As you all are aware by now, I’m a huge fan of reading and the lessons you can learn from a good book. I know that not everyone is able to get through as many books as they would like, myself included, so I’m going to go over Mark Manson’s The Subtle Art of Not Giving a F*ck (Amazon link).

While I would classify this as a self help book, Mark Manson is a very atypical self help author. He acknowledges the toxic aspects of the self help craze; how constantly seeking improvement in your life can focus on what you lack and what is wrong with you, which ultimately leads to an unhappy and unfulfilling existence where happiness is always just out of reach. Although the title seems to imply you should not care about anything, the underlying message of the book is actually this: Everyone cares (gives a f**k) about certain things – choose wisely what those things are.

 

EMBRACE THE UNCOMFORTABLE

He explains it best when he says

The desire for more positive experience is itself a negative experience. And, paradoxically, the acceptance of one’s negative experience is itself a positive experience. The more you pursue feeling better all the time, the less satisfied you become, as pursuing something only reinforces the fact that you lack it in the first place.

On the other hand, pursuing the negative often generates positive. For example, the pain in the gym improves your health and energy. Failures in school or work give you a better understanding of your own shortcomings and how to improve in the future. Being open with your insecurities makes you more confident. Overcoming challenges and fears is what allows you to build courage and character.

“Everything worthwhile in life is won through surmounting the associated negative experience.”

If you constantly run from the uncomfortable, you will feel constantly entitled to being happy at all times, therefore any challenge coming your way is seen as an injustice, any disagreement becomes a betrayal. We must all be comfortable with the idea that some suffering is always inevitable. No matter what you do, you will face challenges, failures, loss, regrets, and ultimately death.

 

THE PROBLEM WITH HAPPINESS

Many of us are guilty of delayed gratification, particularly those of us pursuing the medical profession. We say when I finish training I can be happy, or when I’m an attending I’ll know I’ve made it. Or we can have superficial aspirations. If I can look like person X or be with person Y, then I will be happy. This entire approach is the problem, however. Happiness is not an ultimate end goal or solvable equation. Instead, it is an emotion, and emotions have evolved to be directions to our life compass. Positive emotions are positive feedback for good behaviors, and negative emotions serve as a call to action – evolution telling you that something is not right.

The struggles that you overcome are equally important to creating and sustaining happiness. Manson argues that problems never stop; they merely get exchanged and/or upgraded. Happiness comes from solving these problems. In fact, it’s a huge problem that many of us, at least in American culture, are taught to suppress our negative emotions for social and cultural reasons. However, to deny one’s negative emotions is to deny many of the feedback mechanisms that help a person solve their problems.

 

LIFE GOALS

I love Mark Manson’s breakdown of life goals. It’s a common question to ask someone “what do you want out of life?” And everyone is going to have a fairly similar answer. Happiness, family, great job, etc. Instead ask yourself “what pain do I want in my life? What am I willing to struggle for?” This is the question that will give you better insight on how to live your life. What pain are you willing to sustain? 

For example, many premeds early in their college career dream of the many advantages of being a physician. But not everyone is willing to put in the long days and nights studying, the 4 additional years of medical school, the 80+ hour weeks in residency, etc. That’s a big reason why majority of premeds on the first day of college are no longer premed at graduation time. Asking yourself what are you willing to struggle for will lead you down a path that is more worthwhile for you.

Manson also applies this logic to relationships: “Most people want to have great sex and an awesome relationship, but not everyone is willing to go through the tough conversations, the awkward silences, the hurt feelings, and the emotional psychodrama to get there. And so they settle.” People want a romantic partner, but you don’t find someone you believe is amazing without first appreciating the emotional rollercoaster that is dating, rejections, and failed attempts.

People want an amazing body, but you only get there if you are able to endure and appreciate the pain and challenges associated with regular exercise and meticulous tracking of your caloric intake. You’re defined by what you’re willing to struggle for. Those who enjoy the struggles of the gym are the same people who are strong and athletic.

 

EMBRACE CHALLENGES AND FAILURES

Going back to the toxic nature of the self help culture, the truth is that we are not all exceptional. Feeling good about yourself for no reason will actually do more harm than good. Facing challenges and obstacles head on is a useful and necessary component in development. You guys know how much I appreciate a good challenge from the My Story video. If challenges and suffering is inevitable, we shouldn’t ask ourselves “how do I stop suffering?” Rather, “why am I suffering – for what purpose?” The beautiful thing is that while problems can often not be changed, we have complete control over how we choose to think about them.

Problems add meaning and importance to our lives. So embrace them. Beasting the MCAT and getting into medical school makes us happier than watching Netflix. Raising a child makes us happier than eating McDonalds. Each of these activities is stressful and at times unpleasant. They also require enduring through problem after problem, yet they add value, meaning, and can create joyous moments in our lives.

As Freud said,

“One day, in retrospect, the years of struggle will strike you as the most beautiful”

We can only be successful at something we’re willing to fail at. If you are unwilling to fail, then your’e unwilling to succeed. If someone is better than you at something, it’s likely because she has failed at it more than you have. If someone is worse than you, they likely haven’t been through all the learning experiences yet.

 

BE HONEST WITH YOURSELF

While some may argue that you measure self-esteem by how positively you feel about yourself, Manson argues that the more accurate way is to see how someone feels about the negative aspects of themselves. Someone who actually has high self esteem can honestly assess their negative qualities and subsequently act to address them. Entitled people, on the other hand, are unable to be honest with their problems and therefore are unable to improve their lives in a lasting and meaningful way. They live in denial.

This entitlement usually manifests in one of two ways: 1) I’m great and you all suck, therefore I deserve special treatment. Or 2) I suck and the rest of you are all incredible, so I deserve special treatment. The former referring to those who are extremely arrogant and consider themselves superior, and the latter referring to those who constantly pay the victim card.

 

CHOOSE YOUR VALUES CAREFULLY

Our values are what determine the metrics by which we measure ourselves and everyone else. Resist human nature in wanting to compare yourself to others. Instead, figure out by what standard do you measure yourself? The best way to reframe how you see your problems is to change what you value and how you measure failure and success.

Here are some examples of good and bad values.

Good values: honesty, innovation, vulnerability, self-respect, curiosity, charity, humility, creativity

Bad values: dominance through manipulation, feeling good all the time, always being the center of attention, not being alone, being liked by everybody, being a gunner (for those of you who don’t know, gunner is a term used in medical school to describe someone who is overly competitive and brigs others down in order to get ahead)

Figuring out your values comes down to priorities. What are the values that you prioritize above everything else and therefore influence your decision making more than anything else? Better values lead to better problems which leads to a better life.

 

TAKE RESPONSIBILITY

Often the main difference between a problem sucking and being bearable is the sense that we chose it and are responsible for it. If you’re miserable right now, chances are that you feel like a big part of it is outside your control and you cannot solve it. It’s a problem that was thrust upon you without being able to choose.

Once you learn to accept that you are responsible for everything in your life, no matter the external circumstances, you will be able to achieve greater levels of self improvement and growth. We do not always control what happens to us, but we always control how we interpret what happens to us, as well as how we respond. Accepting responsibility for our problems is the first step to solving them, because as soon as we choose to accept responsibility, the more power we exercise over our lives.

It’s important to note the difference that taking responsibility for your problems DOES NOT mean you are at fault for your problems. Fault is past tense. Responsibility is present tense. Fault is due to choices that have already been made. Responsibility is due to choices you’re currently making.

My college health, family, and financial struggles coming together at the same time was the single most painful and challenging experience of my life, but it was also one of the most important and influential one (video here). Most of what happened was completely out of my control, but I took responsibility of each problem and was able to approach them in a constructive way. I didn’t blame myself or take fault for these problems, but by taking responsibility it became the single most defining period in my life.

So how can you all apply this in your lives now? It can be something as simple as the example from Steph in the organization video. He holds himself accountable for 15 questions every day and crosses it off his calendar each day he accomplishes the task. If he doesn’t, he acknowledges the consequences, which are that he may not perform as well in his board exams. He is taking responsibility for his position and is making actionable steps to ensure an outcome he wants.

 

DON’T BE SO CERTAIN

Certainty is the enemy of growth. Nothing is for certain until it already happened, and even then it is questionable. That’s why it is so important to accept the imperfections of our values. Growth is an iterative process. When we learn something, we don’t go from “wrong” to “right”. Instead we go from wrong to slightly less wrong.

So rather than searching for certainty, search for doubt. Doubt about our own beliefs, feelings, and what the future holds for us. And instead of looking to be right all the time, try to be wrong. Being wrong opens up the possibility of change and brings the opportunity for growth.

Don’t even trust your conception of positive and negative experiences. Like I told you about my own struggles, some of the most difficult and stressful moments end up being the most formative and motivating. Most of our beliefs are wrong. They are malleable, and our memories are horribly unreliable.

If we become certain of our intelligence and our ability to get into medical school, we are more likely to feel worse in the end. When you see someone else getting into a better school, you feel slighted, unappreciated and under-acknowledged. In these moments we become susceptible to entitlement: believing that we deserve to cheat a little to get our way, that others should be punished, etc.

Uncertainty is necessary for progress and growth. The man who is certain that he knows everything learns nothing.

 

YOU’RE NOT SPECIAL

Going back to the concept of not being extraordinary, Manson applies this with a different spin. If you believe your project idea is the dumb one that everyone will laugh at, or you are the person that is lame and no fun, you’re implicitly telling yourself “I’m the exception, I’m unlike everyone else, I’m different and special’. Manson argues that this insecurity is essentially narcissism.

So choose to measure yourself in mundane identities: a student, a friend, a creator. Not as an undiscovered genius. The more narrow your definition, the more threatening and intimidating it will be. This means you must give up grandiose ideas about yourself: that you’re uniquely intelligent, or talented, or good looking, or victimized in ways other people could never imagine.

 

DEFINE YOUR GOALS WISELY

Traditional goals like graduating from college, buying a lake house, losing 10 pounds, etc… are limited in the amount of happiness they can produce. These goals are useful when pursuing quick, short-term benefits, but as guides for our life trajectory, they are useless.

Rather, our proudest achievements come in the face of the greatest adversity. This is why many cancer survivors report feeling stronger and more grateful after winning their battle to survive. Fear, anxiety, and sadness are not always undesirable or unhelpful – rather they are representative of the necessary pain for psychological growth. Just as one must suffer physical pain to build stronger muscles, one must suffer emotional pain to build greater resilience and a happier life.

“Our most radical changes in perspective happen at the tail end of our worst moments.”

 

SUSTAIN THE PAIN

“Many people, when they feel some form of pain or anger or sadness, drop everything and attend to numbing out whatever they’re feeling. Their goal is to get back to ‘feeling good’ again as quickly as possible, even if that means substances or deluding themselves or returning to their shitty values. Learn to sustain the pain you’ve chosen. When you choose a new value, you are choosing to introduce a new form of pain into your life. Relish it. Savor it. Welcome it with open arms. Then act despite it.”

 

JUST DO IT

Action isn’t the effect of motivation; it’s also the cause of it.

Motivation is an endless loop that looks like this:

Inspiration → Motivation → Action → Inspiration → Motivation → Action → Etc

If you lack the motivation to make an important change in your life, do something and then harness the reaction to that action as a way to begin motivating yourself.

This also applies to the pomodoro technique I’ve spoken about several times on this channel. Just by starting something small and menial, larger tasks become much easier. Once you do the easy stuff, continuing to work on the harder parts is a piece of cake.

 

CHOOSE QUALITY OVER QUANTITY

Have you heard of the paradox of choice? It refers to the fact we are happier with less. When we’re overloaded with opportunities and options, we are actually unhappy.

When you pursue a wide breadth of experience, there are diminishing returns to each new adventure or thing.

Strangely, there is liberation and freedom in commitment. Manson argues there is increased opportunity and upside in rejecting alternatives and distractions in favor of what he’s chosen to let matter to him. Commitment makes decision making easier and removes FOMO, the fear of missing out. You know what you have is good enough, so why would you ever feel the need to stress about chasing more?

Commitment allows you to focus on a few highly important goals and achieve a greater degree of success than you would otherwise.

 

REMEMBER YOU’RE GOING TO DIE

Strangely, reminding yourself that your life is finite helps us remove the superficial and meaningless values in life. In ancient Greece and Rome, keeping death in mind was thought to help you appreciate life more and remain humble in the face of its adversities.

“The only way to be comfortable with death is to understand and see yourself as something bigger than yourself; to choose values that stretch beyond serving yourself, that are simple and immediate and controllable and tolerant of the chaotic world around you.”

This is often easier said than done. I have found that meditation can help provide perspective to your life’s challenges. I personally use the insight timer app on my iPhone for free guided meditations. Try it out and let us know how meditation works for you.