"The Doctor's Art" is a weekly podcast that explores what makes medicine meaningful, featuring profiles and stories from clinicians, patients, educators, leaders, and others working in healthcare. Listen and subscribe/follow on Apple, Spotify, Amazon, Google, Stitcher, and Podchaser.
We live in a culture that vilifies stress. Stress, we are told, is unhealthy both physiologically and emotionally, and something to be avoided at all costs. But Stanford University health psychologist Kelly McGonigal, PhD, believes that by suppressing or ignoring it, we're missing out on the benefits of effective stress management. McGonigal is also a bestselling author whose work focuses on the mind-body connection and the psychology of compassion and mindfulness.
In this episode, Henry Bair and Tyler Johnson, MD, talk with McGonigal about the personal experiences that led her to this work, the myths and misconceptions surrounding stress, the role of physical movement in promoting our well-being, and how even busy physicians can find space for self-compassion.
In this episode, you will hear about:
- 1:55 The early-life experiences that led McGonigal into a career in psychology
- 3:50 What health psychology is
- 6:13 How physical health impacts mental and emotional well-being
- 11:58 Why many physicians find it difficult to maintain physical health
- 15:06 The behaviors that can make a big difference in one's physical and mental well-being
- 25:50 How McGonigal helps physicians provide care to their patients while holding space for the exhaustion and frustration that can come with this work
- 38:39 Common misconceptions about stress
- 43:00 The importance of self-compassion for those working in high-stakes fields like medicine
- 55:48 Advice to clinicians on better supporting patients going through stressful times
The following is a partial transcript (note errors are possible):
Bair: So you are a health psychologist, and we're going to spend some time exploring what that actually means. But for now, can you tell us what first drew you to a career in psychology?
McGonigal: So I think it goes back to when I was a little kid. I dealt with both chronic pain that was unexplained and untreated intense headaches every day. And basically nobody believed me. And also, I grew up with an anxious temperament. You know, just from the day I was born, it's like I was filled with anxiety, existential dread, the kind of thing that also, back then, when I was growing up, kids weren't in therapy. This was not something that people were actively looking out for, kids' mental health.
So growing up, I had this, you know, day-to-day experience of really difficult inner states, pain and anxiety that nobody really took seriously because I was young. And I think that led to a couple of things. One is that it made me realize at a very early age that people can have stuff going on in the inside that's not visible to others but is real. It led me to an understanding that I call "not surprised by suffering." So I'm not surprised when I find out that other people are in pain or struggling with depression or grief or addiction or anxiety. It makes sense to me that human beings struggle.
And the other thing that it led me to is trying to find ways to deal with those difficult inner states that are hard to control. And that got me really interested in the mind-body relationship and psychology. And so like a lot of people who get into psychology research, I was interested in solving problems that I had experience with.
Bair: So what is health psychology and what are some of the questions and issues you're interested in addressing?
McGonigal: Yeah, so probably as a field, health psychology is interested in both how psychological and social factors influence physical health and also the mind-body relationship more generally. So I got started in psychophysiology, which is like when you're angry, how does it affect your heart, your blood pressure, your immune system?
I think the other part of health psychology that really drew me to it is this understanding that humans are embodied. We are biological, and to understand even psychological phenomena through the lens of biochemistry, what's happening in your brain, what hormones are in your blood system. The idea that we're biological creatures is really interesting to me. So that's part of how I think about health psychology.
But the questions that I'm most interested in answering, the things that I've looked at across all of my work, basically comes down to understanding the paradox of human nature. One thing that's been really clear to me is that human beings have competing instincts. For example, we are both motivated to protect ourselves and defend ourselves to be vigilant, to avoid. And also we're brave and we're courageous and we take risks. We have the desire for immediate gratification. We like to feel good now, but also we can invest in the future and imagine the future.
We can be both violent and aggressive and hostile and also incredibly kind and cooperative and compassionate. So when you look at the interventions that I've designed or the books that I've written, I think they basically all look at that paradox of how do we hold the opposites of human nature?
And I'm really interested in helping people tap into what is good in human nature, not just from some kind of moral point of view. Like, wouldn't it be great if we were all brave and kind and investing in the future? But because when I was looking at those questions like, how do I deal with my anxiety? How do I deal with the fact that I have physical pain every day that I can't control? Actually, it was often those things helping others, imagining a better future, these positive human capacities. They were the things that actually helped me deal with, reduce or, transform things like chronic pain or anxiety.
And so I feel like that's the perspective that I bring to everything that I do, is this idea that we can actually transform pain and suffering by turning to what is good in human nature. It's actually like a coping choice we can make.
For the full transcript, visit The Doctor's Art.
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