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[00:00:00] Hey, guys. Welcome back to the podcast. I'm Amanda. I'm Laura. And I'm Kendra. And we have a fabulous guest for you today. Dr. Christine Kempton is an emeritus professor of hematology. She spent more than two decades as a hematologist and academic physician leader. She cared for patients, she mentored trainees, and she led meaningful work.
From the outside, her career looked like a success story, but she came to realize she'd s- she had slowly stopped listening to herself. she was trusting her responsibilities more than her own needs, intuition, and voice. Oh, goodness, does that sound familiar? Through coaching and a deeper understanding of her own nervous system, she rebuilt that self-trust, and today she coaches women in medicine on self-trust, self-abandonment, and building sustainable success without giving up their ambition.
She recently explored these ideas in her KevinMD article titled, "Physician Burnout Often Begins with Self-Abandonment." Thank you so much for joining us today. [00:01:00] Thank you for having me. I'm thrilled to be here. Okay, so before we get into this self-trust, can you take us back to the moment you realized that despite a career that looked successful from the outside, you had slowly stopped listening to yourself?
Yeah. I reflect back, it was in January a number of years ago. My husband had been looking at a new job, an, an exciting new job for him. And in the past, me moving had always been pretty off limits. I I had a good job. It was supported, it was unique, unlikely to find it anywhere else, very specialized.
I was the director of a hemophilia treatment center, so kind of very niche and unique. And but he was excited about this. It was a really big job and really important for him. So he was telling me about it, thinking I was going to be like, "No way, no how." But the reality is I actually felt relief. Mm. I... And that surprised me, and the way I put it together, I was, I was carrying so [00:02:00] much responsibility at that time.
As one progresses, you just take on more and more and more and more. And what I had was so heavy, and I had no idea how to put it down. I had lost myself in all of everybody else's needs, and the idea that I could just move away and be like, "Sorry, it's my husband. Not my problem. I didn't do it," was kinda thrilling.
And in the end, we didn't move. We stayed there, but that really helped me recognize and understand that something was off, that I had, I had abandoned myself. I had lost where I was. I was no longer connected to me. I, I didn't even... I don't know that I was ever connected to my emotions, but I surely wasn't then.
I wasn't at all connected to my, my body. I didn't, didn't really know what my needs were. I just was, was focused on everything outside of me and had no space for me. So that, [00:03:00] that was really the turning point for me. It took me a while before I then got to really doing more deeper work, but eventually I got the support, and I became more aware of the conditioned patterns that were driving my response that...
but actually were also perpetuating my own burnout and overwhelm. And it was even- when I did get the respon- get- started to get help, one of the, like, aha moments that may sound a little odd, but it was this, this sense that- That there was something that I was doing. And although I know we don't like to do any kind of victim blaming, but it was this moment of like, oh, it's not just the, the system out there is, is, has its issues and needs to have some changes and some fixes for sure.
But there was also kind of a sense that like, oh my gosh, I have some agency here. Like I can do something to feel better [00:04:00] while this dysfunctional system is all going around. So that was, that was really an aha moment for me, and I then kind of went in deeper and deeper and really starting to use my own interior world and pay attention to that interior world to help to navigate the world.
Rather than relying on what was outside of me, I began to rely on what was inside. I went, I went from kind of looking for the outside in to inside out, and things got a lot easier that way Yeah, that's a great perspective. I think a lot of times that awareness, like you said, is it's like the curtain being pulled back.
You're just like, "Oh, wow, look at this," and opens up a whole new realm of possibilities. But it isn't until you kinda let yourself understand that despite the fact that we, we love to say we work in the dumpster fire, there is a way to actually survive and maybe thrive. [00:05:00] So that's, that's a great perspective.
So tell us a little bit about this self-trust, and how is it different from confidence or certainty, and why do even highly accomplished physicians struggle with it when making decisions? Yeah. I'm gonna kinda start at the end and take the high-level view of how we get here as physicians in our medical training.
And because we are trained to use facts and logic and find the right answer, that there is information to be had that will tell us what to do. So we're very oriented, again, to the outside of finding that right answer. And uncertainty is Oftentimes something that's like, "Well, no, you just don't know the right answer."
Additionally, in our training w- in through school, we get lo- lots of external validation. There's grades, there's evaluations, there's reports, all of that, and, and most people in medical [00:06:00] school are very good at meeting the mark. Like, "I can do what people want and be the, be the, be the positive pleaser in the, in the world."
So again, our medical training and medical orientation gets us very much towards managing and looking towards the outside world for validation, whether it's for the answers or for just being good enough. And then I think being a woman on top of it only amplifies some of these things, 'cause the conditioning and the messaging for women are to not make waves, stay small, be quiet, don't be too difficult, make it easy for everyone, be the good girl.
So that also just sort of amplifies that we're taking care of everybody else's needs before we're paying attention to our own needs. And then as we move through our careers and the sort of the, the validation, we move from getting the grades and the evaluations to being a independent physician, as potentially an attending where you're responsible for others or, [00:07:00] you know, in your own career and now you don't have any of that can be very disconcerting.
Or the, the measures that you have are, like, patient satisfaction and RVUs are very not satisfying. Like, they don't really jive. So we're left, like, " Am I good enough? Am I good enough? What's, what's the measure that I'm good enough?" And when we're spending all of our time looking outside of us for the answer to, am I enough, we're never gonna find it.
So we're just always feeding that hungry ghost. Whereas that, the answer to are we enough, it needs to come from the inside. We need to be able to answer that ourselves which isn't always so easy. It takes some work to be able to do that. So it's within that background that we learn to look for certainty, not tolerate uncertainty.
We, we equate uncertainty with, which is uncomfortable, with danger. Discomfort becomes some danger. They're like, "Oh, we're missing something," and the answers are in [00:08:00] the outside world. So that's how we grow up as, to b- to become doctors. Self-trust I see as it's kind of there's some similarities to confidence, but confidence is much more grounded in are we competent?
Are we capable of getting something done? Do I th- if I do this, will I get the outcome I want? Whereas self-trust, and I'll be clear here, there's not a lot of research in self-trust, so there's no agreed upon validated definition. There's no... There are some measures of it, but there isn't one that's bubbled up to be like, "This is the gold standard of how we measure self-trust."
So my, my kind of, my thinking about it, what I think of self-trust is really my, my definition accumulated from this reading, from my own work, from work with other women. And so I think of self-trust as being connected to your feelings, your thoughts, your values, your intuition [00:09:00] without judgment, and then giving them weight, consideration in how you're navigating the world.
It might not be exactly, you know, you have to always be dictated by what it is, you know, "Oh, I'm feeling this, therefore I must do that," but you're considering it as you move through the world and navigate. And so it's not dependent on the outcome. So it has nothing to do with whether you're confident with anything or not, or what outcome you're gonna get.
You're, you're, you're grounded in who you are and what you do, and you consider that internal experience as then you navigate what, what else the world needs. It's not, you're not abandoning that. Certainty is really knowing what will happen, that you can predict the outcome. I think with self-trust, you really don't need to know the outcome in order to feel comfortable and move through the world.
And so often we don't. Like, we never can control the outcome. We never know what it is. [00:10:00] And a lot of times even the outcome that we think we want may not really turn out to be the best or the thing that we think like, "Ah, shoot, this happened," and then, "Oh, look," in the end you're like, "Wow, I'm so glad that did.
I... You know, it did." You know, it was really difficult for me to move from... I grew up in California, and I went to medical school in Minnesota, and then was in Port- back on the West Coast in Portland for residency. And the idea of moving to North Carolina for fellowship was, you know, oh my gosh. And as I did it, I was constantly second-guessing myself through that whole, through that whole process.
But in the end, so much of my life, this is where, where I met my husband, it's where I then I, you know, stayed in Atlanta or stayed in the Southeast, moved to Atlanta, so, so much of my life came from that one decision that scared the shit out of me. Yeah, I think that that framework of self-trust is, is so important, and I love that you highlighted all the societal [00:11:00] conditioning that we as doctors, you know, we, we coach men too, and they have a lot of the same conditioning.
But you're exactly right that women get this piled on more, this idea of being pleasing and being a team player and being a hard worker. And when we pay more attention to that and more attention to what other people think about us than what we think about ourselves, we get into trouble.
So thank you for highlighting all of that. And there's a piece that is very common in doctors that gets in the way of, of having self-trust, and it is this delightful little personality running around in our heads called the inner critic. again, most doctors have a very active inner critic, and I'm just curious what your take is on how that inner critic shows up after mistakes or setbacks, and how do hindsight and fear of [00:12:00] future regret sometimes shape the decisions we make next?
Yeah, great question. The inner critic is present in so many of us, and people often think that it will go away as one becomes more competent, but it doesn't. Stakes get higher. Things are new all the time, and it's not really about competency. I think of the inner critic as really the voice of fear, and the inner critic gets loud when there is uncertainty and discomfort.
And she's trying to tell us that we're in danger of some sort. So I like to think of the inner critic as what I listen to is like, "Ooh, I'm, I'm stirred up here. Something-- there's fear here for me. There's uncertainty. There's something that's, you know, that's getting stirred up." I don't necessarily listen to what she has to say, you know, or the action she's asking me to take or the-- how she's describing me, but the fact that [00:13:00] she's there is giving me useful information.
So she's telling me that doubt and uncertainty is present, that I'm scared about something. And mistakes or setbacks, the inner critic's gonna show up again because of that uncertainty that we're wondering, " Well, what's... You know, I made a mistake. What's gonna happen?" And particularly if we're tied to an identity that a good doctor doesn't make mistakes.
If I'm an expert, I wouldn't make a mistake. It's gonna be even more challenging to who we are and there's gonna be even more fear and threats to, to that mistake. It's more, more of a-- about a verdict about who we are as opposed to just this is a thing that happened and now I'm gonna go move forward. So when you trust yourself, you can start to examine those mistakes honestly, take responsibility and change what needs to be changed without really making it a verdict about the worth and who you are.
It's just a thing, and you get to [00:14:00] decide what to, what to do about the mistake. It's not about who you are. hi-hindsight, I think that's where I think we're, again, expecting to know the outcome. And then once we know the outcome, we start to judge our earlier decision as though we should have known it too.
But when we just let go, like we're not supposed to know the outcomes, we don't ever know they are, and we can be present with what we are here now in the moment with curiosity, we can kind of let go of some of that hindsight and not necessarily think that a disappointing outcome automatically means the decision was poor, that we did the best we could in that moment.
And maybe, maybe there is something, y- you know, with a disappointing outcome, you're like, "Well, okay, what, what... Is there something I would have done differently?" Okay, we can go back and evaluate that, but really have compassion for the person in the moment, like being there and doing the best they can. So something to learn, maybe, maybe [00:15:00] not And self-trust allows you to really stay connected to yourself, to recognize the decision as being the best that it could at that time.
And if there was opportunity to do it differently, okay. But it's done without judgment or risk to your identity and your worth
Yeah. I, I love that. I, I d- I, I did a, a little class on inner critic a few years ago, and I thought it was so interesting is that it's the, the voice that is, is just trying to keep us safe. It's a, an adaptation that many of us developed in childhood that helped us feel safe when things around us didn't feel safe.
Mm-hmm. And so just being able to honor it and say, "You know, thanks." Mm-hmm. "Thanks for the heads-up." Yep. "And I think we're gonna be okay." Yes. Can, can help us move away from that. And certainly not... If we, i- if we think about that inner critic as being a child, I mean, are we gonna let the child define who we are?
Yes. Yeah. [00:16:00] No, I think that's right on, that you, you see the inner critic as a younger version of yourself that's like, "Hey, hey, this feels an awful lot like when Tommy stole your doll or stole your ice cream, and something's bad's gonna happen here." You're like- Mm-hmm ... "Mm, no, this is not at all..." Your wiser self can then, like, "This is not at all like that.
I'm grown up now. We don't have to worry about that. Thank you for letting me know. We're okay. We can move on." Yeah. Yeah. I love that. So you talk about distinguishing fear, and this kind of ties into what we were just talking about, I think. Mm-hmm. Distinguishing- Yeah ... fear from a wiser internal voice. How can we tell the difference, especially when we genuinely don't know how a decision will turn out?
Yeah. It's a good question. I think this is, this is really, this distinction between finding your wiser voice and un- and hearing and understanding your fear voice is, like, a key skill for really navigating life through a per- [00:17:00] perspective of self-trust and being able to sort of let a lot of stuff go.
And the fear voice is often urgent. It's very certain. It's absolute. It may be contracted and tight. You know? So, like, the, so th- that's the kind of the way it's gonna be speaking. It's gonna maybe shaming. That's your fear. If your, if your inner voice is talking to you in absolutes, urgently, shaming, "You've got to do this.
Horrible things are gonna happen," like, yeah, total fear voice. Your wiser voice is gonna be quieter. So that's a part of the hard thing is it's not gonna be as loud as your fear, so it's gonna be much harder to hear. Your f- your wiser voice is gonna be more likely to be calm, compassionate, slower, be more relaxed, expansive.
But you gotta get quiet in order to hear her is the challenge. it's really a practice to, to connect to that voice because most of us [00:18:00] are not quiet enough to, to hear it or even know it's there. So that's why we don't really even recognize that those two voices are there because we're spending so much time in urgency and hustle and don't ever make it a practice to sit in some calm and to check in and ask like, "What is here and present for me now?"
That's amazing. One of the things I think is interesting about medical training is that a lot of us will go into it being ... Having, you know, a decent level of self-trust, and up for the challenge, and ready to sign on to dedicate our lives to help others, and we come out of training feeling less than, like not sure of ourselves despite 10,000 hours of studying on how to take care of patients.
Somehow we're less confident than when we started. And I don't think it's just the Dunning Cr- Kruger Curve. There's something specific about our training. And we see this over and over, including myself, spending so much [00:19:00] time and energy second-guessing, ruminating, seeking reassurance for decisions that just aren't knowable.
For in life and with patient care, like we're dealing with human bodies that aren- don't always do what they're supposed to do. We're seeing things that maybe we've never seen before. Like, there's uncharted territory a lot of times. So how do physicians start to build greater self-trust so that they spend less time and energy with the second-guessing and seeking reassurance?
And then what changes when we stop asking, how can I be certain that this is the right decision? Because so many times there is no- Mm-hmm ... th- there, there isn't a right decision. This is uncharted. This is unknowable at this time with what we have available. So how do we stop asking, how can I be certain, and start asking, can I trust myself to meet what happens next?
Yeah, yeah. That's good. Great. I think the first step is, is allowing [00:20:00] the uncertainty and the discomfort that comes with uncertainty, and that discomfort doesn't mean danger. To no longer equate the two together. And then how we relate to that uncertainty helps us then move forward. But so often I, I don't think we're taught how to, how to recognize the uncertainty and, and know the difference between like, oh yeah, I've asked six experts.
Like, it's not about more, it's a ... This is about my discomfort with it versus like ... ' Cause y- sometimes it is the right thing to do to go talk to more people And sometimes it's not. And, and that's why I think with the self-trust, like, there's no, there's no one action that says, "Ooh, I'm not trusting myself."
There-- Like, every action can have, can be done in a vein of trusting or it can be done in a vein of abandonment. It is kind of what the energy and the intent and the, what is behind it. But for how to learn more self-trust so that you can be, you can stay with yourself [00:21:00] through the uncertainty rather than, you know, "Ah, I'm not, I'm not it.
I need to go outside of myself. I, I can't be with myself during this," is through, I think, really small everyday moments. 'Cause you're not-- you can't wait until that crisis or the really high-stakes decision to then be like, "Oh, okay, I gotta trust myself now." Like, that's gonna be really hard. But I think of it as that there's really ma- four main components to self-trust.
There's mindfulness, there's self-compassion, there's curiosity, and there's self-regard. So mindfulness I think is key to understanding what is happening in your interior world, whether it's your thoughts or your, your emotions or your body sensations. But having awareness of what is happening and a practice to, to check in.
When we're mindful, we can start to see how the perfectionism and the people-pleasing and controlling, those protective mechanisms [00:22:00] are present and how they're starting to derail us So I, I love a practice of meditation. I think there are also other mindfulness practices that are out there, but anything that you can do to even just spend a moment that's just what, what, what's going through my head right now, let me just watch it, again, without judgment.
Acceptance. The next, practicing self-compassion I think is, is really helpful, and I just anytime it's kind of uncomfortable, I'll be like- I see, I see you. I see you don't wanna be here. Like, Atlanta traffic is terrible, so this is where I always... people I know in Atlanta, I'm like, just see practice. You know?
You're like, "Here's... Oh, I'm stuck in traffic. Gosh, I know how this is, this is so frustrating to be wasting my time here. I'm worried I'm gonna be late. You know, who wants to be here with this? And here we are. I see this. You know, it's okay." And I put my hand on my chest, 'cause that's sort of m- the universal sign of compassion.
I always feel better about myself when I'm putting my hand on my chest. So [00:23:00] practicing that in those small moments. And I think getting curiosity. So getting curious about what... about your thoughts, you know? Like, many of our thoughts aren't true. So maybe questioning them with s- again, some, bringing some curiosity.
Just like, "Well, why am I thinking that? Is that really true? What's going on? What is it? What's happening in my body?" Like, "Oh, I'm, I'm... Why is my heart racing every time I open my email or I get that page from the transfer service? What's going on? What are the thoughts then that I'm having about all of this?"
So starting to have some of the curiosity that just brings an openness. It's kinda like having a beginner's mind about your life. Just an openness to what's around you and what's happening, both inside and outside. And then the self-regard, I practice that by when you're making even, you know, small decisions, and I think you can even start with things like what do I want for lunch today?
But just stopping and being like, " What do [00:24:00] I really want for lunch today? Is it the sandwich I brought? Is it the something downstairs? Is it, you know, tacos?" And, you know, and maybe it's tacos, and you can't have tacos, but you can just go like, "Yeah, I really want tacos. That's really what I want." And you can't act on it, but knowing what it is is still value.
I think so often, I even remember, like, with tacos, my husband is... One of my realizations again with my husband when he's like, it was a default. He'd say, "I wanna go get tacos." And I'd just be like, "Oh, okay." You know? It's just easy. It's easy to say that's what you want without ever considering, you know... And, and I'd hang up the phone really, and then I'd be like, "I don't want tacos, but I don't wanna say anything."
But, you know. So what is it that I really want? And it's not confrontational to, to tell my husband that I really, I'm not, I'm not excited about tacos. What... Is there another option where we... you could get tacos, and we could go someplace else, or I could get something that I want. Is there some way that we could both have what we want, or is there a compromise?
Or I'm gonna go to the taco place tonight, and then we'll do something else later. Like, you can, [00:25:00] you can state your preferences, and you don't always have to Doesn't mean you're demanding that they act, but you're recognizing it and giving it space, which I think so often we just don't do. So just little practices like that incorporating them into just the mundane, ordinary times.
I love that. Yeah. And I'm also surprised that tacos isn't always the answer. yeah, when we learn to trust ourselves and stay present, regardless of the circumstances or where the discomfort arises, we're less likely to get caught in that spin of overthinking, overpreparing, trying to control what's not ours to control.
We can be focused. We can just let go of the focus on making everybody else present and, and, and good so that we can stay Stay with ourselves. So self-trust doesn't remove the discomfort. It allows us to stop making discomfort mean danger, and allows us to stay open and curious about what's happening now, to meet it in the [00:26:00] moment now.
That is so good. And as a recovering perfectionist, one of the things that surprised me in Tal Ben-Shahar's book about perfectionism is that perfectionists have an incredible intolerance of negative emotion. And so since human brains do not like uncertainty for survival reasons- Mm-hmm ... that discomfort feels like, it feels threatening.
Mm-hmm. But the fact that, that there's uncertainty there doesn't mean that there's anything going wrong. Mm-hmm. It's just being a human means all of it, the good, the bad, the uncomfortable, the elation, like the whole gamut of it. Right. You're really numbing out your experience if you don't allow yourself e- experience all of it.
And you're not living life wrong if sometimes things are uncomfortable, and sometimes- Right ... you don't know all the answers. No. Right? So I loved how you phrased it, tolerating uncertainty, 'cause I- that is a, I swear that is a big, that's a big deal. Yeah. I would often say even living right means you're gonna have uncertainty and [00:27:00] discomfort.
Mm-hmm. Because you're gonna take risks, and you're gonna change and evolve. Risks and change and evolution mean you're, it's gonna be uncomfortable, and that's part of a good life. Totally. Otherwise, you turn into a curmudgeon, which is my fear growing older. Yes. If you're never uncomfortable, if you're never pushing yourself, if you're never uncertain- Yes
you're probably in a rut, you know? Yes. Yeah. So we just have to- Just talk with the people living with you, see how they're doing. Yeah. Yeah. We just ha- I, yeah, it's getting calm and curious and checking inside of like is this, is this just discomfort and uncertainty because I am doing something new, I am taking a risk, I am moving out there, there is no known answer.
I, I'm, and this is where the direction I have to move, or no, there really is something. I mean, sometimes there may be something. Like, no, I, I'm, I do have something I need to respond to. I do need to check in with someone else. I do need to cool my jets and not take that [00:28:00] action. That's not right for me. I'm feeling the contraction, and this is, this isn't right.
So again, uncertainty can, can be a mixed bag. It's not to just go, "Oh, there's uncertainty. I'm not gonna do anything with that," but it's to be able to hear it and interpret it and, and know. And that does take checking in with what we know about ourselves, with where we are, and listening to our bodies and our thoughts and feelings, emotions.
Yeah. And then moving ba- the best way forward in that from love- Which is where our wisdom goes, not fear Yeah. I like, I like the idea of the mixed bag because let's be honest, it's there for a reason. If you overestimate yourself, you probably meet untimely... Mm-hmm. You know, if you're overconfident, that's not necessarily what we're shooting for either, but- Mm-hmm
just a deliberate checking in, and that's that quiet self-trust- Mm-hmm ... that's something that you can count on. Mm-hmm. This was so good. Thank you for joining us [00:29:00] so much. Where... So listeners are gonna wanna be able to find you and learn more about your coaching work with women in medicine, how... What, what's the best way to do that?
Yeah. So they can find me on Instagram at Christine Kempton Coaching. I'm also on LinkedIn at Christine Kempton, and my website is christinekempton.com. Yeah. Okay. Awesome. We'll put those in the show notes, so all you have to do is scroll down, and you can click on the links. And so, any last thoughts that you'd like to leave with our listeners before we close?
Yeah. I think if folks would like to better understand what's getting in the way of them trusting theirselves, I invite them to take a quiz of mine. It's a free hidden patterns quiz. Takes about two minutes, and you'll discover which of the five patterns, which of five patterns you may rely on when things are feeling uncertain or uncomfortable, and then you can begin to understand the pattern it's trying to protect you from and how recognizing it is really the first step towards rebuilding that [00:30:00] self-trust.
And you can find that at christinekempton.com/quiz. Yeah This was a pleasure. Well, thank you. Yeah, thank you so much, Christine, for coming on today and, and sharing the work that you're doing, and I'm sure making such an impact, not only in your clinical work, but with our colleagues too. It is much appreciated, and thank you so much for spending the afternoon with us today.
Thank you for having me. It was a lovely conversation. And that's it for today's episode. Friends, if you found this conversation helpful, the best way to support us is to subscribe. So click that button now and leave us a rating and review. It helps other physicians find this podcast, and it moves us up on the list.
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