The Virtuous Psychiatrist: Meditations on Success and Flourishing

The July issue of Psychiatric Times contains a brief reflection piece by me titled 10 Meditations on Succeeding—and Flourishing. Since the published version is a revised product with editorial modifications, I would like to make my preferred text of the article available here.



The Virtuous Psychiatrist:
Meditations on Success and Flourishing

Awais Aftab, MD

When it comes to happiness, success and moral well-being, I have been deeply influenced by the Greek philosophers, particularly Aristotle. Aristotle speaks of eudaimonia ("flourishing") – a sort of moralized happiness, distinct from mere pleasure – and virtue is excellence in his eyes (arete: virtue/excellence), signifying qualities necessary for living well. To borrow words from Emrys Westacott, in so far as we fail to cultivate and exercise virtues – wisdom, curiosity, intellect, aesthetic sensitivity, compassion, empathy, generosity – we fail to exemplify human flourishing [1].

One is not likely to flourish as a psychiatrist if one cannot flourish as a human. Professional success alone is no measure of eudaimonia, and one must be wary of paths to professional success that are littered with oppressive loneliness, alienation, apprehension, and self-indulgent greed. Flourishing will not be found in successful drudgery but in intellectually stimulating and fulfilling work that urges us to be our best selves.

As I graduate from my psychiatry residency program, these thoughts weigh heavily on me. I can think of no better gesture of good will to my fellow trainees and other psychiatric colleagues than to share some meditations on success and flourishing – reminders of virtue, pieces of advice – that I have found helpful in my own life as an ambitious psychiatric trainee. I certainly cannot claim any degree of arete; I aspire to and fail to live up to them on a regular basis, but they have been valuable guides on an uncertain path.

1) Invest in a community of colleagues and friends because no one succeeds alone. And even if you somehow do, what meaning does success have in a vacuum?

For the ambitious, there will never be enough awards, presentations, and publications. These are hollow achievements by themselves. Kept in the solitude of one's CV, they are meaningless, a collector's obsession. It is only in the context of one's relationship with a community that these become meaningful: a community that one has contributed to and a community that takes pride in one's achievements. What is left psychologically of one's success without this, except hauteur and snobbery?

2) Be wary of the psychological costs of empty ambition

Professional success and personal happiness does not have to be a zero-sum game, but success pursued blindly often is. A healthy degree of ambition is necessary for success in life, but it needs to be tempered by other values in the context of meaningful life goals.

"If you worship money and things — if they are where you tap real meaning in life — then you will never have enough. Never feel you have enough.... Worship your intellect, being seen as smart — you will end up feeling stupid, a fraud, always on the verge of being found out." (David Foster Wallace) "This is the great irony about ambition. If you wish to be smarter and more successful than everybody else, you will always feel like a failure. If you wish to be the most loved and most popular, then you will always feel alone. If you wish to be the most powerful and admired, then you will always feel weak and impotent." (Mark Manson)

3) Be radically honest with yourself; seek honesty in relationship with others

The realities that are hardest to bear are often the realities of our inner lives. If my experience with psychotherapy as a trainee has taught me one thing, it is our need to be honest with ourselves. We all have aspects of us that are dark, shameful, or embarrassing, and they would be frowned upon by society if they were ever to be revealed. Yet, we do great damage by refusing to acknowledge these fragments of our psychological lives. We should extend our hidden selves the same non-judgmental understanding and compassion we extend to our patients. We cannot run from ourselves without great cost.

Those who have achieved some degree of self-honesty will understand the frustrated recognition of how emotionally constricted most of our social relationships are. Ethical considerations are valid restraints to self-expression, but social prejudice and mindless etiquette should not be. Seek honesty in friendships the same way you seek honesty in your relationship with the self. It is better to have fewer, deeper friendships, than to have many, superficial ones.     

4) Approach your opinions with a measure of humility

A body of research literature in psychology has revealed that intelligence is no refuge against cognitive biases. For instance, it has been shown that the magnitude of myside bias shows very little relationship to intelligence [2]. It is easy to identify biased thinking and behaviors in others, but we are largely unaware of our own biases (bias blind spot). Not only does higher intellect fail to attenuate this, a higher cognitive ability may even be associated with a larger bias blind spot [3].

This highlights to me the need for immense humility: we need to be incessantly mindful of our own vulnerability to self-deception. In other words, don’t take yourself too seriously.

5) Be charitable to your fellow sufferers

We are all damaged, even the best of us. The facts of life have tarnished us.

"... the appropriate form of address between man and man ought to be, not monsieur, sir but fellow sufferer, compagnon de misères. However strange this may sound it corresponds to the nature of the case, makes us see other men in a true light and reminds us of what are the most necessary of all things: tolerance, patience, forbearance and charity, which each of us needs and which each of us therefore owes." (Arthur Schopenhauer)

6) Accept the inevitability of failure and loss

Success is never guaranteed, even to those who may deserve it the most. And certainly, even the successful do not always succeed in everything they do. Accept that no matter how intelligent, powerful or resourceful you are, you will fail, at one point or another. 

Life is fragile, and we are all helpless in the face of entropy of existence. There is no escaping loss. How we respond to pain and evil in our lives, and how it impacts our character is of moral significance. Confronted with suffering, we can transform ourselves for the better, with hope and courage, and by cultivating compassion, humility, and sensitivity – instead of allowing it to turn us into bitter, base, and vengeful creatures.

"The most beautiful people we have known are those who have known defeat, known suffering, known struggle, known loss, and have found their way out of the depths. These persons have an appreciation, a sensitivity, and an understanding of life that fills them with compassion, gentleness, and a deep loving concern. Beautiful people do not just happen." (Elisabeth Kübler-Ross)

7) Be curious and make connections; ‘have free affections and wide interests’

Curiosity is a remarkably under-valued virtue. The world is incredibly vast and unbelievably complex, and it deserves to be approached with curiosity and awe. There is intrinsic value in our attempts to understand this existence. Ask questions, seek out answers.  Be curious about yourself, and be curious about others; take delight in the discoveries of shared curiosity.   

"The happy man is the man who lives objectively, who has free affections and wide interests, who secures his happiness through these interests and affections and through the fact that they, in turn, make him an object of interest and affection to many others." (Bertrand Russell)

8) Choose to grow. Be inspired by giants; hope to stand on their shoulders

We are imperfect creatures, and there is always room for more growth: personally, professionally, morally, emotionally, artistically, intellectually…  meaningful success is rarely achieved by staying within one’s comfort zone.

9) Seek solace in our finitude

Wisdom is in making peace with our finitude in a potentially infinite world (“All of us are creatures of a day” – Marcus Aurelius), and in finding meaning in the pleasures that come our way, in being our better selves, and in generative concerns to leave this world a better place, even though this world will eventually forget us.

Dr. Aftab is the chief resident for education and research in department of psychiatry at Case Western Reserve University/University Hospitals Cleveland Medical Center in Cleveland, Ohio. He is on the Junior Advisory Board at Psychiatric Times.

He dedicates this article to his program director, Cathleen Cerny, and his fellow graduating residents (Alex, Andrew, Cheryl, Christine, Christy, and Sam).


References:

1. Westacott E. Critique Of The Smiley Face. 3 Quarks Daily. April 2017. https://www.3quarksdaily.com/3quarksdaily/2017/04/the-ubiquitous-yellow-smiley-is-the-perfect-representation-of-our-cultures-default-conception-of-happiness-it-signifies-a-pl.html (Accessed May 31, 2018)

2. Stanovich KE, West RF, Toplak ME. Myside bias, rational thinking, and intelligence. Current Directions in Psychological Science. 2013; 22(4): 259-64.

3. West RF, Meserve RJ, Stanovich KE. Cognitive sophistication does not attenuate the bias blind spot. Journal of Personality and Social Psychology. 2012; 103(3): 506-519.

Comments

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