As a physician, you might find yourself grappling with a challenge many of us have faced: the struggle to feel and process emotions. 

For most of my career, I didn’t know how I felt—most of the time, I didn’t even think about it. As a child, I remember experiencing a wide range of emotions, from the highest highs to the lowest lows. But somewhere between medical school and residency, I learned that emotional detachment was the key to surviving the intense pressures of becoming a doctor. Determined to be the best physician I could be, I buried my negative emotions, put my head down, and focused on the work.

It’s been 28 years since I started medical school, and I still vividly remember moments where I struggled to hold back my emotions:

• The day I got a needle stick and had to inform a colleague I knew from a committee (ironically, we were working on education around needle sticks) that I was pregnant—before I had the chance to tell my mother. His congratulations felt hollow, and the situation seemed profoundly unfair.
• The day I helped a patient in the emergency room who was bleeding out from a carotid blowout while his family cried around me. I was devastated. I went to the ambulance bay to cry, where my supportive senior resident assured me it was okay, though he didn’t shed a tear.
• The time I said goodbye to a child whose family decided to move to palliative care. I cried softly as we left the NICU, but my resident seemed unsure of how to react. I didn’t have the tools to tell him it was okay to feel sad, or to let him know that his discomfort was normal. We eventually talked about it years later, but not in real-time.

It wasn’t until the last few years that I realized I was so disconnected from my own feelings that I couldn’t even name them. I learned this through the Empowering Women Physicians coaching program with Sunny Smith that I participated in last year. Sunny would ask us to identify our feelings, and I often found myself at a loss. I couldn’t name what I was feeling.

So, I did what any good physician would do—I looked it up. I discovered depersonalization: a state of feeling detached from one’s emotions and experiences. I then researched ways to address it.

Today, I want to share three things:**

1. Tips that are helping me regain the ability to feel and process emotions.
2. The data behind why it’s so important to feel your feelings.
3. A reminder to be compassionate with yourself as you unlearn emotional detachment—this is not an easy process.

The First Step: Recognize and Acknowledge Emotional Detachment

Awareness is the first step toward change. Recognize when you are experiencing emotional detachment and understand its impact on your life and work.

Strategies to Address Emotional Detachment

1. Learn to Label Your Emotions

• When you notice an emotion, label it. Simply identifying and naming your emotions can reduce their intensity and help you manage them better.
• I realized I needed to expand my emotional vocabulary. If you struggle to find the right words, consider using a website or app like WordHippo. You can input a broad emotion like “mad,” “worried,” or “happy” and see which options resonate.

2. Keep an Emotion Journal

•  Document your feelings at the end of each day or at a time that works best for you. Note any instances where you felt detached or numb and reflect on what might have triggered those feelings.

3. Do Daily Self-Check-Ins

• This can be as simple as setting reminders on your phone to periodically check in with yourself throughout the day. Take a moment to pause and ask yourself how you’re feeling.
• I use the app “How We Feel” (it’s free). It reminds me to name how I feel each day (or multiple times a day, depending on how I set it up). It starts by asking two key questions: “High or low energy?” and “Positive or negative emotions?”—a great starting point for beginners like me!

4. Try Mindfulness Meditation

• The internet advised me to set aside 10 minutes each day to practice mindfulness meditation. I started with just one minute.
• I like to rub my thumbs together and focus on the texture of my skin, the temperature, and the sound it makes. You can also focus on your breathing.
• Consider using an app like Calm or Headspace, or search for mindfulness meditation videos on YouTube or Spotify if you find it hard to do on your own.
• Once you’ve centered yourself, or at least pulled yourself into the present moment, allow yourself to notice any emotions that arise. Try to do this without judgment—negative emotions are just as valid as positive ones.

5. Find and Create a Supportive Environment

• Seek out colleagues, mentors, and mental health professionals who understand the challenges of academic medicine. Regularly meet with fellow physicians to discuss the emotional challenges of your work. Sharing experiences and coping strategies can reduce feelings of isolation and promote emotional healing.
• Foster open communication within your team. Encourage discussions about emotional well-being and create a safe space where team members can share their experiences without fear of judgment.
• Set clear boundaries between work and personal life. Make time for activities and people that bring you joy and relaxation.
• Don’t hesitate to seek help from a mental health professional. Therapy can provide a safe space to explore and process your emotions. 

The Data Behind Emotional Detachment

1. Emotional Detachment Impacts Patient Care & Colleague Interactions: 

A study published in JAMA found that physicians experiencing high levels of depersonalization were more likely to report suboptimal patient care practices, including making errors and being less empathetic toward patients. This same study noted depersonalization was linked to difficulties in team collaboration, with affected physicians reporting strained relationships with colleagues.

• Reference: West, C. P., Dyrbye, L. N., Satele, D. V., Sloan, J. A., & Shanafelt, T. D. (2011). Concurrent validity of single-item measures of emotional exhaustion and depersonalization in burnout assessment. Journal of General Internal Medicine, 27(11), 1445–1452. doi:10.1007/s11606-011-1967-5. 

2. Depersonalization Reduces Professional Satisfaction: 

Burnout, characterized by both emotional exhaustion and depersonalization, affects more than 50% of physicians, with those in academic medicine particularly at risk due to high demands and stress.

• Reference: Shanafelt, T. D., & Noseworthy, J. H. (2017). Executive leadership and physician well-being: Nine organizational strategies to promote engagement and reduce burnout. *Mayo Clinic Proceedings, 92*(1), 129-146. doi:10.1016/j.mayocp.2016.10.004.

Depersonalization has also been shown to correlate with lower job satisfaction among physicians, as noted in a study published in Academic Medicine, where 45% of physicians with high depersonalization scores reported dissatisfaction with their jobs.

• Reference: Dyrbye, L. N., Thomas, M. R., & Shanafelt, T. D. (2006). Systematic review of depression, anxiety, and other indicators of psychological distress among U.S. and Canadian medical students. Academic Medicine, 81(4), 354-373. doi:10.1097/00001888-200604000-00009.

3. Depersonalization Impacts Cognitive Function: 

Research published in Medical Teacher found that depersonalization can impair clinical decision-making abilities, with 34% of physicians reporting that their cognitive functions were negatively impacted during periods of high depersonalization.

•  Reference: Brazeau, C. M., Schroeder, R., Rovi, S., & Boyd, L. (2010). Relationships between medical student burnout, empathy, and professionalism climate. Academic Medicine, 85(10), S33-S36. doi:10.1097/ACM.0b013e3181ed4c47.

Moreover, a study in Academic Medicine noted that physicians experiencing burnout and depersonalization showed reduced research productivity, with publication rates dropping by as much as 20% among those most affected.

• Reference: Shanafelt, T. D., Sloan, J. A., & Habermann, T. M. (2003). The well-being of physicians. American Journal of Medicine, 114(6), 513-519. doi:10.1016/s0002-9343(03)00117-7.

4. Depersonalization Decreases Personal Well-being: 

Depersonalization is closely linked to mental health issues. A study in the Journal of Occupational Health Psychology found that 40% of physicians who experienced depersonalization also reported symptoms of depression or anxiety.

• Reference: Maslach, C., & Leiter, M. P. (2016). Understanding the burnout experience: Recent research and its implications for psychiatry. World Psychiatry, 15(2), 103-111. doi:10.1002/wps.20311.

In addition, a survey conducted by the American Medical Association (AMA), 60% of physicians experiencing depersonalization reported that their work negatively impacted their personal relationships and work-life balance.

• Reference: Shanafelt, T. D., Hasan, O., Dyrbye, L. N., Sinsky, C., Satele, D., Sloan, J., & West, C. P. (2015). Changes in burnout and satisfaction with work-life balance in physicians and the general US working population between 2011 and 2014. Mayo Clinic Proceedings, 90(12), 1600-1613. doi:10.1016/j.mayocp.2015.08.023.

5. Depersonalization Lowers Professional Reputation: 

In a study published in The Journal of General Internal Medicine, 28% of physicians who experienced high levels of depersonalization were perceived by their colleagues as less competent or committed to their work.

• Reference: West, C. P., Dyrbye, L. N., Satele, D. V., & Shanafelt, T. D. (2015). Medical licensure questions and physician reluctance to seek care for mental health conditions. Mayo Clinic Proceedings, 90(12), 1592-1599. doi:10.1016/j.mayocp.2015.08.013.

Teaching and mentorship are also affected as reported in a survey in Medical Education which found that 35% of academic physicians experiencing depersonalization reported a decrease in their effectiveness as mentors, negatively impacting medical education and trainee development.

• Reference: Dyrbye, L. N., & Shanafelt, T. D. (2011). Physician burnout: A potential threat to successful health care reform. JAMA, 305(19), 2009-2010. doi:10.1001/jama.2011.652. 

Summary

I hope we can move away from the habit of suppressing our emotions and instead recognize that connecting with our feelings makes us better friends, partners, and physicians. Depersonalization is not a healthy way to manage emotions, and we need more supportive environments to overcome this misconception. Reclaiming our ability to feel and process emotions isn’t just possible—it’s crucial for our long-term well-being.

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If this resonates with you, know that you're not alone. Many of us are on this journey to reconnect with our emotions and reclaim our well-being. I’d love to hear from you if you’re experiencing any of these issues! DM me on instagram @sishmancoach