Magazine article Clinical Psychiatry News

Nautical Metaphors Can Capsize Physician Burnout

Magazine article Clinical Psychiatry News

Nautical Metaphors Can Capsize Physician Burnout

Article excerpt


SCOTTSDALE, ARIZ. -- Linda L.M. Worley, MD, was stunned when a meeting she'd requested with her supervisor to address a shortage of beds turned into a rebuke.

"You're on the tenure track, Linda. If you want to keep your job 6 years from now, you'd best pick up the pace. You need to see 20 private patients a week, and get moving on your research and publications," Dr. Worley remembers the supervisor saying.

At the time, she was a 32-year-old mother of two, wife, academic faculty physician, and sole attending running a general hospital consultation liaison psychiatry department and the college of medicine student mental health service.

She also worked as the 24/7 on-call psychiatrist for a week at a time, said Dr. Worley, now a staff psychiatrist in the Fayetteville, Ark., Veterans Health Care System of the Ozarks and chief mental health officer for South Central VA Health Care Network.

Dr. Worley's immediate response was to go home and "collapse into anguished sobs," she said in an interview. Her ultimate response, however, was to change tack, as a sailor does to make the most of how the wind is blowing.

"When I told my husband I couldn't manage and felt as though I was capsizing, he told me to 'reef in my sails,' " she said, describing the technique sailors use to reduce their exposure to dangerously strong winds. "That was the day my Smooth Sailing Life nautical metaphor first crystallized."

The system takes shape

Over the decades of an academic medical career complete with tenure, and dozens of published articles and book chapters, Dr. Worley has developed a system for achieving success while avoiding burnout, based on nautical references.

In a session that was cofacilitated by Cynthia M. Stonnington, MD, chair of psychiatry and psychology at the Mayo Clinic's campus in Scottsdale, Ariz., Dr. Worley presented her tips for self-care at the annual meeting of the American College of Psychiatrists.

"I use the nautical framework as a biopsychosocial-spiritual model," Dr. Worley said in an interview. "I teach it to medical students; I teach it to residents; I teach it to distressed physicians. I even teach it to patients when I am explaining a framework for a necessary treatment approach. With sailing, you have to stay in balance. That's the same with taking good care of ourselves so we are less likely to get sick physically and mentally," said Dr. Worley, who commutes to Nashville, Tenn., several times a year as part of her appointment as an adjunct professor of medicine at Vanderbilt University.


Her "Smooth Sailing Life" seminars have evolved over the past 20 years and are rooted in her training in psychosomatic medicine, which she said emphasizes the complexity of the entire person.

"It's about the biology and about the emotions, and the bridge between them," according to Dr. Worley, who has a website, SmoothSailingLife. com, and is working on a book aimed at helping to meet what she said has been a steadily growing thirst for her approach to developing resilience.

"I am not studying anyone, but I am helping people to self-diagnose. I teach people how to avoid having to see a psychiatrist or a mental health provider but also to feel good about reaching out for help when necessary," she said.

"Life is far too short to suffer needlessly. …

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