Why is happiness and pleasure so fleeting, and how can we change that wiring? Sanj Katyal, MD, has explored these questions through the lenses of positive psychology and philosophy, and shares some of his findings in this webinar presented by WBI in conjunction with the JCC Manhattan.
Caroline Kohles, the JCC’s Senior Director of Health and Wellness, speaks with Sanj about his book, Positive Philosophy: Ancient and Modern Wisdom to Create a Flourishing Life, and the Positive Medicine and Thrive Rx programs he cofounded to support the well-being of physicians. Sanj holds certifications in positive psychology and Positive Psychology Coaching from WBI, and has published and lectured extensively on well-being and the science of happiness.
Highlights from the Conversation
I began kind of researching and studying. And I was really trying to figure out an answer to a single question. I was tired of just functioning. I really wanted to figure out how to go beyond that. And I didn’t really have a word for it, but the word probably is flourishing. I really immersed myself in a lot of philosophy and psychology, and I came across Tal Ben Shahar’s book Happier. And this was a great book because it was kind of an analytical approach to happiness. And as an engineer, I kind of really resonated with that. So I reached out to him via email and just said, “Hey, this is a great book, I’d love to learn more.” And he’s the one that connected me with Megan and invited me to apply for CiWPP. And that’s really the the entry to positive psychology for me, and it’s been great.
I wanted to understand why that occurs. And to do that, you really have to go into the evolutionary traps of our mind. I think this is a key to some of the chasing that we’re all doing in life. At our primitive state, our brainstem and our limbic system were adapted to look for threats and opportunities. On the banks of the Sahara, we were basically searching for threats and opportunities. If you look at how a dog behaves, it’s going to bark at strangers and it’s going to pick up food on the floor. That’s basically, in a nutshell, how we are at our primitive level. And then, as society evolved, we grew our prefrontal cortex to have this concept of our identity or what people call ego—not bravado, but ego, or what the Buddhists call the self. But the goal was the same, it was to handle hostile interactions. Now, it’s just within society. And so our minds are always searching for opportunities and threats. And if you think about every thought you have, it’s basically one of those two things. You’re either chasing pleasure or avoiding pain. The principle of hedonic adaptation is basically the mind can never be satiated, because to be satisfied at the mind level, or the ego level, would threaten its own survival.
The other thing is affective forecasting—it’s another great field, the study of what will we think will make us happy. Impact bias is another thing—we overestimate how happy or unhappy we’re going to be at some future event. Tenured college professors overestimated their unhappiness or happiness after being granted or denied tenure. This is a motivational tool based in our evolutionary survival instinct, because it makes us work extra hard to get something that we think is going to be really great, or avoid something that we think is going to be really bad. And it’s all at the level of the mind and its evolutionary traps.
So we feel at a baseline not good. And so happiness is this chase, that we want to feel differently, we want to feel better. We want to feel pleasure, we want to feel something other than the way we normally feel. But pleasure is fleeting, right? Hedonic adaptation—we get used to it. And if it’s related to a favorable circumstance or something that goes our way … we know that life is unpredictable. And there will be another circumstance that doesn’t go that way. So this feeling of feeling better doesn’t last. And it’s just a never-ending chase. And it just keeps us right back where we are, with varying degrees of restlessness and dissatisfaction.
REVAMP (relationships, engagement, vitality, accomplishment, meaning, positivity) is a model I’ve created with my partner in Thrive Rx, Jordyn Feingold. Relationships, as we all know, are the most important predictor of well-being. Getting out of your mind, not calming your mind, but really just getting out of your mind. Being in a flow state, losing yourself. The mind-body connection is very important. We go into heart rate variability, we go into some physiological things with meditation. And then accomplishment is really about doing meaningful work, high-impact work that is at the cusp of where your skill and your desire meet. And then meaning is really taking your work or your accomplishments or your fully realized potential in the service of something other than yourself. And then P is for positive emotion—finding time to play, to laugh, to infuse optimism, and all of those things.
That’s something that we’ve tried to do pretty consistently as a family, teaching the kids about hedonic adaptation. So my son wants to get the new MLB PlayStation game even though he has last year’s game at home. I asked, Do you really think that’s worth the money? He replies like he always does when he wants something: Oh, yeah, this is gonna be awesome. And then, three months later, I asked him whether it was worth it, and he’s like, I don’t know, maybe, I guess. He’s adapted. And I’ve had many purchases where I’ve adapted, and I’m sure everybody on the call has done the same.
I pay very close attention to what they are naturally inclined to do as children, their natural interests, where they naturally flow to, before the indoctrination of school, society, me, all that stuff. We have a lot to learn from our kids if we pay attention to them, as opposed to trying to just mold them—and believe me, I’m as guilty as anyone on this, because we think we know best. As you know, I’m a physician, and my oldest son wants to be a doctor. You’re trying to guide him into a competitive road, but you’re also trying to understand where he naturally is. It’s about uncovering their own personal strengths and their own personal potential.
Caroline: You led me right into where I wanted to go next, which is flow state, and the importance of that, and how you were talking about that in relationship to working with physicians. Is there a place as a physician where you’re in the flow state, or is that separate from your work? Or is it both?
Sanj: Well, I think it can be part of work. But we’ve introduced too many variables that suck us out of our flow state in our environment. And I think the biggest one, for us and for our kids, is really our phones. It’s hard to be in flow when you’re checking your phone every couple minutes, right? It’s hard to be in flow if you get a notification from social media or from email on your phone. You’ll never get to flow that way. It goes back to cultivating attention. A big thing about attention is imposing constraints on yourself to create the right environment for flow, whether it’s personally or professionally. So if I’m going for a walk outside on a nice day, I don’t take my phone with me, because I know it’ll end up being a distraction at some point. When we’re working as physicians, and we’re in what I call the physician zone—face-to-face interaction with a patient, talking to the patient, understanding what exactly is going on with the patient, and then formulating a diagnostic and treatment plan—it’s not with your back to the patient typing into a keyboard, which is what most of the interactions are. So it’s about imposing constraints and creating your workflow to really maximize your ability to be fully present, personally and professionally. For all of us, this whole digital well-being space and the intentional stealing of our attention by these media conglomerates is a big problem with flow—it’s the antithesis of flow, really. So fighting that, at the first level, is really where everybody should start, and it’s certainly where I start and where I try to teach my kids to start because they especially need it. They don’t know anything other than how they’re living. They’ve grown up with phones, they’ve grown up with social media, and so they need constraints more than ever to really be able to do what they’re meant to do—to unleash their core potential, not just give their attention and their life away, mindlessly scrolling.
Caroline: We had a question in the chat: Why do some people seem to always be living in conflict?
Sanj: I think there are probably two reasons. One is familiarity, and comfort, it’s a familiar place to be in, it’s part of your identity—okay, I’m going to deal with this, I’m going to solve this, I’m going to do this. It’s ironically strangely comforting to be in conflict, if that’s where you typically live, because that’s what you know. I think the other thing is, some people’s minds are wired to search for threats and negativity bias, which we all know about. They’re like a pitbull barking at a stranger, as opposed to somebody else who might be, you know, a little poodle who barks less at strangers or threats. Those are a couple of reasons that I’ve seen with my work with physicians.
Caroline: Can you talk a little bit about stress and positive psychology, and especially in relationship to physicians?
Sanj: Yeah, that’s a big problem. We’re all living in varying degrees of survival mode, and our sympathetic nervous system is overactive for pretty much all of us. Rather than trying to just make myself feel better, I try to understand why it is I’m feeling that way. Is this my mind manufacturing conflict by its natural search for threats and opportunities? Or is it something that’s real? And if it’s real, then what can I do to change it? And I try to make sure that if I change it, I change the root cause. I’m a big believer in figure out the root cause of suffering. Your mind creates thoughts, thoughts create behaviors and actions, behaviors and actions create consequences, which create more thoughts. So it’s basically a feedback loop. Most of us spend most of our time at the behavior/action level, but if you can figure out why thoughts occur in the first place, and maybe change something at that level …. You can thank the mind, which I do all the time: Yeah, thanks. I know, you’re looking out for me. I’m good, you know? And you just ignore it and the more you ignore your mind, it’ll actually quiet down.
Caroline: How about Tal [Ben-Shahar]’s “permission to be human”? How has that phrase affected you as a physician? Sometimes it feels to me like physicians feel like they have to have all the answers. And that’s a certain amount of pressure, right?
Sanj: There’s two phrases of Tal’s that I love—one is the permission to be human and the other is when you appreciate the good, the good appreciates. Permission to be human goes back to not trying to change or squash emotions that arise, right? If I feel bad, it’s not just trying to figure out a way to feel good. It’s understanding why I feel bad. First of all, not judging yourself for feeling bad, right? You don’t want to be unhappy about being unhappy. There’s no effectiveness in that. And I think that’s what Tal is talking about. Let whatever emotion comes up, come up. And then, it’s better to understand the emotions, rather than try to manage them.
Caroline: Do you work with that with physicians? In other words, that whole thing of like, I’m not alone, that you were mentioning efficient physicians, really, when they take your course They were like, Oh, thank goodness, because I was was trained to be the lone competitive wolf. Right? But I’m actually in community with other physicians, I’m not alone in thinking, these thoughts or is having that this permission to be human factor in there or not so much?
Sanj: Permission to be human is just basically saying that we’re all suffering to different degrees, and we’re all connected to each other. And we’re all part of the human race, we’re not separate. So if you’re suffering, everybody’s suffering so we should just not be judgmental about that. A lot of people feel bad about feeling bad, or feel, why is this happening to me, or what’s wrong with me that I don’t feel better? And I think Tal’s thing is just, you know, feel the way you feel. And then try to understand why you feel that way. And then go from there. It’s about understanding.
Caroline: Right, and compassion. And speaking of compassion, has Kristin Neff’s work on self-compassion influenced you at all?
Sanj: I don’t know too much about her work on that. I think compassion is a natural offshoot in physicians. When they can get back to what they were meant to do, the reasons they went to med school, the high-impact work and meaningful interactions, I think compassion flows as a natural side effect, as opposed to trying to be compassionate, or forcing yourself to be compassionate.
Caroline: We have a dialogue going on in the chat around suffering that comes from external circumstances and the difference between that and the ones that are created in the mind. I think you’re talking about two different things, right? If they’re worried about how they’re going to get food on the table, it’s a little hard to feel in the flow state, for example.
Sanj: What I’m talking about is in the absence of extreme poverty or trauma or anything like that. When when you talk about external circumstances playing a relatively minor role in people’s well-being, you’re not talking about a Third World, war-torn country where external circumstances certainly do matter to you. From a physician’s perspective, you can change your environment, you can modify your environment, or you can do things differently to create an environment that enables you to get back to high-impact work. And that’s what we work through a lot with physicians, we get into the details of what is their work environment, what do they do every day? And then you try to basically modify and change that to amplify the things that we want to amplify and remove or eliminate or mitigate the things we don’t want to spend time on.
Caroline: Will you tell us about your Thrive Rx course?
Sanj: It’s the course I wish I had had in med school. I wanted to understand and teach people how to gain professional fulfillment, how to reconnect with the reasons they became doctors in the first place, or healthcare providers, whatever capacity they are in, in medicine. I wanted to figure out ways to help them change active income to passive income, because I think when you’re not worried so much about your paycheck, you can leave toxic work environments, you can maybe create an environment for yourself that may be beneficial. And so financial literacy and financial independence is a big deal. But to be honest, the real reason I created Thrive Rx is to get to the kids of the families of the physicians and the patients. So if physicians see about a million people, you know, for every physician that dies of suicide, a million people or patients lose their physicians, and that’s a lot. So if you can keep physicians in medicine, give these principles to them, so that they can in turn teach them to their patients and to their kids at home, that’s one way to scale a lot of positive psychology principles. And the youth mental health epidemic is only getting worse. So if there’s a backdoor way to get some of these concepts and principles to kids, this is just one other way to do it. It’s through physicians, through their families, through their patients’ families.
Caroline: I don’t think that people are aware that that physician suicide is actually a problem.
Sanj: About one physician every day dies of suicide and these are people that don’t have histories of depression. People look at them and they think they’re on top of the world, they’ve got everything. And in the end, they have nothing. So it’s really a shame. Part of [the course] is creating a community for physicians.
Caroline: What’s one piece advice that you would give to all of us?
Sanj: Try to understand, to just maybe gain a little bit of clarity on how all of our thoughts are chases to feel better. And just kind of watch that for a couple days and see if that’s true in your own life. And if it’s not, it’s great. It’s true in my life, and many other lives. And then I would do negative visualization. You know, when you’re at a stoplight for 30 seconds, mentally subtract something good in your life. You know, when I’m driving home, and I got to take my daughter to softball practice, after a long day at work, I can, you know, imagine where that she’ll be in college, and she won’t be here anymore living with me, and how much I’d crave to have a half hour ride in the car with her. That’s kid of the flip side of gratitude. But our brains respond much better to the negative, to loss, than to gain. So negative visualization is probably even more powerful than gratitude journaling, at least for me and for a lot of people. So if there’s one thing to do, do negative visualization a couple times a week on something. I think it’s a powerful antidote to hedonic adaptation.
Sanj Katyal, M.D., holds a bachelor of science degree with university honors in chemical and biomedical engineering from Carnegie Mellon University and a medical degree from New York University School of Medicine. He is the founder of Positive Psychology Program for Physicians and president of Optimal Life Imaging Group, PC. Dr. Katyal also holds certifications in positive psychology and positive psychology coaching from Wholebeing Institute and has published and lectured extensively on well-being and the science of happiness to audiences ranging from college students to physicians. Currently an adjunct professor at La Roche University in Pittsburgh, Dr. Katyal teaches the class How to Flourish: Lessons from Positive Psychology. His research interests include developing a new model of optimal wellness incorporating principles from psychology, organizational leadership, health neuroscience, and medicine, and he is currently investigating the effectiveness of positive psychology interventions on physician well-being. Dr. Katyal is a co-founder of the course Thrive Rx: A Practical Guide to Flourishing for Physicians by Practicing Physicians. He lives with his family in Pittsburgh.
Sanj is the author of the Amazon #1 Best Seller Positive Philosophy: Ancient and Modern Wisdom to Create a Flourishing Life
His hobbies include kayaking, writing, and traveling.