A 5-Phase Framework for Assessing Stress

How to organize your thoughts when you’re feeling overwhelmed.

THE BASICS

Key points

Unsplash/taiscaptures

Source: Unsplash/taiscaptures

Whether you’re a high achiever in medicine, law, academia, high finance or any other profession, periods of extreme stress are a common experience. They may look and impact each of us differently depending on our unique contexts, circumstances, and personalities. However, the feeling of heightened awareness and tension is one that we can relate to in one form or another.

I learned the hard way, facing my own challenges with stress in medical school, surgical residency, and surgical practice, as an educator in both academic and clinical institutions, and in my personal life. Through years of learning to manage my own stress, I developed what I call the ADMIT framework, which organizes five phases of experience. I use it every day to help patients, and it is relevant for anyone managing stressful times.

1. Adapting to New Ways

Adapting one’s mindset to accept something new is the first phase of experience in the framework. If you can adapt to a new idea or approach, your experience with change will often be relatively smooth. If you are unable to adapt to inevitable change, your experience will be much more turbulent and stressful.

The need to adapt can come in many forms. Sometimes it relates to the physical environment, like when your office moves to a new location. At times it relates to process, like determining your new flow of operations after implementing electronic medical records. Adapting can occur at an intellectual level, like learning a new concept or skill. It can also be at an emotional level, like dealing with stress associated with managing high-stake scenarios.

When you are finding it difficult to adapt to a new idea or circumstance, it is often helpful to review the ultimate goal. If you are able to connect with even one meaningful reason to change, you are more likely to adapt successfully.

2. Doing the Work

“Doing the work” pertains to stressors that accompany your daily actions and their associated responsibilities. In addition to the sheer volume of work that needs to be done, we often face multiple sources of stress and uncertainty.

For example, as a surgeon, I know that life in medicine is not easy. Whether you are a medical student, resident, physician, or surgeon in practice, your work is multi-dimensional and comes with significant consequences to the lives of your patients and their families. You deal with a multitude of personalities every day, each with their own emotional needs and wants. Language barriers and limitations make examinations more difficult, particularly when patients feel unwell and are unable to cooperate. Despite your best efforts and the time you spend, there are inevitably those who are unhappy with your care.

Openly sharing those challenges is essential for our well-being, as well as that of our families, colleagues, patients or clients, and institutions. It’s important not to intellectualize or internalize emotions and suffer in silence alone.

3. Measuring Success

In traditional methods of assessment, your capabilities and potential are measured using external benchmarks of performance. Exams, evaluations, and quotas are a few examples of what you become used to along your path to success. External measures are important to help identify strengths and weaknesses from an objective perspective, and to ensure that certain standards and competencies are met.

THE BASICS

However, external measures are not the only gauge of success and are arguably less impactful than the internal measures we set for ourselves. Internal measures of success are inherent to how you see yourself and what you believe you are capable of accomplishing.

High achievers often forget to be honest, humble, authentic, kind, compassionate, and fair with themselves. Take time to be mindful and actively reflect from within. Pay due attention to external measures of success, but remember that they do not determine your worth. Self-regard and confidence are developed and measured from within.

4. Introspection

Introspection is about examining your thoughts, emotions, and behaviors to understand how and why you react to things as you do. Central to this process is mindfulness, the state of being mentally calm and present in the moment. When your mind is calm and present, you can be more aware of any emotions or thoughts you may be experiencing. Then, with active reflection, you have an opportunity to explore your emotional state, its triggers, and in turn how best to manage your emotional responses.

Stress Essential Reads

Challenges and obstacles serve as learning opportunities for inner growth, particularly when you take the time to reflect on them: Where do your emotional responses come from, and how can you manage them more effectively?

Introspection helps develop emotional intelligence and enhances overall emotional and social functioning. This in turn increases your ability to manage stress effectively. As challenging as it may be, it is important to actively schedule time for introspection despite our busy schedules.

5. Transformation

Transformation is a continual process that involves self-awareness. Depending on how you engage within this process, your physical, emotional, cognitive, and behavioral responses can mold you in various ways.

Consider how you have transformed personally and professionally over the years, and what circumstances and events have contributed most to your transformations. How you would like to evolve and make a positive impact, and become an even better version of yourself? You may adapt to new ideas, accomplish unexpected goals, learn new ways of measuring success, and understand yourself more deeply.

A positive outlook, a growth mindset, and introspection are all essential in helping you become stronger and better as you transform.

Accomplish Your Goals

The ADMIT framework can be applied in all contexts, professionally and personally, and helps to organize your thoughts when you’re feeling overwhelmed. It also helps you see a way through that stress so you can effectively accomplish your goals.

Copyright Dr. Nina Ahuja, MD