Before I began my training as a guide for Nature and Forest Therapy, I had never heard the term. A sit spot is simply a favorite spot in nature or even looking out your window at nature, where several times a week, one sits with awareness and open senses. If it is ten minutes 3 times a week or an hour five times a week, it doesn’t matter. Ideally, this special spot is easy to get to. If it requires getting into the car or a long hike to get to the sit spot, the likelihood of doing this practice diminishes. I have a bench that I thought would be my sit spot in the woods overlooking a creek that is just a few minutes away from my house. It is lovely, but it is also crawling with ticks during the summer. For that reason, I decided to use a camping chair and place it nearer the house next to my garden where ticks are rare and I found I used it far more often. A deck, patio, or porch works too. It doesn’t have to be fancy or exotic. Initially, I was restless and felt that my time could be better spend getting through my endless to do list, but I stuck with it. The sense of time dissolved. The sense that I should be doing something else disappeared. Slowly, but surely, it has become a treasured part of my week. To sit still and listen and look, to feel the breeze, the warm sun, the sprinkling rain, snow, all feel like a gift from nature. A sense of calm and peace settles inside me. I feel grateful to have a sit spot in my life. Try it, give it some time, and I suspect you, too, will feel replenished by this simple ritual.
What are values? Values are fundamental beliefs that help guide us in life through attitudes and actions. They can be our motivation in life. Everyone has a set of values. If we live by them, a sense of peace and fulfillment is attained. When not aligned with our values, there is a sense of conflict or discomfort that can affect purpose and meaning in our lives. Recognizing this is a decisive step in redirecting our personal and work lives to reflect our values more clearly and consistently.
This list is by no means exhaustive. Try going through the list above and pick out your five most important values (and if a value that is important to you isn’t there, you can add it). Go through your list of five values and think about how these align with your life, professionally and personally. Are there prominent areas where the life you currently lead is not aligned with your values? Are there ways you could make changes so that your life and values are synced more closely? I wonder what insights come up for you? As a coach, I like to do this exercise with most clients early on so they can begin to redirect their lives toward a more fulfilling path reflected by their values and behavior. Clients see where they were off track and why; and how to regain a sense of purpose and peace when their values are front and center and can serve as a guiding light.
If interested in clarifying your values, please get in touch with me below. I would love to partner with you to discuss your values and aspirations.
“What would you like to talk about today?” and so begins the coaching conversation. What exactly is coaching? The International Coaching Foundation’s definition is as follows:
“Partnering with clients in a thought provoking and creative process that inspires them to maximize their personal and professional potential.”
A coach is not a therapist, advisor, or mentor. Nor is coaching involved in remedial or disciplinary action. Instead, coaching is non hierarchical with the assumption that the physician (client/coachee) is whole and resourceful and they have their own answers within. It is peer to peer as equals. By being present, listening, and asking questions, the coach facilitates self awareness in the client and actionable items to further the progress. Within the relationship between coach and client, confidentiality and non judgement are paramount which creates an atmosphere that fosters openness and willingness to learn more about oneself. This sort of work helps the physician to tap into their full potential and is on par with CME but for personal development and growth rather than professional acumen.
Numerous topics, personal and professional, can be broached in coaching using different tools and assessments such as Wheel of Life, Values alignment, DISC assessment for communication, and many others. Books and articles are frequently shared and discussed also. Some of the over-arching topics include:
Align values at work and home
Improve patient and client experience
Self kindness Improve communication with patients, staff, colleagues, family
Transition into retirement, a leadership role, or a new career
Onboard new providers
Physician and professional leader impact
Being a physician and professional today is extremely difficult and fraught with many challenges never encountered before. In addition, the personality of many physicians and professionals is one of hard driving perfectionism which contributes to the daily pressure, stress, and anxiety. Shame and stigma, unfortunately, prevent many from seeking help. There is neither shame nor stigma in coaching and, instead, coaching provides a safe container for the client to aspire to an improved sense of well being and the potential to lead a more fulfilling life.
There are several paths for pursuing coaching including ad hoc or impromptu sessions or a planned series of coaching sessions over 3-6 months. An initial conversation with the coach is always important to assure that coaching is the right fit. Most coaching sessions are by phone for maximal flexibility, but zoom and in person, including on-site observation, are other options as well. If in person, besides indoors, the conversations can also be outdoors for a walk, a bench in a park, or mindfulness-centered nature immersion (Forest Therapy).
Not changing is choosing; consider the cost and risk of doing nothing.
Effect of a professional coaching Intervention on the well-being and distress of physicians: A Pilot Randomized Clinical Trial. JAMA Int Med 2019; 179 (10)
Changes in burnout and satisfaction with work-life balance in physicians and the general US working population between 2011 and 2014. Mayo Clin Proc 2015; 90 (12)
Physician Wellness: a missing quality indicator. Lancet 2009; 374 (9702)
Potential impact of burnout on the US physician workforce. Mayo Clin Proc.2016; 91(11)
Effective Physician Leadership. Mayo Foundation for Medical Education and Research. Mayo Clin Proc 2015;90(4)
Forest Therapy is a practice that supports health and wellness through guided immersion in forests and other environments to promote the well-being of both people and the land and to help them reconnect with nature or establish a relationship with nature. It is inspired by Shinrin-yoku, the Japanese practice of “Forest Bathing.”
In Forest Bathing, people spend time in forested areas to enhance health, wellness, and happiness and to ease anxiety and depression. In Forest Therapy, people are guided through a clearly defined sequence of invitations to slow down, allow the senses to open, and experience nature in a different sort of way. This supports the relational nature of the participant and nature. These walks are typically very short and slow and fit for all ages and physical conditions. The guide is not a therapist, but facilitates the connection with the forest which is truly the therapist.
Invitations are open-ended and non-prescriptive. There is no expectation for what participants should experience. Rather, participants spend time in silence, listening and feeling in a quiet and accepting, non judgmental space.
Reasons to do Forest Therapy:
The improvement of human health. People are more stressed, anxious, and depressed and have more chronic health conditions. Forest Therapy provides a pathway for people to remember how to immerse themselves in nature to rest from all that consumes them in their daily lives.
A greater sense of connectedness and relationship with themselves, each other, nature and time. In addition, a heartfelt, embodied relationship with nature naturally leads to a love of nature and recognition that we are nature too.
More about Association of Nature and Forest Therapy:
ANFT, founded in 2012 by M. Amos Clifford, combines elements of Shinrin-yoku with Clifford’s four decades of experience in wilderness guiding, Zen meditation, psychotherapy, educational consulting, and nature connection. His emphasis has been on the relational aspects of Forest Therapy.
A few links to research on Forest Therapy benefits:
1. A website: Immerse Yourself in a Forest for Better Health, New York Department of Conservation: dec.ny.gov/lands/90720.html
2. A book: The Nature Fix: Why Nature Makes Us Happier, Healthier, and More Creative, by Florence Williams (see the Resources section in the back of the book for a list of other recommended reading)
3. Published research: Shinrin-yoku (Forest bathing) and Nature Therapy: A State-of-the-Art Review, Margaret M.Hansen,* Reo Jones and Kirsten Tocchini. Academic Editors Yoshifumi Miyazaki, Hiromitsu Kobayashi, Sin-Ae Park, and Chorong Song: ncbi.nlm.nih.gov/pmc/articles/PMC5580555/
I think most of us know what stress and exhaustion feel like from either work or home (or both!), but when does this cross over into burnout, and what to do about it?
Burnout has three primary characteristic signs:
Physical and emotional exhaustion;
Cynicism about work resulting in doing only what is needed at work: dissociation and depersonalization of patients and clients;
Perceived reduced professional ability: What is wrong with me? Why can’t I do this?
Yikes! You feel all three of these! So what causes burnout?
A heavy workload;
Juggling too many balls at once;
Lack of support;
Lack of job clarity;
Personality traits like perfectionism and pessimism can also contribute;
Interestingly, burnout is more common in those that feel their work is their calling.
Ok, so you have all the signs of burnout. You understand the causes, and some of them reflect your situation, so now what? The good news is that this is reversible!
Acknowledge what you are feeling and perhaps discuss this with a colleague, a family member, or friend;
Gain control where you can: as a physician, perhaps hire a scribe, for example;
Take frequent breaks- go outdoors regularly; nature is incredibly therapeutic (see Forest Therapy);
Check-in with yourself throughout the day- may be some specific tasks or meetings exacerbate the problem? Knowledge is power here;
Eat well, exercise, and get some rest. Try to do these things on repeat, not just an infrequent visit to the gym or week off occasionally;
Modify your work schedule so that there is more time for your personal life;
Think about your values and assess if you are living a life that reflects those (a coach can help you realign with what is important to you);
Talk to a wellness coach to help develop strategies to improve self-compassion, engagement, fulfillment, and resilience.
Reassess why you went into your profession. Is it time for a change?
Email me if interested in discussing coaching or Forest Therapy as ways to begin on a more satisfying path at work and in your personal life. Coaching can make a huge difference. It is completely confidential.
Please note: If you feel burnout has led to depression or a feeling of hopelessness, please see a psychiatrist or therapist and get appropriate treatment. The rate of suicidal ideation and suicides, especially among physicians, has gone up dramatically. There is no shame in seeking help. If more urgent help is needed, for American College of Physician members, The I.M. Emotional Support Hub has links to numerous resources. You can call the Physician Support Line at 1-888-409-0141 or seek resources at their site. The National Suicide Prevention Lifeline is at 1-800-273-8255 is open for anyone needing help.