The Virtuous Psychiatrist: Meditations on Success and Flourishing
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.
[A revised version of this with editorial modification was published in Psychiatric Times as 10 Meditations on Succeeding—and Flourishing. ]