter and making the time really count by asking the right questions, saying the right things, and developing your presence (more to follow).

We are Not Very Rational: Our Choices are Driven by Our Emotions

In today’s excerpt – each decision we make, however rational we believe it to be, is an emotional, neurochemical tug-of-war inside our brain:

“Consider this clever experiment designed by Brian Knutson and George Loewenstein. The scientists wanted to investigate what happens inside the brain when a person makes typical consumer choices, such as buying an item in a retail store or choosing a cereal. A few dozen lucky undergraduates were recruited as experimental subjects and given a generous amount of spending money. Each subject was then offered the chance to buy dozens of different objects, from a digital voice recorder to gourmet chocolates to the latest Harry Potter book. After the student stared at each object for a few seconds, he was shown the price tag. If he chose to buy the item, its cost was deducted from the original pile of cash. The experiment was designed to realistically simulate the experience of a shopper.

“While the student was deciding whether or not to buy the product on display, the scientists were imaging the subject’s brain activity. They discovered that when a subject was first exposed to an object, his nucleus accumbens (NAcc) was turned on. The NAcc is a crucial part of the dopamine reward pathway, and the intensity of its activation was a reflection of desire for the item. If the person already owned the complete Harry Potter collection, then the NAcc didn’t get too excited about the prospect of buying another copy. However, if he had been craving a George Foreman grill, the NAcc flooded the brain with dopamine when that item appeared.

“But then came the price tag. When the experimental subject was exposed to the cost of the product, the insula and prefrontal cortex were activated. The insula produces aversive feelings and is triggered by things like nicotine withdrawal and pictures of people in pain. In general, we try to avoid anything that makes our insulas excited. This includes spending money. The prefrontal cortex was activated, scientists speculated, because this rational area was computing the numbers, trying to figure out if the product was actually a good deal. The prefrontal cortex got most excited during the experiment when the cost of the item on display was significantly lower than normal.

“By measuring the relative amount of activity in each brain region, the scientists could accurately predict the subjects’ shopping decisions. They knew which products people would buy before the people themselves did. If the insula’s negativity exceeded the positive feelings generated by the NAcc, then the subject always chose not to buy the item. However, if the NAcc was more active than the insula, or if the prefrontal cortex was convinced that it had found a good deal, the object proved irresistible. The sting of spending money couldn’t compete with the thrill of getting something new.

“This data, of course, directly contradicts the rational models of micro- economics; consumers aren’t always driven by careful considerations of price and expected utility. You don’t look at the electric grill or box of chocolates and perform an explicit cost-benefit analysis. Instead, you outsource much of this calculation to your emotional brain and then rely on relative amounts of pleasure versus pain to tell you what to purchase. (During many of the decisions, the rational prefrontal cortex was largely a spectator, standing silently by while the NAcc and insula argued with each other.) Whichever emotion you feel most intensely tends to dictate your shopping decisions. It’s like an emotional tug of war.”

Author: Jonah Lehrer
Title: The Decisive Moment
Publisher: Canongate
Date: Copyright 2009 by Jonah Lehrer
Pages: 192-194

Being Realistic is Over-rated

“Being realistic is the most common path to mediocrity…The moment you decide to be realistic you can pretty much guarantee that is what will happen…”-Will Smith

Is anyone else tired of being realistic?  A saboteur (or gremlin) is a self limiting voice that whispers into our mind.  The saboteur is the voice that “shoulds” on us.  It tells us what we should do not what we can be.

Realistic is the penultimate saboteur.  I can hear the voice: “You will never be able to do that, be realistic.”

Let us today press pause on that voice, and listen to the other voice-the voice that speaks to our heart and soul.  The voice that says, “You can do it!”