Heart for the Doctor

Foreword 9
The making of Heart for the Doctor 11
Introduction 15
Reader’s guide 17
In conclusion 18

Part 1 Background 19
1 Why is it so tough to be a doctor? 21
1.1 Why do doctors become doctors? 21
1.2 Why do doctors struggle? 24
The world 26
The healthcare system 27
The organization 28
The nature of the work 29
The patient 31
Doctors themselves 31
The COVID-19 pandemic 35
1.3 The logical consequences 37
The doctor’s well-being 37
Patient well-being 73
The interests of the organization, the healthcare system, and society 74
Consequences of the COVID-19 pandemic 75
1.4 Approaches: from burnout prevention to wellness promotion 77
What do we know so far? 77
Interventions at the organizational level 78
Interventions at the individual level 80
Our focus: self-compassion 82

2 Self-compassion: the theory 83
2.1 History 83
2.2 What is self-compassion? 85
2.3 How does self-compassion work? 87
2.4 Objections to self-compassion 91
2.5 What are the effects of self-compassion? 92
2.6 Can you learn self-compassion? 94
2.7 Effects of self-compassion among health professionals 96
Self-compassion as a trait 96
Self-compassion training for health professionals 99
2.8 Why offer self-compassion training to physicians? 103
Self-compassion as an antidote to the typical doctor traits 105
Self-compassion as an antidote to shame 107
Self-compassion as an antidote to anxiety 108
Self-compassion and self-care 109
Self-compassion in the wake of the COVID-19 pandemic 112
Getting started! 112

Part 2 Workbook 113
How to use this part of the book 115
3 Self-compassion: the practice 117
3.1 Discovering self-compassion 117
Exercise: Discovering self-compassion 118
The components of self-compassion 120
3.2 The effect of self-criticism and self-compassion 121
3.3 Activating the care system through self-compassion 122
Exercise: Give yourself an oxytocin shot 123
Exercise: The self-care break 124
3.4 Self-compassion: how do I get started? 126
Negative trumps positive 127
Breaking the habit of self-criticism 128
3.5 Mindfulness 128
Exercise: Developing mindfulness 129
Resistance to the present moment 130
Exercise: Noticing discomfort 132
3.6 Watering the seeds of self-compassion 132
Meditation exercise: Breathing with compassion 133
Meditation exercise: Loving kindness to ourselves 134
Exercise: Finding your own sentences 134
3.7 Hard work and happiness in life 136
3.8 Bringing more self-compassion into your daily life 138
Exercise: Create your own self-compassionate activities list 138
3.9 Self-compassion and the emergence of difficult feelings 139
Why can practicing self-compassion produce difficult feelings? 140
Exercise: Dealing with backdraft 142
Exercise: Soles-of-the-feet meditation 143
Exercise: Self-compassion in everyday life 144

4 Establishing a relationship with yourself 147
Moving toward acceptance 148
4.1 How can you motivate yourself? 149
4.2 The uses of self-criticism 151
Exercise: Is there another way to motivate yourself? 152
4.3 Dealing with intense emotions 154
Strong emotions: the trap 154
Dealing with strong emotions: the practice 156
Dealing with our emotional storms 156
Exercise: Dealing with strong emotions 158
Strategies for dealing with strong emotions 159
4.4 Shame, a special case 161
Shame is no longer about what happened but about who you are 162
Shame-prone people 163
Toxic shame 165
Escaping the trap of shame 165
4.5 Dealing with challenging relationships 166
4.6 Heartache: the pain of rejection 167
Heartache: the consequences 169
Exercise: Dealing with the pain of rejection 170
4.7 Heartache: the pain of connection 172
Exercise: Dealing with the pain of connection 176
The infinity exercise 176
4.8 Heartache: what to do in the workplace? 178
Self-compassion in action in the face of the pain of rejection 179
Exercise: Responding with self-compassion to the pain of rejection 179
Self-compassion in action in the face of the pain of connection 180
Exercise: Responding with self-compassion to the pain of connection 181

5 What do I need to be happy? 183
To be happy you need to do something that makes you happy 183
If we don’t know what makes us happy, we can’t give it to ourselves! 184
The top five regrets of people on their deathbed 184
5.1 What is important for me to be happy? 185
Exercise: Get in touch with what is really important to you 185
5.2 Watering the seeds of happiness 187
An example of the negativity bias in action 188
Exercise: Enjoyment 188
The art of happiness 189
Exercise: Gratitude 189
5.3 Happy with me! :-) 189
Exercise: Happy with me :-) 190

In conclusion 193
Resources 195