Saving our best advice for others

A friend is worried about 4th year med, stressing out about the changing circumstances and expectations, afraid of failing.

I offered lots of advice, but none of it seemed truly satisfactory.

In the end, I asked what she would tell me, if I were in her situation.

We both knew the answer: stop whining. Just do what you need to do. Do your best, try your hardest, if you pass you pass, if you fail you fail.

It’s a comfort because there’s no ambiguity. Either you have what it takes to pass, or you don’t. Passing is either dependent on your efforts or it isn’t.

But what intrigued me is how clear the answer is when we’re looking at other people’s circumstances. Call it ‘the clarity of not caring’ if you like.

Not that we don’t care about others, but we don’t care in a way that obscures the obvious course of action.

When it comes to our own lives, we’re blinded by worries and possibilities. We lose the clarity that lets us be frank with others.

It reminds me of a passage from Zhuangzi:

When an archer is shooting for nothing
He has all his skill.
If he shoots for a brass buckle
He is already nervous.
If he shoots for a prize of gold
He goes blind
Or sees two targets –
He is out of his mind.

His skill has not changed, But the prize
Divides him. He cares,
He thinks more of winning
Than of shooting –
And the need to win
Drains him of power.

It’s not easy, but when we’re struggling with a problem we can sometimes benefit by imagining someone else in that situation and what we would then advise them.

I once read a book by a psychologist that suggested we have greater insight into ourselves when we look at our objective behaviour rather than using introspection.

These methods aren’t foolproof, nor are they necessarily always the right approach. After all, our advice to others isn’t exactly omniscient, is it?

But it can at least help us gain clarity, temporary respite from fears and desires that otherwise cloud our assessment of the situation.


Stress and the melancholic temperament


Last week I was talking to a friend and fellow melancholic, stressed out in the middle of her Med exams, overwhelmed and fearing the worst.  Why do melancholics get so stressed and what can we do to alleviate stress?

Melancholics are always fearing the worst.  We’re haunted by thoughts of what could go wrong, as if by anticipating it we can avoid it.  But in practice we just end up plagued by worries, anxieties and an overriding pessimism.

It’s a lot like watching my toddler son in a new environment. I take it for granted that I have to watch him constantly. I literally cannot take my eyes off him for a moment. At the same time I’m hyper-vigilant for anything within reach that he might damage or that might damage him.

My wife is the opposite.  She finds herself easily distracted, and is often taken by surprise when our son reaches some precarious object or takes a tumble over an obstacle.

It’s not that she’s any less caring, in fact she’s much more caring than I am, but she doesn’t have the same lifelong practice of expecting things to go horribly wrong.

I’ve found I can’t really help it, but my mind is almost always preoccupied with thoughts of how things could go wrong, have gone wrong, or will go wrong. It’s partly a side-effect of trying to understand how things work: if you know how something works you’re immediately much more conscious of how it might cease to work.

But it’s also because melancholics are a little slower at forming impressions and reaching conclusions compared to some of the other temperaments. In practice it might mean that a conversation with a choleric, a sanguine or phlegmatic unfolds with the melancholic experiencing a definite but incomplete sense of something wrong with the other person’s logic or intentions.  It might take days or weeks for the melancholic to unravel the errors and clearly define the problems in the other person’s proposal.

This increasingly wary attitude to human interaction seeps into everyday life. Whether I’m driving, working, going to the shops, not going to the shops, talking to people, cooking, exercising, reading, or just sitting still – I can’t help but be acutely aware of the possibility of error, an awareness of all the possible threats, dangers or pitfalls in what I am doing, not doing, or planning to do.  The resulting hyper-vigilance is a little like having PTSD but without the flashbacks.

I’ve found it is possible to ‘switch off’ this wariness, but it requires a concerted effort. Doing nothing is hard work.

In times of acute stress it’s not the fear per se that makes life unbearable, it’s the effort to avoid the feared outcome within a condition of uncertainty.  What stresses us is the effort to, for example, avoid failing an exam when the precise requirements for avoiding such an outcome are unclear.  ‘Study hard’ is the obvious answer, but how hard is hard enough?  For a melancholic these situations become a terrible trap because we tend to err on the side of excess, downplaying the costs of stress, and demanding of ourselves an impossible effort as though feeling stressed and exhausted is itself the only valid evidence that we have worked ‘hard enough’.

Unfortunately this extreme and idealistic approach actually blinds us to more creative, considered, and efficient methods.  It doesn’t allow us the space to reflect on how best to prepare, and is especially difficult for young melancholics who are as yet unaware that their most efficient methods of studying might differ markedly from the mainstream approach.  It takes a great deal of experience before we learn to rely on our own idiosyncratic ways of learning.

The best way to make space for reflection is to embrace the underlying fear of failure: to identify the worst, most humiliating outcome, and embrace it as a possible reality.  If you fail your exams you will indeed be humiliated and set back a year, but as undesirable as such an outcome would be, it would at least bring certainty and with certainty an end to the stress.

Taking time to really face such fears soon shows that they are not as dire as they seem.  Remember: it’s not so much the feared outcome that causes stress, it’s the self-imposed effort to avoid the outcome without really knowing whether one’s efforts are efficacious.

Another way to diminish the uncertainty is to build a sense of context, or a set of parameters which might give at least an approximate sense of certainty.  For example, you may not know if you’ve studied hard enough to avoid failure because you expect that studying ‘enough’ should bring with it some magical sense of competence and sufficiency.  But you can start to build a context by asking yourself whether you have consciously chosen or allowed yourself to not study as much as you usually would, ie. are you slacking off according to your own usual standards?

Alternatively, you can imagine what it would be like if you were trying to fail.  How different would that be from your current level of work?  It’s often reassuring to realise that you would find it hard to do nothing; you would struggle to really give up and let yourself fail.

There’s a measure of self-honesty required here, but I think for melancholics self-honesty is not a problem, rather the problem is knowing what questions to ask ourselves, or the broader context we need in order to put our problems in perspective.

The ultimate perspective for a melancholic is the idea that we are all going to die one day, and that nearly every stress we face in life pales in comparison to our final destination.  As morbid as it might seem to other temperaments, the thought of death can help a melancholic regain a healthy perspective on otherwise stressful situations.  The fear of failing an exam is ultimately misguided once we realise that no exam result, medical or other career, nor most of the things that cause us daily anxiety and stress will matter at all when we are gone.

As Marcus Aurelius wrote:

Soon you will have forgotten the world, and soon the world will have forgotten you.


Consider thyself to be dead, and to have completed thy life up to the present time; and live according to nature the remainder which is allowed thee.

As idealists and perfectionists, life for a melancholic is never straightforward or easy.  We need these creative and eccentric approaches to help us navigate a complex world replete with sources of anxiety and stress, a world increasingly dominated by the worst tendencies of other temperaments.