If we fail to cultivate and exercise virtues such as wisdom, curiosity, intellect, aesthetic sensitivity, compassion, empathy, and generosity, we fail to exemplify human flourishing.
Awais Aftab, MD
What does it mean to be a virtuous psychiatrist? The answer might lie in the wisdom of the Greek philosophers. When it comes to happiness, success, and wellbeing, Aristotle speaks of eudaimonia (“flourishing”), a sort of moralized happiness, distinct from mere pleasure. Arete (“virtue/excellence”) signifies the qualities necessary to live well and to achieve eudaimonia. Moral virtue embraces the notion that if we fail to cultivate and exercise virtues such as wisdom, curiosity, intellect, aesthetic sensitivity, compassion, empathy, and generosity, we fail to exemplify human flourishing.1
One is not likely to grow 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 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 goodwill to my fellow trainees and other psychiatric colleagues than to share some meditations or pieces of advice that I have found helpful in my own life and career. I certainly cannot claim any degree of Arete. I aspire (and frequently fail) to live up to these ideals on a regular basis, but they have been valuable guides on an uncertain path.
1 Invest in a community of colleagues and friends
No one succeeds alone. Even if that were possible, 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 confines of one’s CV, accolades 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 embrace of community and family, except hauteur and snobbery?
2Be wary of the psychological costs of empty ambition
Professional success and personal happiness do 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. As identified by David Foster Wallace2:
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.
3Be radically honest with yourself
We cannot run from ourselves without great cost. 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 in 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 to our hidden selves the same non-judgmental understanding and compassion we extend to our patients.
4Seek honesty in relationships with others
It is better to have fewer, deeper friendships than to have many superficial ones. Those who have achieved some degree of self-honesty will understand and recognize how emotionally constricted our social relationships can be. 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.
5Express your opinions with a measure of humility
It is easy to identify biased thinking and behaviors in others, but we are largely unaware of our own biases. Intelligence is no refuge against this; in fact, a higher cognitive ability may even be associated with a larger bias blind spot.3 Intelligence fails to protect from other kinds of cognitive biases as well. For instance, it has been shown that the magnitude of myside bias shows very little relationship to intelligence.4
This highlights to me the need for immense humility: we need to be continuously mindful of our own vulnerability to self-deception. In other words, don’t take yourself too seriously.
6Be charitable to your fellow sufferers
We are all damaged, even the best of us. The facts of life have tarnished us. Arthur Schopenhauer5 said:
. . . the appropriate form of address between man and man ought to be, not monsieur, sir but fellow sufferer, compagnon de de miseres. 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.
7Accept the inevitability of failure and loss
Success is never guaranteed, even to those who may “deserve” it. And certainly, even the most accomplished people 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.
Instead of allowing disappointment to turn us into bitter, base, and vengeful “creatures,” we can transform ourselves for the better. We can do so by answering hardship with hope and courage, and by cultivating compassion, humility, and sensitivity when confronted with suffering. How we respond to pain and evil impacts our moral character, as expressed by Elisabeth KÃ¼bler-Ross.6
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.
8Be curious. Approach the world with an open mind
Curiosity is a remarkably undervalued virtue. Life is vast and complex, and it deserves to be approached with awe. There is intrinsic value in our attempts to understand this existence. Ask questions. Seek out answers. Be curious about yourself and others. Take delight in the discoveries of shared curiosity. According to Bertrand Russell:7
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.
9Choose to grow
We are imperfect, and there is always room for improvement-personally, professionally, morally, emotionally, artistically, and intellectually. Meaningful success is rarely achieved by staying within one’s comfort zone. Be inspired by leaders in your field. Although one may feel miniature in comparison, aspire to see the world from their vantage point and build from there. As expressed by Sir Isaac Newton,8 “If I have seen further it is by standing on the shoulders of giants.”
10Seek solace in our limitations
Wisdom is in making peace with our finitude in a potentially infinite world. We find meaning in the pleasures that come our way, in being our better selves, and in generative concerns to leave this world a better place.
Acknowledgement- Dr Aftab dedicates this article to his program director, Cathleen Cerny, MD, and his fellow graduating residents (Alex, Andrew, Cheryl, Christine, Christy, and Sam).
Do you have other pieces of advice for the new crop of psychiatrists?
Send them to us at firstname.lastname@example.org and we may include it online or in a future issue!
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 a member of the Psychiatric Times Advisory Board.
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 June 8, 2018.
2. Wallace DF. This Is Water: Some Thoughts, Delivered on a Significant Occasion, about Living a Compassionate Life. New York: Hachette Books; 2009.
3. West RF, Meserve RJ, Stanovich KE. Cognitive sophistication does not attenuate the bias blind spot. J Pers Soc Psychol. 2012;103:506-519.
4. Stanovich KE, West RF, Toplak ME. Myside bias, rational thinking, and intelligence. Curr Dir Psychol Sci. 2013;22:259-264.
5. Schopenhaur A. Studies in Pessimism: The Essays. London: S. Sonnenschein & Co.; 1891.
6. KÃ¼bler-Ross E. Death: The Final Stage of Growth (Paperback). New York: Touchstone; 1975.
7. Russell B. The Conquest of Happiness. Horace Liveright, Inc; 1930.
8. Newton I. Letter from Isaac Newton to Robert Hooke; 1675.