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10/25/18
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Let the Sunshine In:Understanding Your Habits and Fostering the Ones You Want
Sara Petruska, MD, FACOGAssociate ProfessorClerkship Director
Medical Director of Labor and DeliveryUniversity of Louisville
Nadine T. Katz, MDProfessor Ob-Gyn & Women’s HealthAlbert Einstein College of Medicine
Medical Director and VPMontefiore Medical Center
Disclosure
We have no conflicts of interest to report related to the content of this presentation.
Learning Objectives
• Understand how beliefs and thoughts direct our actions• Apply a model for change to an action, feeling and thought to create a
new result• Choose and apply tools to help new actions become habits
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Session Plan
• Present models for organizational and personal change• Large group: articulate things we’d like to change• Small groups: map the path to change using the models• Present tools for making an action into a habit• Small groups: apply tools for habit change to our needed actions
Current Actions
Current Results
Current Results
Current ActionsCurrent
Beliefs
Experiences
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Current Results
Current Actions
Feelings
Thoughts
Circumstances
Cohen-Smith Ubell
(organizations) (self)
Current Results
Current Actions
Feelings
Thoughts
“85 hour work week”
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Current Results
Current Actions
Feelings
Thought: “I deserve a treat”
“85 hour work week”
Current results
Current actions
Feeling: Indulgence
“I deserve a treat”
“85 hour work week”
Current Results
Action: Online shopping on call
Feeling: Indulgence
“I deserve a treat”
“85 hour work week”
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OverbudgetShort on 401K
Action: Online shopping on call
Feeling: Indulgence
“I deserve a treat”
“85 hour work week”
Financial controlFunded 401K
Spending within budget
feeling
thought
“85 hour work week”
Financial controlFunded 401K
Spending within budget
Love for 80 year old me
thought
“85 hour work week”
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Financial controlFunded 401K
Spending within budget
Love for 80 year old me
“I treat myself by thinking of the long game” “85 hour work week”
burnout
Writing notes in bed until 00:30
Meticulous
I am a careful physician who knows my patients as human beings 34 EMR notes
to write
Sustaining quality of lifeat home
Brief notes done during the day
Sufficiency
Sleep helps keep me an excellent physician
34 EMR notes to write
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Cohen-Smith Ubell
(organizations) (self)
What current results are undesirable to you?
What current actions would you like to change?
In groups by theme:
1) What are your new, desired results?
2) What actions need to stop, change or begin to achieve your new, desired results?3) What feeling would motivate you to want to act in this new way?4) What thought brings out this feeling in you?
Extra credit5) What experiences would help you hold this thought?
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Action becomes Habit
Gretchen Rubin’s 21 Strategies
• We differ in how we make new habits• Much of the difference: how we respond to expectations
• Our own• Expectations of others
Gretchen Rubin’s 21 Strategies
Four Tendencies• Upholder• Questioner• Obliger• Rebel
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Gretchen Rubin’s 21 Strategies
Self-KnowledgePillars of HabitsThe Best Time to BeginDesire, Ease and ExcusesUnique, Just Like Everyone Else
Gretchen Rubin’s 21 Strategies
Self-KnowledgePillars of HabitsThe Best Time to BeginDesire, Ease and ExcusesUnique, Just Like Everyone Else
Self Knowledge
Four TendenciesDistinctions
Gretchen Rubin’s 21 Strategies
Self-KnowledgePillars of HabitsThe Best Time to BeginDesire, Ease and ExcusesUnique, Just Like Everyone Else
Pillars of Habits
MonitoringFoundationSchedulingAccountability
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Gretchen Rubin’s 21 Strategies
Self-KnowledgePillars of HabitsThe Best Time to BeginDesire, Ease and ExcusesUnique, Just Like Everyone Else
The Best Time to Begin
First StepsClean SlateLightning Bolt
Gretchen Rubin’s 21 Strategies
Self-KnowledgePillars of HabitsThe Best Time to BeginDesire, Ease and ExcusesUnique, Just Like Everyone Else
Desire, Ease and ExcusesAbstainingConvenienceInconvenienceSafeguardsLoophole SpottingDistractingRewardTreatsPairing
Gretchen Rubin’s 21 Strategies
Self-KnowledgePillars of HabitsThe Best Time to BeginDesire, Ease and ExcusesUnique, Just Like Everyone Else
Unique, Just Like Everyone Else
ClarityIdentityOther People
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Key Points
• Actions rarely permanently change unless we address the why behind them• We have the opportunity to choose how we think and feel about our
circumstances• We can use this choice to direct our actions to serve us• We can help action become habit with Gretchen Rubin’s tools
Questions?
Thank You!
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References• Connors, R. and Smith, T; Change the Culture, Change the Game: The
Breakthrough Strategy for Energizing Your Organization and Creating Accountability for Results. Portfolio/Penguin, 2012.
• Ubell, Katrina; Weight Loss For Busy Physicians podcast available through iTunes and at https://www.katrinaubellmd.com/podcast/
• Rubin, Gretchen; Better than Before: Mastering the Habits of Our Everyday Lives. Random House, 2015.
