“So, Dr. Hass, let me tell you about how it really started,” said an elegant but frighteningly thin 85 year old, Ms. E. “Things really started to fall apart when my husband was diagnosed with cancer a couple of months ago.”
I squirmed in a hospital room chair. “I want to get to the real reason you have lost all this weight and ended up in the hospital, but I can’t give it the time it deserves now,” I said as I got up and hurried to the door. “Let’s talk about it tomorrow.”
People often ask what the hardest part of my job is as a hospital-based doctor. Telling people about a cancer diagnosis? Resuscitations that don’t go well? Honestly, it’s interactions like the one I had with Ms. E—when I can’t have the conversation that would build our connection and lead to the heart of what ails my patient. Because, often, having those conversations—which are both healing for the patient and meaning-making for me—means missing priceless moments with my family.
That day, I got out of the hospital as soon as I could and jumped into my car. My youngest daughter was graduating from high school that weekend…and I had somehow ended up working through most of it. I had screwed up again, or had I? Perhaps I’d been screwed again by my amazingly rewarding, but at times amazingly painful, job. Driving home to join my family, I realized I needed to give my work-life balance deeper thought.
I have learned that I am not the only one struggling. A recent study by Tait Shanafelt and his colleagues showed that after a slight dip in 2020, burnout rates in my profession increased by almost 100%, with 62.8% of physicians having at least one symptom of burnout and almost half unhappy with their work-life balance. The data are equally dismal in nursing, teaching, and mental health services. In our always-connected world, even those with a “9 to 5” can’t always “leave it at the office” either. Women, especially those with children at home, and people of color tend to suffer more than others.
This is a good time to ask, yet again: How can we find ways of balancing the needs of people at work, the needs of those at home, and our own needs for both connection and alone time?
From balance to integration
Work-life conflict arises in a couple of ways. We suffer when our tasks (like seeing my patients) and our values (like valuing time with my family) are misaligned. That was me walking away from a patient who wanted to talk and stressing to get to my family party before the end of the day!
I don’t like the word “balance” in this context because it suggests tradeoffs: We must take from life to give to work. With balance, there is the implication that life and work are in opposition and that “life” happens outside of work.
But, for many of us, work is an important, generative, meaning-making part of life. The struggle is how to integrate work with our other roles and responsibilities—both those we must do and those we want to do. That’s why I prefer to think in terms of work-life integration, not balance.
Work-life integration suggests there can be a blending of work and life and even possible synergies across aspects of life, such as family, work, community, and personal well-being. In my view, our goal should be an alignment of our personal values and our priorities—the tasks we must complete—in terms of our allocation of time and energy.
Conflict can also arise with loss of control of boundaries. Constructing those boundaries needs to be highly individualized. Reading for work in the evening after coaching your child’s team might be a good form of integration for some—but, for others, evenings might be non-negotiable downtime. The goal is to set clear boundaries so we can be present and productive in the tasks we are engaged with.
How exactly to create these boundaries might be easy in principle but tricky in practice; getting it right requires careful thought and repeated revisions. Not getting it right leads to feeling overwhelmed; the resultant stress leads down the road to burnout. So, how should we work toward a state of integration?
What’s most important to you?
Cory Pitre and his colleagues at the University of Indiana developed a great program to help their medical staff with this process. I’m going to borrow from their work in order to suggest steps you can take toward better work-life integration.
One of the first steps in their program involved asking participants to sit down and first write down their values. According to the program, these should be more philosophical; they should be about what guiding ideas we want to live by, such as love, time with family, service to community, wisdom, or self-care.
Then we must identify our most important roles and responsibilities in home, work, and our personal life. These should be specific, such as a yoga class, earning money, caring for kids, patient care, the big project at work, time with friends.
It has been said that “the key is not prioritizing your schedule but scheduling your priorities.” Once you have given some thought to your most important responsibilities and values, you can use that information to guide your schedule-making.
When done in small groups, this exercise leads to durable improvements in work-life integration. Similarly, individual coaching on this improves integration and reduces burnout, according to a 2019 study. Not every organization and individual can afford such coaching, of course, but we can answer these questions on our own and even just with friends who are struggling with similar issues.
Many people have offered plans to allocate our time and energies to improve our work-life integration, but they tend to be about efficiency rather than addressing the cognitive conflicts. For example, telling yourself that you are done with work doesn’t necessarily stop your thoughts about work. Nor do they include strategies for coping with the work-life conflicts that will arise in a busy, purposeful life. This is where a Greater Good-informed work-life integration (WLI) framework can help us, drawing on research that this publication has covered for years. Here are some steps you can take.
1. It starts with self-awareness. Simply recognizing the need for WLI requires awareness; making a habit of noticing where our minds are going and what our body is telling is key to make sure we are on the right path with our plan.
Our boundaries are not solid like a stone wall. A defined time frame and locations can help, but in the end the boundaries must be cognitive, too. Our mind is apt to wander to places we would rather not have it go, like back to work! Mindful self-awareness is our best method to investigate why this might be and then work on solutions.
2. Articulate your priorities, plot out your boundaries, and make your schedule. Look at the exercise above and let it inform you as you plan. Weekly or even daily planning is time well spent. As you schedule, plan to take on your important work tasks first when you are at your sharpest. Schedule in time for yourself and those you most care about, too. Put good boundaries around your personal life’s “must-haves.”
3. Hone your time-management skills. Find tech “hacks” to help with planning and coordinating those plans with others, like using and sharing Google Calendar at home as at work. Turn transition times such as commuting into productive time; reflect on your successes and failures as you review your time-management strategies.
4. Delegate. At home this means hiring things out, if you can afford it, and getting those you live with to do their share. At work this means operating at the top of your skill set while empowering others to take on tasks when appropriate.
5. Maximize your attention by taking breaks and working in bursts. Do the tough work in bursts; avoid disruptions and multitasking. You will be more productive and creative if you take breaks that use other parts of your brain. Also note that being outside and vacations make you more productive!
6. Work fluidly but be mindful of your boundaries. It might be OK to take calls when cooking dinner, but only if it gets you time you really want away from work and the work thoughts don’t stay with you all night. You need to know yourself for your boundaries to hold up.
7. Be your authentic self as you connect with others. Essential to WLI is being “the real you” at work; you will be happier, better at your job, and better able to advocate for changes you need to fine-tune your WLI.
8. Communicate. Try talking with family, friends, and colleagues about what’s most important to you. Ask them about their own values, needs, and responsibilities. You might discover what you have in common with your coworkers. At home, you can find out from your loved ones if your idea of WLI works for them.
9. Draw strength from your sense of purpose. Finding meaning in our work and personal life helps affirm our values and provide strength to buffer against the stress that arises when we run into inevitable boundary issues.
10. Go easy on yourself. Stuff happens, the best-laid plans go awry, and most of us don’t have the most realistic expectations. Your house might not be as clean as you like, and your kid’s hair might be better brushed, and not all your work products will measure up. Keep an eye on your values, keep making time to organize—and see what might need to change! Also be sure to give yourself a little love and be thankful for your rich and dynamic life.
Work-life integration won’t look the same for every person; it depends on your personality and type of employment. For those on the computer at home, or for “digital nomads,” the challenges will be around “when am I off work?”—and perhaps about meaning and connection when not regularly in the company of others. For those of us in the people professions, the challenges will be around managing the suffering of others while dealing with misaligned incentives and a lack of control.
Personally, I learned that not thoughtfully working on work-life integration is a form of passive acquiescence to work that can take much more than you’re able to give. I can miss some important events—like that weekend of my daughter’s graduation. Addressing this requires some mindful self-reflection and some bigger conversations about what I need from work and what work needs from me. I suspect delving into work-life integration will provoke similar thoughts in just about everyone.