What to do when you can’t do it all

There was an interesting little discussion on the forum this week about the perceived pressure to do everything, and to do it all right now. That fits with the concept of the insecure overachiever that is actively sought out for certain high demand jobs (and was the topic of a recent radio 4 show) and also the concept of Imposter Syndrome, where you constantly feel like a fraud who might be found out and identified as inadequate for the job. There is a widely perpetuated narrative in modern society that people should be willing to work longer and harder, and there is always a mythical person who is doing more than you. Whether that is more revision before exams, or more prep for their clinical application or assessment day, or more voluntary work, or managing to juggle more things in their working week, it always makes you feel a bit guilty and inadequate no matter how much you are doing or how hard you are trying. The truth is we are in a profession where demand for our services will always exceed supply. The early stages of the clinical psychology career path are competitive, and there are lots of people who claim impossible workloads and huge amounts of experience that can make you feel like you’ll never measure up. So how do we tackle this pressure to do more?

There are probably lots of layers to the answer. Some are political, as this culture springs from job insecurity, underfunding, and the focus on attaining wealth and status – so the ideal is to change the game, rather than trying to win a game that is rigged against us. Another layer is to communicate with others and band together, as this undermines our personal insecurities that see it as our own personal failings, and allows us to normalise our experiences and work together to resolve the systemic issues that underlie them. But even at a personal level, there are things that we can do.

So this blog is about my top ten suggestions to tackle that feeling of having too many plates spinning and not enough time, and the cognitive distortions that maintain the belief that we should do more. I’m not saying I’ve got all the answers, or that that I’ve resolved all these issues in my own life. Far from it! I’ve mentioned many times that I’m not a good role model in this regard. I think I am a bit of a workaholic, and whilst other people say I’ve achieved a lot, I always feel like there is more I could/should be doing. However, the things that have started to help me change my own patterns are:

1) Know when you are taking on too much. Having had a minor car accident, the physical repercussions made me cut down my work to a more manageable level. They remain a good reminder if I’m overdoing things, as I get aches and pains in my ear/jaw and shoulder. Obviously, I’d not recommend having an accident as a self-care strategy to others! The bit worth sharing is to be aware of your own physical and mental state, and to learn to recognise your own signs of stress as early as possible. Then you can be responsive to your own needs, and learn to stay within your own limits. It is also a good reminder to ensure that you build self-care and exercise into your routine.

2) Fit in friends and fun. Giving higher priority to the people and things you enjoy and are recharged by. We all need to have support networks, and family and friends need to be given enough time and priority in our lives to perform that role. I can’t persuade myself to “do less work” or to leave gaps in my diary, but I can put in commitments to the people and activities I value in my life that compete with work. I make it a personal rule that I finish work at 4pm on Mondays to take my kids to their swimming lesson and do my 30 lengths. Every evening the 7.00-8.30pm slot is time I always give to my kids’ bedtime routine, and 8.30-10.30pm is time I always spend with my husband. I’m also trying to cook with the kids twice a week, to fit in a creative activity each month and not to work on weekends. My advice it to start small, commit to something for at least a month and then build on good routines once they are established. Once in a while make time for fun or frivolous things like having a spa day, or sneaking out for a cinema or lunch date with my husband, or booking a holiday.

3) Sleep. No matter what else is going on, make sure to get enough sleep. For me that means eight hours per night. I’m a night owl, so I often work until the task is done, even if that means resuming work after everyone else in my house is asleep and working through until the small hours. Then I often have to get up and fulfil work commitments the following day. If I could stop doing those extra bits of work after everyone else is asleep and get a proper sleep routine where I sleep during the hours of darkness and get out into the sunlight more in the daytime, that would have positive knock-on effects on my energy levels, mood, appetite and attention span. You can see from the fact I’m drafting this post at 2am that I’m not managing that yet, but for now allowing myself to have at least one lie-in on the weekend is a lifesaver.

4) Use your time better. Stack commitments together with similar content, that involve particular colleagues or that you can do in particular locations. Get the right kit to do the job efficiently. Travel less. Use video chat rather than meeting in person. Minimise your commute, or use it for something relaxing like reading a novel or listening to music or audiobooks. See if you can work from home even if it is just a small proportion of your time. Work out what the blocks or bottlenecks are in your process, and how you can solve them, For me having templates of common reports and letters was one helpful step. According to where you are in the power structure, you can also look at how you can draw in support or what you can delegate to others.

5) Diarise the in between stuff. Don’t just fill your calendar with the face to face stuff and expect to fit in the admin and support tasks in the cracks, because they either escape into non-work time or don’t get done.If you have to write a report between appointments, give yourself a diary slot to do it in. Need to read the papers before a meeting? Book the hour beforehand for that task. Want to write up a paper? Diarise three days for it. Then make sure that you keep that time for that sole purpose. Book an admin slot at the beginning or end of each day, or a half day at the beginning or end of the week. Check out how much time you need and when you are most productive. If that is a time that is earlier or later than other people work, make sure that you take the time back somewhere else*.

6) Prioritise, then focus on the key tasks. Isolate yourself if you need to get something important or time critical done. Turn off your phone and your email alerts, ideally unplug from the internet, and prevent distractions. Then give it your full attention. Work out what is interrupting you, and then stop it so you can get work completed in one steady sprint, rather than having to come back to it again and again after dealing with phone calls, emails, other people interrupting, or diverting onto the internet. Deal with the quick stuff straight away. But then make yourself a task list and work down it. Prioritise the important stuff over the seemingly urgent but unimportant. Try to check email and messages at the beginning and end of the day, not every few minutes. When you need to get something done turn off social media, email alerts, etc. Turn your phone onto silent and then put it out of sight.

7) Clarify your goals, and how to reach them. Envisage where you are trying to get to, what the steps you need to take are, and what barriers are preventing you getting there. If you wanted to lose weight you could picture yourself thinner and see how it would play out in your life, then think about what you need to do to consume less calories or burn off more. Then see what is stopping you. You could identify that you aren’t getting to the gym if you go home from work first, or that you are always tempted when there is cake in the office, or buy unhealthy snacks when you don’t take a lunch to work. Once you recognise them, you can then make an informed choice, and if the benefits are worth the extra effort you then need to address the barriers. One of my goals is to make my business self-sufficient enough to continue even if I went off long-term sick, and could provide me an income in retirement. So I have been thinking about how to recruit and train others to sustain the business, and create products that can utilise my skills and knowledge without me having to deliver everything in person (eg can I train others to deliver training, deliver it as a webinar, or make videos of the training available to subscribers).

8) Get a better bubble. They say that we are the average of the five people we spend most time with, and whilst that isn’t a scientifically validated concept, I think that it has some merit to it. We are all normed by those we spend most time with, so I’ve actively chosen to seek out the company of people I admire and want to learn from, and who will challenge my assumptions and habits. More specifically, I’ve been trying to spend more time with other social entrepreneurs, rather than the long-term NHS, education and social care professionals I already know, so that I move away from the common assumptions of this kind of work, and can be more creative and less risk averse in how I look to create impact. You also need to enlist the support of the key people in your life so they reinforce your goals, rather than unwittingly draw you back into old habits.

9) Get reflective. Use your supervision, your trusted confidants or keep a journal. If you want to take it one step further, why not seek out therapy, or coaching, or personal development opportunities. Give yourself time to think and regroup, particularly after stressful or emotional experiences. As well as the benefit of some wonderful supervisors, I’ve had various coaches and mentors since I left the NHS, and I’ve attended various groups and training programmes. Each one has helped me understand myself better, and refine my plans to make them more likely to success. It is really good to take time outside the pressure of spinning all the plates to look at why you are spinning them, which are most important, and how they make you feel. It can help you to consider the pros and cons of different options, and to identify goals and actions.

10) Be kind to yourself. Remember that you need to attach your own oxygen mask before you can help others with theirs. Take time out when you need to, and find the things that replenish you. Be realistic about what is possible or what you have capacity for, and learn to say no to unreasonable demands. Don’t be too self-critical. Seek out and remember the positive feedback, and the things you have already achieved. Take the time to note the positives and be grateful.

And above all: Enjoy the journey. There is no rush to get to the destination. Dance whilst the music is playing.

 

*with the agreement of your manager, of course.

The attraction of small rewards

I went to the Y Not Festival last month. It was a bit of a mixed bag because of the weather, and the terrible app that was supposed to function as a map and timetable was a daft idea on a site with limited mobile in the first place and totally useless in practice as it wasn’t updated when things changed. But we saw some good bands, and ate some good food, and it was only half an hour from home so we also slept in our own beds! But the reason I mention it was because of a trivial but unexpected thing: They had an incentive to recycle the plastic pint glasses that were being used and dropped on the floor. They offered 10p per glass to take them to a recycling point in sets of five. For the most part that wasn’t enough for people drinking to bother keeping and pooling their glasses to cash in. But a small economy developed amongst people who found it worthwhile to go around collecting the dropped cups. There were some sets of kids excitedly supplementing their pocket money by collecting piles of cups during the day, and also a few adults who increased in numbers in the evenings.

At £5 per pint the beer was not cheap, and I joked with my husband that I’d see if I could collect 10 cups to offset the cost each time he drank one. But as soon as we started collecting cups, we realised that there were loads of them, and it was easy to make quite good money from them. In three hour-long collecting binges, and whilst listening to bands I enjoyed, I stacked and recycled well over 500 cups. That was enough to pay for all our food over the weekend, and the couple of drinks my husband had. Of course my legs ached like crazy the next day, after all that walking around punctuated by 500 bodyweight squats. But I felt good about being part of the efforts to clear up the site and recycle the cups.

Of course I’d much rather they used reusable cups as they did at Timber festival, or ones that are biodegradable as they did at Woodside. And it doesn’t really make much sense to pay random people more per hour than they pay their bar staff or rubbish pickers, let alone to pay the people who were simply emptying out the plastic recycling bins, stacking up the plastic cups and taking them to the recycling point like their own little black market scheme. And I wasn’t persuaded that they were actually going to recycle the cups at the end of the weekend. But I was interested in the fact that I somehow found it fun to do a dirty, smelly, physically demanding job earning way less than I can earn from work. Apart from the novelty and fact it filled in the gaps between artists, the reason was as obvious as those demonstrated in Pavlov and Skinner’s seminal experiments: The small but proximal rewards were enough to reinforce the behaviour, and make me want to repeat it over and over again. In fact it became quite addictive. The small payments made it feel like a game in which I was succeeding and earning five to ten pounds per trip to the recycling point made it really tangible that I was being rewarded. I could have spent the entire weekend picking up those crushed and broken plastic cups and straightening them out into stacks to cash in, and my kids were jealous that they’d missed out on the opportunity to earn cash because they had chosen to go to their grandparents rather than the festival.

In another example, I’ve been playing a really rubbish game on my iPad called Hidden City. It is a hidden object game, where you have to find items within a picture of a scene before the time limit runs out. For example, there might be a picture of a greenhouse full of caged birds and exotic plants, and you will then be asked to find a pair of binoculars, a fan, an oil lamp, a walking cane, a string of rosary beads, a bunch of chilli peppers, a pair of shoes, a turtle, and various other objects to click on and collect. Each will be visible within the scene, some in plain sight and others tucked away or masked by being in front of similarly coloured items. In certain quests there are also keys to find in the scene that are smaller and better hidden. Whilst this has some inherent mental challenge and novelty, it really is a very simple premise for a game, and quickly becomes repetitive, so you’d think the game would be very boring – in fact it seems boring to have explained it in writing, so I hope I haven’t sent you off to sleep! You would therefore assume that people would drop out of the game very quickly, but that doesn’t appear to be the case. In fact, the makers are so confident that players won’t be bored enough to drop out that they make you search each scene for objects selected from the same list and placed in the same range of places in the scene many times. In fact, to complete some quests you search the same scene over a hundred times. The task becomes more difficult because you are expected to find more objects in a shorter time interval, and the scene becomes more cluttered so it is harder to pick out the specified items, and you have to alternative with searching other scenes to get the tokens required to go back to the main scene. To compound that, there are multiple locations in the game, and each needs to be searched a large number of times, so to complete the whole game you probably have to complete about ten thousand search quests.

It sounds like an enormous and monotonous task, and the game itself is full of bugs, glitches and poor translations, yet it is the most popular hidden object game in the world. More than half a million people have played it, and there are tens or maybe hundreds of thousands of players active at any one time. They are not only signing up to play in huge numbers, they are choosing to pay for the optional purchases to assist their searching, making this game and the multiple other games by the same company, and the multitude of similar games available, highly profitable.  Estimates suggest that over £3 million of in game payments have been made since the game launched four years ago, and tens of millions of pounds are being spent in in-game micro-payments across all the games by this maker each year. It seems illogical, but many players spend way more than they’d need to pay to purchase a really good game to play this glitchy game that is constantly interrupted by advertising for in-game purchases and other games by the same company.

So why do people keep playing, and why do some of them keep paying? I think it is the same idea of reinforcement through small rewards. As a player you experience a lot of small successes. They make the first few searches really easy. Then each time you search and don’t find all the items you are told to try again. If you find them all you are rewarded by a random selection of small icons, and you can collect these items in sets. Completing the set gets you a rarer icon, with some bonus points or magical powers to boost your energy or increase your ability to find other bonus items. In the bigger quests you might also get tokens to unwrap gift boxes containing more icons. You also get overnight bonuses, daily bonuses and components of a magical piece of jewellery each time you play again after more than 8 hours but less than 24 hours. They compound so an unbroken chain of about a month gets you the finished item, and 12% more items to find for a 10 day period. If you break the chain you either have to use or buy in game currency to restore it, or you lose the components you gained. Something about our psyche likes gaining these pseudo possessions and dislikes missing out or losing them, enough that these games are quite addictive. But they are all just small pictures of random things. Why should I care if I have a magical tuning fork in my collection, or whether I get the apple strudel icon that completes the huntsman set that gives me the Austrian clock? There is no intrinsic value in the drawing of the clock, or the strudel or the tuning fork. They bear little relation to the scenes I search, or to the token plot about the magical city trapping people, or the candy-crush style mini-games. My life is not better in any tangible way if I collect 75 keys and open the golden chest to receive 6 bonus items, or if I play the scene 100 times and get a new avatar of the lady of the manor, or the Samuri, or the gardener. Being at a higher level on the game doesn’t convey any greater skill that would garner respect from other players, let alone in the real world, nor does it teach me anything I can generalise outside the game.

So why is a badly made game with such a simple and repetitive premise so popular? I’d suggest that is intentionally designed to be rewarding to play, and to tap into what we know about reinforcement with the number of small rewards it offers. Our brains are set up to love rewards, no matter how meaningless they are, or what the longer-term cost is. Like scratching an itch, or eating something tasty but unhealthy, using drugs or smoking cigarettes, the immediate rewards are often much more effective as an incentive than the longer-term consequences are as a deterrent. The logical decisions we make about changing our behaviour struggle against these proximal sources of gratification. It doesn’t feel like a big effort or commitment, because we are only playing a three-minute mini-game. We are tempted to take the small action to sample the reward, but this then lures us in to take the next step with another small effort, and the result is that we repeat that for far longer than we planned. Even if this means losing out on sleep, or getting things we objectively rate as more beneficial or necessary done.

The same is true of our online behaviour. We chain from one news article to another, or one social media post to another, or one youtube video to another until whole evenings disappear into a black hole. Even when we are going about our daily lives, we constantly check for the small rewards of messages, likes or responses on social media. For many people this becomes something done obsessively, to the detriment of other activities in our lives. As well as hitting our reinforcement pathways, these small social connections also fire up our desire to feel belonging and acceptance in a group, and to gain the approval and/or attention of others. I’ve blogged before about the toxic aspects of social media. Studies have shown that stopping using social media, whether for a couple of hours per day, a day per week, a longer block of time, or permanently, makes people happier (journal articleanecdotes, article citing studies, more anecdotes, even more). Yet for most of us, we are enticed by the sense of connection (albeit often a much more distant and less authentic connection than we make in real life) and the promise of these small rewards.

It makes me think how despite all the progress of technology, we really are quite primitive creatures in some ways, tied to the way our biology has evolved to reward behaviours that had some adaptive function that had evolutionary benefits. So can we make a conscious choice to use these inherent reward systems for more positive purpose? Possibly. For example, we can benefit by building chains of positive behaviours that we don’t want to break – like a colleague who told me he hasn’t drunk alcohol for 92 days after realising he was drinking almost every night. That challenge of having a dry month, or to do without meat, or caffeine, or cigarettes for a set time period seems an effective way to change behavioural habits. It is less final and impossible sounding to have a break from something than to give it up permanently, but it can give you a chance to see what life is like without it, find alternatives that fill that gap and build up some of these rewards for going without. It then becomes easier to continue that pattern, and there can be a reluctance to break the chain, particularly if there have been social or financial or health rewards for the change.

Likewise we can gamify exercise. When I used to weight lift I would share my achievements with a group of other weightlifters online. This gives a sense of a peer group who can reinforce your behaviour and some social pressure to sustain the pattern (though I was never one to post every gym visit on facebook the way that many runners/cyclists use their apps to, or to post lots of philosophy and photos the way that yoga fans seem to – I just posted to a weightlifters group when I made gains, and could compare my progress to others in the group). But even without this online support I had a sense of achievement each time I went to the gym, or completed my routine, or increased the weight I could lift in a specific exercise. I liked to record my weights in a journal and to feel that I was making measurable small gains. I also liked confounding expectations by being an overweight middle-aged woman who had hidden physical strength. I’ve mentioned my joy in having “ninja muscles” before. I’d like to get back to it, and I’m sure my core strength would return. I’ve still got surprisingly muscular legs, though I wouldn’t risk picking up an 18 stone barbell these days!

So I guess the knack is working out how to make our innate reward systems work for us in a modern world. I’m certainly far from achieving that. Change is hard. But maybe I can at least recognise the patterns better now I’ve thought about it more. Maybe I’ll come back to that theme in a future blog.