57. Cultivating the Emergency Mind | Graduated pressure, sangfroid, and acknowledging the suboptimal
Aug 23, 2021
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Dr. Dan Dworkis, an emergency physician, discusses cultivating the emergency mind, including handling pressure, deliberate training, acknowledging suboptimal situations, and mastering sangfroid. They also explore breaking down tasks, supporting ALS research, and the discipline of the suboptimal in medicine.
Cultivating a calm and composed mindset under pressure involves practicing graduated pressure scenarios and finding techniques to control physiological responses and create mental space to act.
Acknowledging mistakes as suboptimal, accepting them as reality, and using them as opportunities to reset and improve subsequent actions.
Training tired moves by practicing skills and techniques even when fatigued helps build endurance, efficiency, and resilience, enabling individuals to perform with economy of movement and confidence in demanding situations.
Deep dives
Developing Sangfroid: Stay Calm in Stressful Situations
Sangfroid, meaning calm under pressure, is a skill that can be cultivated. It involves physiological, mental, and interpersonal skills, all of which contribute to remaining calm in stressful situations. To develop Sangfroid, one can practice graduated pressure scenarios, starting with minor stressors like spilled coffee or traffic, and progressively escalating to more high-pressure situations. By experimenting with different techniques and finding what works for individuals, such as controlling physiological responses and creating mental space to act, one can train themselves to maintain composure in intense moments.
The Discipline of the Suboptimal: Dealing with Mistakes
In high-pressure situations, mistakes are bound to happen. The discipline of the suboptimal involves acknowledging the severity of a mistake, but also accepting it as a reality and using it as an opportunity to reset and take a better next step. By saying phrases like 'Well, this is suboptimal' out loud, individuals can create a momentary pause to choose their next action and move forward. It is not about accepting or being okay with the mistake, but rather acknowledging it and using it as a catalyst for improvement in subsequent actions.
Training Your Tired Moves: Excelling Under Pressure
Training tired moves refers to practicing skills and techniques even when fatigued. By doing so, individuals can build endurance, efficiency, and fluidity in their movements. In disciplines like martial arts or emergency medicine, where physical and mental demands are high, training tired moves helps individuals maintain excellence under pressure, allowing them to perform with economy of movement and confidence. By repetitively practicing under exhaustion, individuals can master skills and build resilience, enabling them to efficiently perform even in the most demanding situations.
The Importance of Graduated Pressure in Training
Graduated pressure is a crucial aspect of effective training. It involves mastering a skill in low-stakes environments and gradually increasing the pressure until one is ready to apply the skill in real-life situations. This approach ensures that failure is not wasted, as information is captured from failures and used for improvement. By training with graduated pressure, individuals can better deploy their knowledge and skills under high-pressure situations, such as in emergency medicine.
The Value of Tired Moves and Recognizing Fatigue
Tired moves are basic, reliable actions that remain effective even in highly fatigued or stressful situations. In fields like emergency medicine, it is important to acknowledge and address the limitations that come with mental and physical fatigue. By recognizing our reduced mental state, we can adjust our approach and prioritize essential tasks in high-pressure situations. Rather than viewing fatigue as a personal failure, understanding it as a physiological response allows for the development of effective strategies to optimize performance and decision-making.
The emergency mind is cool under pressure. But how do you get there? For most us, it’s not an innate skill. Dan Dworkis MD, PhD lays out the path: graduated pressure, deliberate training, tired moves, and acknowledging the suboptimal.
⭐ Join us at Awake and Aware 2025, a game-changing 3-day workshop from May 5-7 in Bend, Oregon. Learn how to stay cool when the pressure’s on and lock in the mindset you need to flourish. Space is limited.
The hidden anti-burnout curriculum we all should have learned in training. Cohort 3 begins Sept 10, 2024. Get the deets
For full show notes of this episode and all sorts of other goodies, visit our podcast website
We discuss:
Deploying psychological countermeasures when you’re under stress and dealing with uncertainty [05:40];
Whether the approach to managing pressure is universal for all stressful situations [11:15];
Different modes of thought: system 1, system 2, and the recognition-primed decision-making model [15:50];
The deliberate path to becoming an expert (beyond just repetition) [20:00];
The value of training with an idea of graduated pressure [21:45];
What it means to borrow pressure from other events to succeed in something that's unrelated [25:50];
The Yerkes–Dodson law [28:45];
Why sangfroid is a good thing and how you do it [35:20];
The path to excellence which goes far beyond mastery of a specific skill [38:30];
How acknowledging the suboptimal nature of a situation when something goes wrong can help you “regroup, recover, and evolve out of any crisis” [41:50];
What does it mean to train your “tired moves” [42:55];
Dan’s challenge for the Stimulus audience [52:44];
And more.
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