Deborah Gilboa's Blog, page 7

Watchful waiting IS doing something

Hi!

“Aren’t you going to do something?” the mom of this two month old baby asked. Her daughter was covered in an alarming looking rash, red bumps had been popping up, disappearing only to reappear on some other part of her tiny body for days. Maybe weeks. The most likely diagnosis in the case of this common newborn presentation (no other symptoms, eating and sleeping and voiding well, energetic even smiling) is a horrible sounding “erythema toxicum.” For which the treatment is watchful waiting. And all we’re watching for are new symptoms or something that would indicate it’s not the totally benign e-tox. The problem is – and I’ve been this sleep deprived mom of a newborn who looked like the tragic victim of some terrifying eruption – doing “nothing” is a real challenge.

Last week I wrote to you about my challenges this month with waiting. I mentioned this medical phrase, “watchful waiting,” and dozens of you reached back about this concept. One close reader of my work asked an amazing question:

“Why is watchful waiting so stressful when you’ve said over and over that it’s change our brains struggle to handle?”

Yes! Right! What’s that about??

Here’s the quick answer: Our brains don’t like change and so we are inclined to make the change stop. In the case of this mom, she’s understandably panicky (and not to mention exhausted) every time she sees this rash evolving on her baby. Her brain doesn’t like the change from clear skin or how it thinks the baby should look and wants steps taken to make it go back to “normal.” The quotes are because e-tox is normal, with studies of full term newborns estimating as high as 72% prevalence.

Anyway, there are situations – mostly upsetting, surprising situations – in which our brain demands action and resists observing. The higher your emotions are about the situation, the more likely you are to want to do something to “fix” it.   

Watchful waiting is action. It’s not ignoring the situation, it’s a plan to observe it, with parameters for action.

Over to you. What situation is making you itchy for action right now? Is an action the most useful way to get to your goal (be resilient)? Or would deciding to observe – and deciding what might happen that would spur you to action – be the most resilient way of facing it?  Hit reply, I’d love to hear.

All my best,

Dr. G

The post Watchful waiting IS doing something appeared first on Ask Dr. G.

What opportunities to learn do you need?

Hi!

Have you seen the movie “Evan Almighty?” It’s a modern day version of Noah and the Ark with a pretty great cast, including Morgan Freeman in the (possibly autobiographical cameo) role of God. In what may be my favorite movie scene ever, Morgan Freeman says to a woman (playing Noah’s wife), “Tell me. When someone prays for patience, do you think God gives them patience? Or the opportunity to be patient? If they prayed for courage do you think God gives them courage or does he give them opportunities to be courageous?”

This short scene informs my approach to how I’ve raised my kids. I want them to make good choices, so I try to get out of their way and give them the opportunity to make their own choices. I want them to be brave, loving, resilient and family-focused. So I encourage them to adventure, create relationships, get uncomfortable and connect to nearby and far-flung relatives.

But this scene has a lot to teach me about my own path as well. Not to put too fine a point on it, I’m not someone most people would describe as taking a back seat or fading into the crowd or, you know, patient in any meaningful way. I tend to believe that the more informed I am, the more involved I am, the more in control I am, the better things will turn out for me and everyone I know.

Can you see how the parenting I mean to do and the worldview I so firmly hold don’t always mesh beautifully?

Especially as my kids become adults – and as my business grows to be more than just me – I need to learn more about letting go, stepping back, watching and waiting. As a matter of fact, “watchful waiting” is something doctors do a lot when symptoms have presented themselves but may resolve without intervention. We’re so bad at not intervening that we named not doing anything as “watchful waiting” so that we can name it as a plan. For an isolated abnormal lab value or a vague, new pain I am excellent at this plan. For my own life, though, not so much.

And so I notice that this month the universe has given me opportunities to step back. I mentioned last week being the least informed, experienced and qualified person in the room and the opportunity that was to keep my mouth shut. This week my son had surgery and (despite the number of friends and relatives who thought it would be funny to suggest that I step into the OR and assist) my job was to wait. Now that he’s recovering, my job is to watch, listen, help when needed but let him guide the hour, day and weeks. He – we – have months ahead of him in this and I’m starting to recognize this for the opportunity it is. I’m grateful and growling at the same time.

What opportunities are you finding in this season? What are you getting the chance to learn? Comment and tell me!

All my best,

Dr. G

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The value of being new

Hi!

When’s the last time you were new? New at a job or in a new community or took a new class or learned a new skill?

This week, through a strange set of circumstances and my well-connected partner, I had a brand new experience. I was asked to help plan a trip for the First Lady of the United States. For these few days I was the lowest person on the totem pole in a much more experienced and very smart group of people. These folks stepped into an American Legion hall and hosted an event that honored the incredible veterans who’ve dedicated their retirement to supporting current and past military families in their community. 

I spent these days doing whatever I was asked, not knowing the answer to anyone’s questions and practicing keeping my mouth shut (with varying success). I met new people (which I love), carried heavy things (notsomuch), ran errands, made signs, rode in a motorcade (!) and learned every day.

It made me realize how infrequently I seek out situations in which I will be the least experienced person in the room. So I dove into the science a bit to see what this uncomfortable, invigorating experience accomplished.

For most adults, being new is something we avoid, or at least grow out of for the most part. Kids are new all the time at just about everything and they learn a ton from it, but as we get older there are less situations in which we’re brand new. For example, the majority of Americans are settled by age 25 in the city they’ll stay in until retirement (or beyond).

However, we don’t have to move to get novelty in our lives. And novelty -experiencing new sensations, learning new skills, thinking new thoughts – improves brain health, decreases dementia risk and releases extra dopamine (picture James Brown singing “It feels good”).

For myself, I do feel good! I served others, heard incredible stories from people I’ll always remember and thought about our democratic experience in ways I never have considered before.

Seek novelty, friends. It’s good for you.

And if you do, let me know. I’d like to hear about your experience

All the best,

Dr. G

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Whose opinions matter?

Hi!

I’ve had some hard decisions to make recently and it’s got me thinking about how other people figure into our resilience. 

No man is an island. What we do effects our people, so of course we need to consider the impact of our decisions on others. However… 

Resilience is the ability to navigate change towards a positive goal. To become more the person you mean to be, to get closer to the life you want to live. And sometimes the people around you aren’t on board with your goal, or the path you take to get there. So how much should their opinions matter?

Part of the person you mean to be needs to include doing the best you can to keep your promises. Anyone under 18 that we’re responsible for deserves our attention – we don’t get to go off and pursue a goal that leaves their needs unmet. 

If you’ve made commitments about your time and focus to your partner, your parents, your work – these are adults who deserve clear expectations and open communication. 

Everyone else’s opinions are (wait for it)… none of your business. 

That’s right. Guessing what “other people” will think or how they may judge you or even listening to them gossip about you will only get in the way of your resilience. If you’ve made no commitment to this person then their opinion is theirs. Their problem, their burden, not yours.

Don’t let other peoples’ opinions keep you from building the life you want.

Got anyone else’s opinions stuck in your head?

All my best,

Dr. G

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Make a friend like you’re a six year old

Hi!

I had the opportunity to spend last week with 32 moms and daughters and they taught me something really important about friendship. 

In English we say “make friends.” It’s an excellent reminder that creating a friendship requires intention and effort. 

As adults (and teens) we often stumble on so many obstacles in meeting new potential friends. Which doesn’t make a lot of sense logically. Logically, it should be easier to makefriends as adults. After all, as adults we can set up our own playdates, don’t have to ask for aride, and can even spend money if we choose! So it should be easy but…

We trip on our own insecurities. 

We wonder – is this the right person to make friends with right now? Will they really likeme or do I have to hide some of my beliefs, opinions, preferences, values? Do I have time or attention to be a good friend to them? Will I like the people they like, will those people likeme? 

Back to the women I met last week. They came into a setting with their daughter but no one else they knew. Wondering about their own friend possibilities and their daughters’. And they solved all those insecurities with one choice:

Authenticity. 

This is what little kids have that we tend to lose as we grow up. Young children bring their whole, honest selves to every encounter and that unbridled authenticity allows them to makefriends fast and deep. 

Each woman I met decided to be her true self as a woman and a mom. To be vulnerable and honest in conversation. To be earnest and sincere in her connections. 

And they were shocked – as I was – by the speed and depth of their bonding. In just a few short days these adults created friendship they now want to keep for years. And those connections build their resilience. They’ll be better able to navigate all the changes of raising their preteen daughters, handling their adult relationships, helping their own parents because of these new and true friendships they’ve made. All those insecurities are overcome if we can find the courage to be authentic. When you bring your true self to a potential friendship, you’ll know that you – who you really are – connect with that person and that no conforming will be needed. If you authentically choose the people that feel like a good fit to you, you’ll have the bandwidth for them because they will strengthen you when you’re together. 

To build our resilience, we need to keep building connections. When’s the last time you made a new friend? Comment, I’d love to hear!

All my best,

Dr. G

The post Make a friend like you’re a six year old appeared first on Ask Dr. G.

What does summer break mean to adults?

Hi!

Is it summer where you are? 

If you go by the calendar, we’re still a few days from June 21, the official beginning of summer. 

If you work with or live with kids, just about everyone in North America is already on summer break. 

If you go by the weather, some people have been in “summer” since March at least.

Whatever your metric, adults who were educated on an agrarian system – 9 or so months of school and 3 or so months of break – spend most of our adulthood subconsciously marking the years that way. And that has real value.

Breaks, vacation, “summer Fridays” or changed work hours help our brains reset. That’s right, there is neuroscience of summer vacation. More time spent outdoors helps strengthen our resilience to mental distress through increased levels of Vitamin D and even a moderate increase in exercise (like walking or swimming or hiking). And any change in your usual work routines or time spent in “novel environments” – new-to-you places – improve critical thinking, learning and memory.

So no matter what schedule you live on, make sure you get a little summer break in your life. It will do your brain some good.

Got any plans for June, July or August that are outside the usual? Comment and tell me!

All my best,

Dr. G

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When you can’t say what you feel

Hi!

Free speech gets a lot of attention, and rightly so. It is also pretty fundamentally misunderstood a lot of the time. Free speech is a right given by a government, for example the United States Constitution – saying the government views free speech as a right and therefore the government can’t take it away. 

Lots of other people do not have to allow us free speech. Employers, for instance, monitor and regulate speech all the time and so do schools, and parents and organizations. As well they should. I don’t want my employer to allow anyone at our health center to say racist or sexist things to our patients under the guise of “free expression.” I certainly did not allow my kids the right of free speech at their own discretion, mostly because for some number of years kids don’t have much discretion at all. 

All of this leaves us, though, in situations where we need to feel our feelings or think our thoughts without expressing them in that moment. And in an era of “speak your truth” and “every voice deserves to be heard” it can feel like oppression when you find out not every time or place is an acceptable platform for those feelings and thoughts. 

We’ve spent a lot of important energy in the past 30 (arguably 60) years helping people find their voice and learn to advocate for themselves. I’m not suggesting we undo that work. I am saying, though, that we may have over-corrected and need to work on the skills we need to handle ourselves when we have opinions that need to be held until we’re at a better moment or with a different person or in a different situation. 

Simply put, shutting up takes resilience – often as much as speaking out. 

Honoring the boundaries that exist in a work environment or an educational one, in a community or a club or any group situation, takes strength and will and skills. 

As leaders we can model that, we can speak about it, we can offer empathy when someone struggles with it. We shouldn’t, however, believe that we need to offer “free speech” no matter the impact.

Have you struggled with this in the workplace? Comment and tell me, please. 

All my best,

Dr. G

The post When you can’t say what you feel appeared first on Ask Dr. G.

Guiding vs Rescuing

Hi! guiding

Knowing how to ask for help is a crucial skill. Being asked for help feels like – and usually is – being a good leader or boss (or parent). And yet, there aren’t enough hours in the day to help everyone all the time. You hire people to do things so that you can be freed up to do other things. You raise kids to do things so that they’ll know how to do them without you. 

All of this has been running through my mind this week as I start this season’s summer camp staff training season. Every year in May and June I am lucky to get to travel to some amazing day and overnight camps to help their staff get ready for the joyful and incredible task of being responsible for hundreds of children for the next 10 weeks or so. In preparation for my days with these groups I talk to each camp’s leadership staff about the challenges they want to address. This year a question is this:

How do we teach staff to ask for help when they need it, but not jump to asking for help without trying to solve the problem, just because it would just be easier to have someone else handle the situation? 

It’s absolutely common for bosses and leaders to notice that staff lean on them sooner and faster than in previous generations. We’ve spent a lot of effort in the past 15 years teaching kids to ask for help as a way of getting the support they need and to avoid danger. I don’t think we need to undo this work, it is making people safer and more supported. 

Instead I think we need to ask this important question: What does “help” mean?

Sometimes “help” means “Save me! Do this for me!” Sometimes “help” is a call to be rescued. And sometimes “help” means “can you show me?” or “Do you have any suggestions? I’m not sure how to do this.” No matter what the person asking for help thinks they need, there is some burden on the leader to figure out which kind of help is best to give.

Leaders need to be able to differentiate between danger – in which case we should jump in – and discomfort. Discomfort, even profound discomfort, leads to learning and growth. The next time your team member (or teen!) asks for help, start with some questions of your own:

Is anyone in true danger?What has this person tried that has not worked?What skill is this person lacking that would allow them to solve this themselves next time?

If someone is in danger, get involved and lead by modeling how you want the situation handled. Praise this person later for bringing this to you right away.

If no one is in danger, do the harder thing. Instead of rescuing, teach. Teach this person to think through options, try solutions or build the skills they need to do so the next time. Even though you may meet some resistance, a leader’s job is to rescue people from danger, not from discomfort.

Has anyone asked you for help recently?

All my best,

Dr. G

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Something is better than everything

Hi! Better

In medicine we learn to look for incremental gains. Yesterday on the Think Tank on Resilience one of our guest experts, Mary Beth Levin, pointed out that in the public health field “harm reduction” is not just helpful, it’s the goal. That’s because we’re never going to eliminate diabetes or asthma or HIV but we can and should work to decrease it. We spoke about the idea that “some changes are better than no changes” in terms of moving towards a goal. And that’s an idea that I bet is familiar. 

Further, we talked about the obstacle people try to throw in the way of progress (usually our own progress) by saying “Well, if I can’t do something fully it would be hypocritical or pointless to try it at all. I hate to disagree with Yoda, but there is, actually,  “try” and it’s pretty valuable. For example, if you’re working to improve internal communication in your organization and you send out a daily roundup email of where each project stands on Monday and Tuesday, but forget Wednesday, the first two were still useful. Especially if you pick it back up Thursday. Or the following week. And if you try something that doesn’t work, you’ve learned from that as well. If you put on sunscreen some of the time that you’re outside it IS better than never using it.

So changing a behavior – even when you’re not sure you can be consistent – still has value. 

The big idea I want to propose is that incremental gains can be even more valuable than a huge, all-of-a-sudden shift in behavior. 

If you make a big change all at once you don’t give your own brain – or anyone else’s – the chance to adjust. And that change, as we’ve talked a lot about in this community, feels to your brain like a threat. Small shifts in behavior towards a big goal will often be bettertolerated by us and our people than a huge shift. 

So, to recap: 

Small changes are more practical, more tolerable and often more successful than big shifts.

When I put it that way it sounds obvious, right? What’s a shift you’ve been considering or trying to make that could be more successful if you made it smaller? Comment and tell me!

All my best,

Dr. G

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Why is there so much pressure to not be OK?

Hi! pressure

Welcome to the intersection of my thoughts. I’ve had three ideas swirling around in my head recently and I’m hoping you can help me find the center of them.

The first comes from this video I stitched (just means I played a quick bit and then added my reaction) about how we are often doing OK, with some normal ups and downs of emotion. That feeling “bad” – in the absence of true mental illness or grief – is often pretty short lived and just requires a little patience or distraction to get through.

The second is from this book: Bad Therapy by Abigail Shrier, a review and quick summary of which is here. One of the fundamental messages of the book is that we accidentally reward and reinforce kids who are not OK through a variety of more and more commonly used tools. Frequent social emotional “check ins” in school, for example, not only give more attention to kids and teens who have problems (which can be great), the repetition sows the idea that we think they’re probably not OK at baseline. Though I don’t agree with every premise in her book, this rings for me and she has the research to back it up.

The third and last is this. Last week I asked you to think about who in your life needed to be OK for you to feel OK. I heard back from over a hundred people who told me some version of “I appreciate your thoughts but I can’t possibly be OK when my kids are not.”

I want us to look carefully and critically at children’s mental health (and our own). I want everyone who needs help to get it.

And yet I’m thinking more and more often that there are side effects to the ways we’re trying to intervene. That we’re creating a culture in which kids assume at baseline that they are NOT doing well and that the times they do feel well are the anomaly instead of the other way around.

No action item for you this week, just a question – what do you think? Comment and tell me please! I love learning from and with you.

All my best,

Dr. G

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