Self-Awareness

Self awareness is hard. The ability to reflect on our own actions and thoughts means that we also have the capacity to be disappointed in ourselves. It is the reason we may have a knee-jerk reaction to blame others, rationalize our actions, or lash out; these things are easier than taking a broader view and finding that the real problem is something more difficult than what we are reacting to, perhaps even a flaw in ourselves that we don’t how to fix or simply don’t want to.

But that being said, it doesn’t mean it is not wonderful at the same time. Digging into what makes us tick and how we are perceived is scary and commonly shied away from but is what gives us the ability to improve those outlooks. We can improve beyond simple instinct in order to become a version of ourselves that is closer to who we want to be rather than simply who we are in the moment.

We all love the idea of knowing ourselves and of achieving personal growth but a lot of the time we stay on the surface; it’s easier and safer there. I can confidently say that I am a kind, caring, and people-pleasing person, then leave it at that surface level and call that self awareness. Alternately, I could keep digging and I may be forced to face a truth that I don’t like.

In the same way, it is easy to say we don’t like someone because of what they say or do without ever considering why they are like that. We consider an action to be the person rather than as what it is: an action driven by some motivation that we may not be aware of and that makes up only a fraction of what makes people who they are. In the same way, we hardly look at why we don’t like what they do. What is it that triggers our own beliefs and feelings to elicit that hate or discomfort? And of course, the same can be said about how people feel about our thoughts and behaviors.

I have noticed that when you are with the same people and in the same situations all the time, the behaviors of your group is considered normal no matter what an outside observer might think. Bringing yourself into new situations–stepping out of a personal echo chamber–can make things seem odd or even wrong. An example of this is when I moved to Kentucky and ordered asparagus as a side for my meal. The asparagus came out with white gravy, while nowhere on the menu did they mention any kind of sauce. I asked the waiter if I could get plain asparagus and he was shocked. He didn’t know why I would want asparagus without gravy or even if he could get it for me like that; ordering “asparagus” meant “asparagus and gravy”. Meanwhile, I was confused because I didn’t know why you would serve it with an addition that wasn’t even mentioned. It was a cultural norm of the place I was now living but it took time to realize how normal it was, even if initially it was unexpected and friends from my original hometown still think it bizarre to add gravy to vegetables.

We’ve learned different techniques and patterns of thought in class, but the foundation of all of them is self-awareness. People who are unwilling to exercise self-awareness are little different from those who don’t have the ability at all, but those who choose to explore their own self are those with the potential to become better. This is why I feel simply acknowledging that self-awareness is the key to self-care is critical, because it is more difficult to take care of something we don’t understand and nearly impossible to take care of something we refuse to engage with. I experience emotions like all people do but understanding those emotions helps me identify their cause and, once I’ve done that, I’m better equipped to share positive feelings and minimize or redirect negative ones.

I have found this critical in my marriage. It is easy to take something small or simply irritating and allow it to expand into some great thing that becomes the focus of anger, sadness, or any number of other negative feelings. But viewed through introspection, it is often not my partner I’m actually upset with, or maybe I am but not over the specific action I’m now frustrated with them about. Self-awareness means I have the ability to evaluate the reality of my own self critically and then use the proper tools to address that reality. Maybe I am upset with my partner, but for something we argued about in the past or maybe something I’ve not even spoken to them about. I can then redirect the conversation into the actual problem, which stands a much better chance of coming to a positive resolution rather than if I insisted that the immediate action was the be-all-end-all of my feelings. There are plenty of times where it is not even them and I am simply upset over something else. In these cases, I can actually use my partner as a resource, expressing my actual feelings and relying on them for support rather than as a target.

This leads neatly into the importance of thoughts and words. It is not enough to merely identify a problem. We must set our minds right about it and choose the appropriate words to address it. In the above example, if I allow my thoughts to continue to be small and petty–focusing only on the irritant rather than the cause–I will continue to be irritated because I’m not making steps to fix or at the very least address the problem. Continued and prolonged negative thoughts are consistently affirmed in the medical community to be the cause of many health issues as they place the body in an extended stress condition. Rather, by setting the mind into correct thoughts and thinking about the actual problem, I feel a sense of calm and focus. That isn’t to say I’m immediately calm about the situation, but the sense of urgency and that negative “edge” on my feelings dulls a bit once I set my mindframe right.

Similarly, the words I use to express feelings or my sense of self-awareness fundamentally shape how I feel about the situation as a whole. Using negative words like “can’t”, “never”, “always”, or even “you” sets my mind into a state where the problem is insurmountable or maybe not even related to me at all. Choosing words like “I feel”, “I think”, or stating facts as they are without trying to assign blame along with them allows me to better understand a problem because I feel it sets my mind up to see a situation as something that can be addressed and dealt with, rather than an impassable wall.

Something I find particularly interesting is that, by using words like “I think”, it sets my mind’s focus on the external, big picture. These words, while focusing on me, highlight that I can only experience a situation through my own context. The opposite is true of saying things like “you think” or exaggerating a situation to “always” or “never” be true: by using words focusing on the external, it sets my mind into a frame where I might actually know this information, where I already know another’s thoughts or already understand the reality of a situation. These lead to a much smaller picture–the small mind–of the situation, one where by deflecting the situation outwards, I’m really projecting my own views onto the world. Instead, by choosing internal words, it forces me to accept that what I’m saying is just my perspective. This helps me approach the large mind set of taking the next step and seeing things for what they are and trying to understand the perspectives other’s might have of the situation. I think this is the importance of “rewriting the narrative”. By choosing how I experience a situation through my thoughts and words, it sets me down a path of either treating my view as an absolute truth or treating it as one of many potential perspectives, prompting me to dive deeper into discovering the actual truth.

Which brings me to the necessity of creating good habits and minimizing poor ones. As I write this paper, I’m doing so from the relative calm of my kitchen table, sitting alone with my tea next to me. It would be easy, here and now, to say how simple this whole thing is: choosing the right words, setting your mindset right, making full use of the gift of self-awareness. But I don’t need help doing those things now, I need help doing these things in the heat of the moment. I need to be able to make these same beneficial choices when I’m upset, angry, or just being selfish. Making these choices should be second nature, otherwise I’m much more likely to give into the primal nature of emotion and fall back on the easy, more negative path. That’s why even when emotions aren’t high or situations are straightforward, it is crucial to practice mindfulness. Even in a positive situation, it is useful to think about the feelings and motives of others and to try to understand how others might be seeing a situation differently than I am. By doing these things when it is easy or positive, I am more likely to default to those same positive behaviors in situations which are heated or negative. By making these positive behaviors a habit, I can grow as a person to be someone where these behaviors are just “who I am” rather than an aspect I need to force. By the same token, any negative behavior I fall into makes it more likely that I repeat it without conscious effort and so it is important to avoid those negative behaviors every time because they run the danger of becoming a habit.

Also, by using these techniques to improve myself as a person and practice self-care, I’m improving my ability to interact positively with patients, colleagues, and others I will interact with in my practice. In medicine, it will be even more important to recognize things for what they are, rather than what I want them to be. Patients in particular will each have their own, unique set of experiences and thoughts on themselves and their ailments. Using these techniques, I hope to improve my ability to affirm their feelings while digging deeper for the truth of the situation instead of my own gut feeling. I also think that word choice in particular will be important when interacting with patients because if my words focus on the small or the selfish, those patients are more likely to mirror my attitude or to outright become defensive of their own positions. But by that same logic, if I can use a large mind approach and focus on positive, inclusive thoughts and words, I hope to make room for patients to feel the same so that they will be more honest with both me and themselves, leading to a better diagnosis and treatment outcome.

While patients will of course be the focus of a clinician’s practice, it is a fact that I will be working with other professionals as well. This will range from those with decades of experience where I will have the opportunity to learn from them and improve myself as a clinician, to hopefully one day doing the same for those with less experience than me. Those relationships must be built on trust and respect if they are to be supportive of who I am in the medical community. However, people have their own viewpoints and those in the medical profession are no different. I am sure there will be times I will disagree with a diagnosis or opinion. In those cases, I could be small minded and dismiss it outright because I “know better”. Or I could rewrite that narrative into a large mind framework and try to understand why they think what they do, to assess the value in an opinion even if I might initially disagree. In doing so, I might see a situation from a different angle that my own context and experience would have missed. I might ultimately still disagree, but I will miss many opportunities to learn and grow if I never make the attempt to recognize my own shortcomings or that I can be wrong.