Finding flow and joy in medicine

By David Kopacz, MD, University of Washington 

 

 

“Water and stone What’s softest in the world rushes and runs over what’s hardest in the world. The immaterial enters the impenetrable. So I know the good in not doing. The wordless teaching, the profit in not doing—not many people understand it.” 

From “Lao Tzu: Tao Te Ching: A Book about the Way and the Power of the Way,” by Ursula Le Guin 

  

In my book, “Caring for Self & Others,” I describe flowing as one of three attributes of the human dimension of emotion: feeling, connecting, and flowing.  

 

When we’re in the landscape of emotion, we’re flowing between inside and outside, between ourselves and others, and we’re open to the flow of new experiences in the world. We can be emotional explorers, just the way some people are explorers in the physical world. To be an emotional explorer, to collect emotions, we need to be able to let go of emotions, too. Letting go means that we neither cling to positive emotions nor push away negative emotions. Instead, we ride and surf the waves of the emotional world, learning new things about ourselves and others by connecting, creating a sense of vibrant interconnection, feeling alive and filled with the sensuousness of the world. Emotions enliven the physical matter we are made of. Feeling-connecting-flowing―these actions create the currents that move us through the emotional world. While we can navigate these currents, we can’t control them because they’re a fact of our internal and external emotional geography.  

 

What is flow? 

Psychologist Mihaly Csikszentmihalyi, one of the founders of positive psychology, has spent his life working on the concept of “flow.” Flow states are those in which you’re completely immersed in what you’re doing, where there’s no separation between you and the action you’re doing. Sports, dance, playing music, sex, and being in nature are all states and places where flow can occur, but really it can happen anywhere. Mystical experiences are also an example of flow states where there’s no separation between inner/outer or self/other. Csikszentmihalyi describes eight components of “the phenomenology of enjoyment.”  

 

1. The experience usually occurs when we confront tasks we have a chance of completing. 

 

2. We must be able to concentrate on what we are doing. 

 

3. Concentration is usually possible because the task undertaken has clear goals.  

 

4. It provides immediate feedback. 

 

5. One acts with a deep but effortless involvement that removes from awareness the worries and frustrations of everyday life. 

 

6. Enjoyable experiences allow people to exercise a sense of control over their actions. 

 

7. Concern for the self disappears, yet paradoxically the sense of self emerges stronger after the flow experience is over. 

 

8. The sense of the duration of time is altered; hours pass by in minutes, and minutes can stretch out to seem like hours. 

 

Csikszentmihalyi writes that the “Combination of all these elements causes a sense of deep enjoyment that is so rewarding people feel that expending a great deal of energy is worthwhile simply to be able to feel it.”

 

Do you ever feel this flow state when you’re caring for others? Healing, teaching, doing surgery or a procedure, being with another person as they go through something very intense―all of these can be places where you can feel flow states, although not if you’re burned out. Burnout is the opposite of flow: you’re stuck, everything is difficult, everything is a struggle, nothing is rewarding.  

 

Finding flow in work 

We can think of flow in work as having a harmony of our inner emotional state with our outer actions. When there’s no friction between inner and outer, we enter into a flow state where work can seem effortless.  

 

When you feel a lack of flow in your work or life, you can examine both your inner and outer realities and then look for any mismatches. Sometimes there’s an emotion that you’re avoiding that could block the flow—experiencing and accepting that emotion may restore the flow. Sometimes there’s an outer situation that needs addressing or changing in order for inner and outer to harmonize. This isn’t just about adapting to the outer situation—this is actually how we get into burnout—we adapt and adapt and adapt to work stressors and eventually there’s too large of a discrepancy between our inner calling as healers and our outer roles as protocol managers, technicians, and data-entry clerks. Flow requires us to be honest. Distorting our inner values and emotions in order to push through them to in order to be an efficient and productive widget will only work for so long. When we burnout, it’s an opportunity for us to re-evaluate our inner and outer realities and to see where things are dammed up and blocking flow. Have we compromised our values too much? Is there an outer situation or relationship that is interfering with our ability to flow at work? Is there a need to do some job crafting in your work? 

 

Meditation, reflection on emotions and inner states, job crafting, courageous conversations, consultation with your boss or with an outside friend or job coach—all these can be ways of re-connecting with flow in your life.  

 

 

Read more about the author on his website.

 

 

 

 

 

 

 

 

 

 

This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.

 

 

 

 

 

 

 

 

This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.