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Join us as we explore the habits that might be making your life harder than necessary. Our guest, Cindy Tsai, an internal medicine physician, shares valuable insights into common obstacles that hinder personal growth and alignment. From excessive device usage to self-doubt, we discuss the impact of these habits and offer practical solutions for positive change. Tune in to discover how you can overcome these challenges, prioritize self-care, set boundaries, and embrace a life of joy and peace. Don’t miss this empowering conversation as we unlock the path to a better, more fulfilling life.

Cindy Tsai is an internal medicine physician and can be reached on Twitter @cindytsaimd.

She shares her story and discusses her KevinMD article, “Are these 6 habits making you unhappy?”

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Transcript

Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast and get CME for this episode by clicking on the CME link in the show notes. Today we welcome back Cindy Tsai. She’s an internal medicine physician. Her KevinMD article is titled “Are these 6 habits making you unhappy?” Cindy, welcome back to the show.

Cindy Tsai: Thanks for having me. I’m happy to be here.

Kevin Pho: So, Cindy has been on multiple times. Go to KevinMD.com/podcast; in the upper right-hand corner there’s a little search icon. Click on it and look for Cindy’s old episodes to hear her story. But today we’ll get right into your most recent article, “Are these 6 habits making you unhappy?” So tell us, how did your article come together?

Cindy Tsai: So I think for me, after doing a lot of self-development, self-growth, and reflections, and also in my work helping accomplished clinicians and professionals on their own journey, I found that there were a lot of things that kept coming up. And so I wanted to share, in an article, some of the common habits that I think people are prone to, just being human and living in this modern world, and to shed some light on them to help people feel better.

Kevin Pho: Absolutely. So tell us, what are some of the things that you found?

Cindy Tsai: So I think number one is constantly being on our phones and devices.

Kevin Pho: No, really? No, all the time. I have a house with two teenagers, so I think this affects pretty much everybody.

Cindy Tsai: Yeah, and I think that in this day and age, of course, it’s all around us, right? We’re constantly connected, looking at the news, social media, and all of it. And I think it can be this very slippery slope where you might start out the day with good intentions. You want to check out the news or whatever, but then there’s something about just getting hooked on it, right, with all the dopamine and all that, and before you know it, you’re scrolling all day. You’re spending hours and hours.

And I think it’s really common, because what it does is it causes you to disconnect from your actual reality and how you’re actually feeling. And I think a lot of times we don’t realize that we are absorbing a lot of information and energy, so to speak, from our surroundings and all of it, and it’s basically what we’re consuming, right? And so I think it’s really important to be aware and to be intentional about, OK, what are you actually looking at on your phone? How much time are you spending on it? And knowing that it’s important to take periodic breaks, right, to make sure you’re still grounded in yourself.

Kevin Pho: Now, have you talked to physicians where being on these scrolling apps has actually caused a problem, such that it affects them professionally?

Cindy Tsai: Yeah, I mean, I think a lot of times I find that people turn to phones, and especially social media, as a way of escape. If you’re having a long day and you’re just really stressed out and you’re overwhelmed, then instead of really being present with that and processing and figuring out how to release it, it’s so much easier to just scroll through your phone, look at some cat videos, whatever it is. It’s almost like there’s so much overwhelm that you can’t deal with it right now, so you resort to something else as a distraction or an escape.

And I think that it’s that dopamine hit that you get, right, because it’s that quick fix and you get to take a break. But stepping back and looking at the whole picture, you spend hours on your phone, right, and then afterwards you’re still not feeling good. I know people who, usually at the end of the day, when they’re in bed, right, we all know about sleep hygiene and turning off your devices, but it’s very tempting, and it’s just like, “OK, let me just scroll through a little bit before I go to bed.” And then even after scrolling, you’re still not feeling good, right, hours later, and you’re still having to deal with whatever original feelings you’re going through. So definitely, I see that a lot.

Kevin Pho: All right, so what’s the next one?

Cindy Tsai: So I also talk about not prioritizing your own needs, and I hear a lot about self-care. I like to say that self-care is not just about the stuff, the pampering moments, maybe going to the spa, getting a massage, whatever. It’s also really about just taking care of and nourishing all parts of your mind, your body, your spirit, and knowing that your needs are yours and they look different for everybody. And it actually can be very little moments throughout your day to really re-energize and recharge, as opposed to hustling, overworking your whole week, and then planning that one massage or whatever at the end of the week. Because I think a lot of times, when people do that, you’re already in a state of burnout, right? It’s that much harder to re-energize.

Kevin Pho: Now, you don’t need me to tell you that physicians, of course, can never find time to prioritize their own needs. But what are some easy tips or easy success stories that you could share where physicians can do this on a regular basis?

Cindy Tsai: Yeah, I think a lot of times it’s the very little things that count. And so a lot of times, when we have very busy schedules, we just go through our days in the blink of an eye. And so it’s really helpful to set reminders, and basically you can use alarms on your phone, right? One thing I share with clients a lot is to set three alarms on your phone, maybe 9 a.m., 1 p.m., and 3 p.m., just throughout your day. When it goes off, think of it as a moment to remind yourself to take a breath, to just pause and to check in: “Hey, how am I feeling on a scale of 1 to 10?” And just getting a sense, because a lot of times what it is is we have to have increased awareness of where we’re at. If we’re not aware of what’s going on, we won’t know that we need to change and tweak things.

But once we’re aware, like, “Hey, I’m not feeling good. Oh, I haven’t had water all day,” then you’re like, “OK, let me drink some water. Let me take care of myself, right? Let me roll out my shoulders,” whatever it is, just the little things. But even simple things like that, just having some type of prompt and reminder, so that you can really remind yourself to just check in and take care of yourself throughout the day.

Kevin Pho: Your next point is procrastinating. I think that sometimes can affect some of us, so talk more about that one.

Cindy Tsai: Physicians and clinicians, just being such high achievers and overachievers, we have a lot going on in our lives. And I hear this a lot, where people are like, “I’ll do it. I do my best work at the very end,” right? All of that. And I think that it might feel good in the moment when you’re like, “OK, let me just put it off until later,” but it’s also just so much pressure that you give yourself right at the very end. And I think what we’ve gotten used to is we think that we work better under pressure, but in reality, it’s just been an adaptation, right?

And so I think it’s helpful to just consider, what if I was able to be very intentional and focused in the commitments that I have in my life? What if it was OK that, instead of signing on for five things, I focused on two things that I really, really love and that really light me up and energize me, knowing that it’s not like you can’t do the three other things? It’s just, do these things right now, and then really feel good about that. And then that energy that you get is going to keep fueling you, and you’ll actually have more to expend on later.

Kevin Pho: What proportion of clinicians that you talk to are actively procrastinators?

Cindy Tsai: Well, procrastinating, right? It depends on what’s going on in their lives. And I think a lot of times procrastination also comes when there is underlying fear about failure, or just when it’s something new that you’re about to embark on, or a new passion project, or starting a side business, or if you’re looking at investing, maybe in real estate, or something that you haven’t really explored. And you’re like, “Oh, I think it’s something I should do or want to do,” but it seems like a lot of work. And when you think about the piles of paperwork and whatever else you have going on in your main career, it’s a lot, right? So it comes up, definitely.

Kevin Pho: Now, what are your last three?

Cindy Tsai: Yeah, so I think I talked about not setting boundaries and how that can definitely make you unhappy. And I think a lot of times, especially for physicians, being very altruistic and wanting to help people, it’s hard to set the boundaries and to know, “OK, this is not my responsibility,” right? And I think I see this a lot, especially when you’re wanting to really take care of patients, and then sometimes patients may not necessarily be speaking up or advocating for themselves, and then clinicians may do a lot and all of that, or take their work home with them, right? I see that especially when you’re very empathetic, and that can be really exhausting. And so I think it’s really important to understand what’s important to you and to set those boundaries, knowing that even if you have boundaries, you don’t have to communicate them in a harsh way, right? It’s just knowing who you are and what people can expect of you, and communicating that clearly without having to push people away.

And then I think I also talked about comparing yourself to others in a negative way. I think a lot of times, as I mentioned, being high achievers and overachievers, you’re oftentimes looking externally in terms of, “OK, well, what should I be doing at this point?” and all of that. And I think it can be really detrimental, because it’s that keeping up with the Joneses, right, where it’s like, OK, your neighbor did this, or your business partner did that, whatever, and you make it seem like you’re not doing enough. And that can be just tremendously stressful, right, emotionally and all of it.

And so I think a helpful way to reframe is really seeing that everyone is on their own journey. With what people are doing, if it’s something that you aspire to, it’s actually a really great sign, because it shows that it’s very much possible for you too, but not really seeing it as a way of, “I’m behind. I’m not good enough,” right? And so I think when you find yourself in that place of feeling bad about it, it’s an opportunity to pause and to think about, well, why is it that I’m thinking this, right? How am I not taking care of myself? And really reframing to see that it is possible, right, and not using it against yourself.

Kevin Pho: Yeah. And then the final one?

Cindy Tsai: And then the final one I talked about was not believing in yourself. A lot of times we have this very loud inner critic inside our heads, and we really make it harder for ourselves than it needs to be. And we have that feeling that everything is hard, and it’s a struggle, and you have to put in your dues. And I think what it is, a lot of times, is the old belief patterns that we picked up when we were young, and from society and the generations previous to us, whatever it is. And so we have this negative loop cycle that can keep us stuck. And when you’re in that negative space, a lot of times you’re causing more fear, and that causes you to not want to do things even more, leading to procrastination and all of these things.

So I think it’s really helpful to just pause and notice, just listening to how you’re speaking to yourself, right? When you think about a new position or a new investment, whatever project that you want to take on, what’s the first thing that comes to mind? Do you feel like it’s possible for you, or are you immediately like, “Oh, that’s going to be so hard. It’s not going to work out for me. I don’t know how to do it. OK, they can do it, but I can’t”? All this negative self-talk that comes up, first, it’s very common, right, if you haven’t done this practice of just being aware and all of that. So it’s completely normal for humans to have this negative thinking, because it’s kind of been our adaptation to help us, like, “OK, look out for potential danger,” so to speak. But it’s just knowing that it’s possible to change that and to work through it, so that it doesn’t have to set you back and cause that stress, because that’s for sure going to cause more unhappiness in your life.

Kevin Pho: I want to go back to not setting boundaries, because I think that specific one makes a lot of physicians unhappy and leads to a lot of burnout. So tell us some small wins, some everyday victories that you’ve heard physicians implement in order for them to be better at setting boundaries at work.

Cindy Tsai: I like to share a simple three-step process for people. So first is: Boundaries start with you. So think about what it is that you want. In an ideal world, what’s the solution you’re looking for? Because a lot of times I find that people aren’t even aware. They don’t even think about, “OK, what is the ideal scenario?” right? They just go with it. An administrator tells them, “This is the schedule,” and they’re like, “That’s it,” right? They never question it or even ask them. And so I think first is, start with you, right? Think about what’s important to you.

And number two, step two, is actually taking action and being clear and verbalizing them. And I like to share that, a lot of times, keep it very clear and concise, simple, like one or two sentences: “I want this to be done by this time tomorrow,” right? Instead of a whole paragraph of, “OK, I would like this, but this,” and then whatever. And I think that’s the thing that people may not be aware of: When you’re setting boundaries, it’s starting with you, putting it out there, being clear and concise, and taking out the drama from it, of worrying about how people are going to respond and trying to control for that, right?

And then step three is actually managing discomfort, because I think a lot of times people worry ahead of time about how people are going to respond, and then they’re wanting people to respond a certain way and whatever. And part of it is, it’s going to be uncomfortable, right? If you’ve never told your office manager that you’re not going to work at this time or past this time, it’s going to feel weird and probably very awkward to say, “Hey, I’m not going to take calls after 6 p.m.” And so that’s why I like to include that in this process, because I want people to know it’s completely normal. When you’re saying something for the first time, or the first few times, to speak up, to advocate for yourself, especially if you haven’t been doing it, it’s going to feel uncomfortable and weird, but it’s going to be a huge relief, right? Because you’re actually really being authentic and speaking your truth. So I think knowing that this is a process, keeping it simple and concise, and really knowing that it gets easier the more you do it is really important.

Kevin Pho: We’re talking to Cindy Tsai. She’s an internal medicine physician. Her KevinMD article is titled “Are these 6 habits making you unhappy?” Cindy, tell us some of your take-home messages that you want to leave with the KevinMD audience.

Cindy Tsai: And so, go through this and recognize that you’re not alone, and look at it from a lens of openness and curiosity, to just understanding, like, “OK, that’s interesting that I’ve been doing this. It’s interesting that I’ve been on my phone for a couple of hours.” A lot of times I find that people read these things, they see it, and they immediately go to a place of judgment and shame and criticism, and then they end up not wanting to look at it and not wanting to change it.

And so I encourage people to take the stance of an observer, to just be like, “OK, let me see what I’m doing.” And when you take away that layer of judgment, it really can help you be open to changing and to recognizing, “OK, out of all of these, which one would make the most impact?” right? Don’t do all the things at once, because then we’re going to do too much, but keep it simple and break it down, whatever works for you, knowing that it’s a process and you’re on your own journey.

Kevin Pho: Cindy, thanks again for coming on the show and sharing your time and insight.

Cindy Tsai: Thanks so much.