If we are honest with ourselves, many of us are often bored with our lives. It’s not our fault. We followed the blueprint that society laid out for us. We worked hard to get to this stage of our personal and professional lives. Most of us have achieved more than we could have dreamed of when we were younger. We are in the elite profession of medicine. We have the opportunity to help others every day. We make a great living. The vast majority of people in the world would gladly trade places with us.
So why are we often bored? Why aren’t we happier? What more do we really need out of life? These are uncomfortable questions but important ones to ask ourselves. Fortunately, there are some answers to be found in the field of positive psychology.
This field — often called the science of happiness — studies that which makes life worth living. Positive psychology asks and attempts to answer the question that I found myself asking over a decade ago — how can I learn not just to function but also to flourish?
Like most of you, I had achieved more than I ever imagined. I was married to my best friend, and we have four healthy kids. I had a great job with a radiology startup designing innovative workflow. I found myself wondering why I wasn’t happier. It’s not that I was unhappy, but I began to worry that if I couldn’t figure out how to experience more joy and fulfillment when things were this good, how would I ever deal with any real adversity when it would inevitably come.
I eventually stumbled upon and became certified in positive psychology. This has changed my life. I wrote about it in this JACR article, “Diagnosing Happiness: Lessons from Positive Psychology.” Since that 2018 article, I have taught these principles of well-being to hundreds of physicians in different specialties. This experience has uncovered a few new insights that can be especially helpful for physicians.
Affective forecasting is the study of what people think will make them happy. Being able to accurately predict what will make us happy is crucial since this is the basis behind most of our actions in life. Who we marry, what career we choose, where we work, and what goals we set are all based on how much happiness we perceive these decisions will bring us in the future. Unfortunately, multiple studies have shown that we are lousy at this prediction. While most of us can correctly predict whether something will be pleasant or unpleasant, we often overestimate the intensity and duration of our future emotional reactions to this event. This “impact bias” has been studied in various contexts and populations.
The reason that impact bias is so pervasive is because of another landmine — hedonic adaptation. This process causes us to adapt to stimuli in our lives that are constant. Hedonic adaptation is the reason that the fruits of our labor all lose their sweetness over time. Impact bias is the reason that they were never as sweet as we imagined they would be in the first place.
We can all identify these landmines in our own lives. The thrill of getting into medical school was quickly replaced by the desire to match into residency. The joy of making partner was replaced by dreams of retirement. That new car or larger house gave us a temporary boost, but we quickly returned to our baseline levels of happiness.
What the research on affective forecasting shows us is that generally, things are not as good or as bad as we think they will be (because we will eventually adapt to them). Like most things in psychology, this serves as an evolutionary advantage. By overestimating how much pleasure or pain something will provide us, we are hyper-motivated to act in the direction of our own survival. By adapting to stimuli that are constant, we can differentiate new stimuli (threats) from old ones that should fade into the background. Unfortunately, some of these stimuli that are now in the background of our lives are the ones that are most important to remember — our health, family, friends, and meaningful work.
We can leverage this insight in our quest for flourishing. We can still pursue the next promotion, the bigger house for our growing family or new business opportunity. Realizing that these fleeting rewards won’t be as good as we think they will be, we can focus on our personal and professional journey rather than a destination that we know won’t live up to its hype. We can choose to pursue valuable things while not neglecting that which we should value – our character, relationships, and actions.
Happiness boosters are research-based activities that “not only give us a quick boost of positive emotions, improving our performance and focus at the moment; but if performed habitually over time, each has been shown to help permanently raise our happiness baseline.”
Gratitude/negative visualization: The most widely studied activity to increase our well-being (happiness booster) is the cultivation of gratitude. The reason that gratitude is so effective is that it is an antidote to hedonic adaptation. By forcing ourselves to recall the good aspects of our life, we are less likely to take them for granted. This can be done effectively with a daily or weekly journaling habit where we write down three good things that happened and why we are grateful for them. I’ve been doing gratitude journaling for several years, and I now find myself noticing something during the day that I know I will give thanks for in my journal. This act of noticing makes me a little more mindful of the good as it is happening. To be clear, I still get upset at a difficult work situation or angry with my kids, and I should mention that positive psychology will not make you immune to these aspects of life. What it can do is make those episodes shorter and less frequent, with longer periods of tranquility and contentment in between.
Another widely studied and effective method to cultivate gratitude is the gratitude letter. Once per month, write a letter to someone thanking them for something that they did for you. This person could be a parent, child, teacher, coach or patient. It helps if you read the letter in person (gratitude visit) but simply sending this letter is also powerful. When I taught this exercise in my college class (How to Flourish), the feedback from the students was tremendous. Many students reported a deeper connection with the person that they thanked in the letter, along with a sustained boost in their own well-being.
Many other happiness boosters have been studied (exercise, religious activity, gardening, volunteering, etc.). The key is to experiment with what brings joy into your life and then make sure to schedule an adequate dose of it each week.
Many of us, myself included, struggle with a lack of peace and fulfillment in our lives. We are constantly searching for that next book, life hack, or job title to finally “make it” and be happy. Most of the “well-being” space is cluttered with platitudes and fragmented band-aid solutions that don’t address the root of our suffering – our increasing inability to focus on what matters most in life. The key to improving our well-being is to cultivate attention to things that matter.
Positive psychology provides a comprehensive framework to help us understand what truly matters in our lives. We can learn to recognize the mental traps in our mind’s quest for survival. We can begin to realize that the fruits of our labor are never as lasting or sweet as we think they will be and that simple experience is the nectar of life. We can discover that our constant chase for the next thing is really a chase for security by our mind. We can do better than simply surviving and functioning. With this understanding, we can live more fully and flourish. In a society desperate for attention and accolades, we can remember and, more importantly, teach our kids that working for external rewards won’t be as satisfying as the experience of working on ourselves. That is where lasting happiness is found.
Sanj Katyal is a radiologist and founder, Positive Psychology Program for Physicians.
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