Navigating change and uncertainty

How do you cope with change and uncertainty in your life??

I have not conducted a poll on this, but from my own experience and interacting with other people day to day I would say most people are not that comfortable with it.?

This makes complete sense, as the human brain is wired to see change as a threat. As with many mindset difficulties, this goes back to the days when survival was key.?

However, it is also unfortunate, as change and uncertainty are all around us in the world. As a Greek philosopher once said ‘change is the only constant in life.’ And this has never been more true than over the past few years. Pandemic, changes in ways of working, worldwide unrest, and economic pressures.?

We do need to consider though, that there is also opportunity in change and uncertainty. The outcome is not defined yet, and there is a malleability that gives us a chance to shape the outcome. This can be hard to see at the time and requires consistent practice to see things that way.?

Depending on your baseline ‘programming’ in this regard, you will need to manage some emotional responses. In some cases this can be extreme, e.g. catastrophising and automatically jumping to worst-case scenarios. It can be difficult to see the wood for the trees.?

I am confident I am not alone in this, but I recognise this type of response in myself from the beginning of the pandemic. One of the biggest periods of change and uncertainty that most of us have ever experienced and some of the fallout continues to progress even now.?

I had really mixed feelings at the beginning of the pandemic. The fact that we could follow events as they progressed across the world towards us was a blessing and a curse. It allowed us to prepare, but it also left a gap for us to fill in some blanks. No one really knew what was going to happen for sure, what the effect would be on our population.?

The response was predictably on a spectrum. Some people were convinced it was going to be a non-issue. Others were sure it was going to be the apocalypse. Finding a sensible middle ground here was tricky. I was involved in many planning meetings where it was necessary for us to consider worst-case scenarios, and I found it hard to adjust my mindset to much else.?

I did not speak openly about it much at the time, but it really weighed on me. I worried about what I would see and what I would have to do. I worried about losing people close to me, and perhaps not surviving it myself. It took a while to adjust to these feelings, anchoring myself to the fact that it would be what it would be.?

This was not the first time I found myself having to calibrate my mindset to change and uncertainty. When I first started postgraduate training in Emergency Medicine, I did the thing that most new junior doctors in the specialty do. I was constantly working towards perfection and certainty. I was acutely aware of the responsibility on my shoulders- if I did not do my job right, potentially people could be harmed. I wanted cast iron, solid gold assurances of how I could prevent this from happening. Unfortunately, this is not realistic.?

The main thing that changed my mindset, other than gaining experience, was studying for the critical appraisal exam during training. This exam involved assessing research papers for their strengths and weaknesses, to make sure that you are able to evaluate research quality to choose the best ways of helping patients in the future.?

The side effect of this process for me was gaining a greater understanding of terminology and concepts around risk and probability.?

Something clicked for me whilst preparing for the critical appraisal exam. There was literally no way for me to completely eliminate risk. It cannot be made zero, so pushing for this to be the case is a waste of effort. The best that I can hope for is to minimise the risk, and this is where my knowledge and experience come in.?

This is something, in my opinion, that is very poorly understood by the general population. And I think I understand why- in some ways it is human nature. We crave certainty about all things in our lives. No more so than when we attend a healthcare professional. We want reassurance that nothing serious is wrong, and many times we also want a specific diagnosis.?

This is where it gets a little bit problematic for me, as someone from an Emergency Medicine background. We are not really seeking to make a diagnosis, the main aim is to work out the probability of there being a serious/life-threatening condition.?

How we achieve this depends on a lot of factors from what we know or can see about the patient, what they tell us and what we find on physical examination.?

This can be challenging to explain to someone, for example with chest pain. Whilst many are reassured by the consultation and being told that there is ‘no sign of anything serious going on’, I suspect that a significant proportion probably remain unsatisfied and potentially not reassured by the lack of a diagnosis. How many times have you heard someone in this very situation, come away from the hospital saying that the doctor had ‘no clue’ what was going on with them? I worry sometimes about this mismatch between our intended reassurance, and what actually lands with the patient.?

The point, once again, is that we can never make the risk zero. We can strive to get it as close to zero as possible, with the information we have available to us at the time, but we can never make it zero.?

And this can be transposed to other areas of life too. There is nothing (or very little) in life that it absolute- no always or never. No guarantees. Finding ways of accepting this without being too passive or lackadaisical is the key for me.?

How to manage change and uncertainty

Self-awareness

Take some time now to consider what I have shared above. Be honest with yourself, how do you cope with change and uncertainty? This will give you a good benchmark of where you are now, which is essential in order to make forward progress.?

It matters less that there is a lot of work to do, and more that you know where you are starting from. If in doubt, ask the people who know you best for an honest appraisal.?

Acceptance

Learning to accept things rather than resist them can be a really freeing process. There is a spectrum, of course, I do not expect you to become a doormat. Perform a quick assessment of what you cant control vs what you can, to make sure you are not being too passive.?

Once you have established that things are largely out of your control, this is where acceptance can help.??

I recently listened to an interview with professional tennis athlete Johanna Konta, who outlined an interesting concept around pain and suffering. Her theory is that the more you resist the pain, the greater the suffering. Therefore acceptance, in relevant situations, makes finding the solution(s) much easier.?

Embrace change as an opportunity instead of something to fear

This can take some practice to rewire your automatic responses. Bear in mind that although the outcome is uncertain and this can be scary, it also means that no one has written the end of the story yet. This is your opportunity to have a say in how the story ends.?

Change can be both scary and an opportunity if you can learn to recognise it.?

Align action with vision

As always knowing what your vision is and being connected with it is the key to feeling more confident and purposeful in life. It also gives you some scaffolding to lean on as you work through change and uncertainty. You do not need to know what is happening, as long as you understand why.?

Focus on now, and not what might happen

A lot of discomfort and worry come from our thoughts about what could possibly happen. Cultivating a habit of focusing on what is happening now, including the next best steps, can help to limit and control that sense of discomfort over what may or may not happen.?

Focus on the problem at hand, not the one in your mind.?

Move from ‘know it all’ to ‘learn it all’

Do not be afraid to ‘fail’. Things not going according to plan is actually a powerful educator and motivator. Learning to manage these situations gives us the leverage to learn, grow and improve. Change your relationship with failure, starting with how you respond when things don't go as well as you hoped.?

Be appropriately positive

There is such a thing as ‘toxic positivity’, I completely believe this. I also believe that it is possible to find an appropriate balance between forecasting that events of the day or near future will go well, and anticipating any potential challenges. The two things are not mutually exclusive.?

I used to be an advocate for expecting things to go badly and you can never be disappointed, but I now realise that by programming my mind in this negative way I am making myself seek out the negativity. Take some time each day to visualise the different parts of your day going smoothly and well, and see how your outlook improves.?

Consider the Kubler-Ross change curve

The change curve was originally devised in the 1960s to describe the classic stages that someone tends to go through during the grieving process (denial, anger, bargaining, depression and acceptance). More recently it has been used in the corporate world to anticipate employee reactions to changes within an organisation, and how this impacts productivity and effectiveness in the workplace.?

Be kind to yourself

As always, the most important thing to remember. You will get nowhere fast in your personal development by berating yourself, especially about things out of your control. And even if it is in your control, you will get far more learning from the situation by looking at it objectively.?

Thank you for reading. Let me know your thoughts in the comments.?