As in many professions, academicians in psychiatry and other related disciplines often face tension and conflict in their attempts to balance professional demands and accomplishment with personal obligations and interests (
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3). The purpose of this perspective is to share one father’s approach to dealing with this common tension. The reflections I offer were stimulated by an informal professional development meeting coordinated by my department chair, focused on balancing personal and professional demands and goals within an academic department of psychiatry and behavioral medicine. My perspectives are further filtered through my research faculty position, as a nonclinician, within the department. This position, which is neither "soft" money nor "hard" money, consists of 3-year renewable contracts. Given that promotions and salary increases are historically based on grant revenue and publication counts, there is considerable professional incentive to produce academically.
It is ironic that I should be in a quasi-soft money academic position. For 17 years, beginning in junior high and continuing through my late 20s, I was involved with a community-based organization—first as a participant in its volunteer leadership program, then post-college as a program coordinator, eventually becoming associate director. At age 28, I entered a doctoral psychology program with the goal of attaining a tenure-track faculty position at a small liberal arts teaching college. Little did I envision that I would hold, 16 years later, a senior faculty position at a major research institution. I offer this background because as I reflect on the basic question posed by my department chair, I cannot separate my reflections from my experiences—both professional and personal.
I reflect back to graduate school and the great intimidation or anxious awe that many of my peers felt when interacting around their well-published professors. Given my community-based experiences, I found their anxiety curious. Yes, some of our professors were pioneers and leading experts in their academic field, but many of us, as students, also had unique expertise and skills in other domains.
For example, I worked professionally with developmentally challenged individuals and children with behavioral and/or emotional problems for 15 years prior to entering my doctoral program. While I had considerable respect for the immense breadth and depth of knowledge and expertise that my professors had in their chosen fields of study, I wondered how many of them would know how to deal with a 230-lb man with an IQ of 20 who was aggressively acting out. In sum, the professors knew what they knew, and I knew what I knew. None of our respective expertise made any of us inherently better as people. What really mattered, in my opinion, was who we were as people.
I pondered the extreme stress some of my peers would experience at the thought of performing poorly on an assignment or exam. So many of my colleagues viewed academic success or failure as comparable to life and death. I reflected on the suicidal youth I had worked with in my community-based days. I reflected on the children I worked with who opened vehicle doors at 60 mph on a Southern Californian freeway, who held knives to their wrists or inflicted their anger and pain on others. I reflected on the suicidal tendencies and suicidal attempts of family and close friends. And I thought of the stress I observed among my peers over a test, a manuscript submission, or other academic activities. And I thought to myself, so what if I fail? Will my life be irrevocably damaged in the long term?
When I thought about all of the great tragedy that humans can and have overcome, did a failed test, a manuscript or grant rejection, or any failed academic task really matter? Or, as a dear friend of mine responded when asked what he would do if he failed graduate school, "Well, I guess I would go back to selling skis." Life is what it is. We either live it or it passes us by. Life goes forward regardless of whether or not we choose to move forward with it. Nothing epitomizes this more than being a parent.
It is with this background that I reflected on my department chair’s question about how to balance professional and personal demands and goals. My reflections are further framed within my experience as a married man with two wonderful daughters, who are 7 and 11 years old. My wife is a licensed clinical psychologist who maintains a successful full-time clinical career. Although my thoughts are filtered from a traditional family perspective, I believe they are applicable to people in diverse life situations. My basic model can be applied to the balance of work and relationships, work and hobbies, or work and any other personally relevant area of life. I also must acknowledge that my wife and I both are fortunate to have flexible work schedules which allow us to make adjustments for family commitments. I realize that not everyone is so fortunate.
CPR is an acronym for cardiopulmonary resuscitation. It is a medical term that refers to an emergency technique to restore breath, heartbeat, and life itself. Within the context of this perspective and my chair’s question, I have two alternative interpretations of CPR as applied to my personal life situation. My first interpretation is Child Planning Required (or, for people without children, Career Planning Required). As our daughters age, there is no way that my wife and I will fulfill all of our professional and personal demands and goals. It is neither realistic nor practical to attempt such an undertaking. Thus, we practice CPR-2. Or, as I like to think with my second interpretation of this acronym, Commitment, Prioritization, and Relinquishment.
As a colleague expressed at our professional development meeting, "My family comes first." Or as my mom—who co-founded the community-based organization I referred to earlier in this perspective—often says, "People come first. Paper will always be here tomorrow. But people, you never know if they will still be here come tomorrow. So take care of people NOW because paper will wait." At a macro level, I apply this to my work and the people I deal with in my job. At a micro level, I apply this as, "My family comes first." Period. No exceptions. Commitment.
To commit to family first, it becomes impossible to meet all professional obligations. My daughters’ school bus does not arrive until 8:20 a.m., so I cannot get to work until 9:00 a.m. most mornings. They are home at around 4—4:30 p.m. and in bed by 8:30 p.m. So if I work too late, I miss the 4:30—8:30 p.m. window of interaction with my daughters. The choice is easy—I am home by dinner most nights and I rarely work on weekends. Saturdays and Sundays are my days with my girls. This is our time together. The choices I make mean that I usually cannot meet all of my professional obligations and goals. So, I must prioritize.
I ask myself each week, each day, each hour: "What needs to be done next? What needs to be done now?" I try not to worry or think about what is not getting done, about what needs to be done later, or what should be done. I only focus on what I need to do now. I usually eat my lunch at my desk and I do not socialize much at work. I typically arrive at the office at around 9:00 a.m. and leave by 4:30 p.m. If all of my "must do now" tasks are not completed within this time frame, then I save them for after my daughters have gone to bed. And, in fairness, there are times (e.g., near grant deadlines) when it is necessary to work long hours for a period of time or through the weekend. This is okay and I do not feel guilty about neglecting my family for brief periods, as long as it does not become the norm. In most cases, though, I realize that the "must do now" criteria are self-imposed. In reality, these tasks can often wait. My commitment to my family mandates that I prioritize time with them first. And if I do have a brief period of prioritizing professional tasks, then I make sure that I follow this period with extra commitment to family time.
If one commits to her/his priorities, then (s)he often faces the inevitable guilt about unfinished tasks. This is the moment when it is essential to relinquish. This includes saying no to new offers—no matter how intriguing—and letting go of prior commitments and aspirations if they are no longer a priority. When I am feeling overwhelmed by the tensions associated with balancing personal and professional goals and demands, I go back to:
Commitment: My family comes first—period.
Prioritization: Okay, what do I need to do now? Not an hour from now, not later today, not tomorrow, not next week.…What do I need to do now?
Relinquishment: Okay, this is what I need to do now. This is what I can do now. This is what I will do now…Everything else can wait.
And when I forget to practice CPR-2, one of my daughters will inevitably drop a book or some other not-so-subtle reminder in the middle of my work and demand to be seen and heard. This is a clear sign that I am not tending to my prioritized commitments and need to relinquish whatever I am doing. A not-so-subtle reminder that people come first.
In closing, I do not wish to leave the impression that I neglect my work at all costs. Since finishing my postdoctoral fellowship 10 years ago, I have been the principal investigator on six funded studies with a combined total budget of over $10 million and I have been a (co)investigator on several other funded studies. I have published numerous peer-reviewed articles, have been regularly present at conferences, am actively involved in several collaborations with community-based organizations, and serve on institutional committees. Five years ago, I successfully applied for promotion to Associate Professor. I share these accomplishments not to draw praise to myself but, rather, to demonstrate that it is possible to achieve professional success within academic psychiatry without sacrificing family. In fact, I believe much of my academic success directly results from the commitment I have to my family. It is because of this commitment that I must prioritize my professional commitments. In turn, this forces me to focus on those tasks that are most likely to result in professional achievement.
Nonetheless, I acknowledge that my priorities and choices have both professional and personal costs. Professionally, my goal of maintaining balance between work and family means that I spend considerably less time socializing with colleagues at work than I did before I had children. These days, I rarely take leisurely social lunches or attend social events after work. Although I have been moderately successful in my career, my professional productivity and accomplishment would be far greater if I placed work first. Certainly, I have a backlog of unwritten articles, undeveloped grant ideas, and other initiatives of interest that remain dormant due to a lack of time. As my children have aged and become actively involved in sports, I have scaled back my professional travel considerably, something I have enjoyed immensely in the past. As my career continues to mature, I accept the possibility that these costs may impede my professional growth, accomplishment, and promotion.
On a personal level, I have had to relinquish or greatly diminish time spent on personal hobbies, especially those that involve time away from the family. No longer can I just come home and decide to go camping, on an overnight fishing trip, or to a live music club. There are times that I have to miss my girls’ games or other special events due to work commitments and deadlines, despite my best intentions to maintain an accommodating calendar. Fulfilling obligations to work and children can also, at times, leave precious little quality time for my wife and me to enjoy private company or the company of close friends with whom we visit much less frequently than before any of us had children.
Nonetheless, when I analyze the costs and benefits, I am generally content with the priorities and choices I make. Still, I have periods when my balance is skewed unsatisfactorily. It is during these periods that I am reminded to go back to my basic coping model. CPR—it is actually easy once you commit. With commitment, the necessity of prioritization becomes crystal clear. And once you prioritize, what needs to be relinquished becomes obvious. It all starts with commitment to priorities and then letting go of what does not fit. Ask yourself: "In the far future, will my life be richer or poorer given what I have relinquished? Will it be richer or poorer because of the commitments I have prioritized?" For me, I know my life will be richer by practicing CPR (Child Planning Required) and adhering to its three tenets: Commitment, Prioritization, and Relinquishment.