Intended for healthcare professionals

Career Focus

The ABC of change: V, W

BMJ 2004; 329 doi: (Published 06 November 2004) Cite this as: BMJ 2004;329:s194
  1. Susan E Kersley, retired doctor, life coach
  1. susan{at},


Valuing yourself is crucial in visualising and verbalising your ideas. And taking the initiative rather than wondering may be the way forward, opening up that crucial window of opportunity you have been waiting for. How? Susan Kersley explains


If you are someone who finds it difficult to say no, someone who won't consider going home until every possible task is done and more, then you need to ask whether you value yourself and your own needs enough. This is all about the balance between work and life.1 To have a balanced life you have to recognise that life is more than work, more than things you do for others—it's also about you and your needs. It's easy to be weighed down, not only by the challenges at work but also by the demands and expectations of people at home. Consider how much of your daily routine at work or at home you could delegate to others. Do you do things that someone else could do instead? It's no help to say that no one else can do them as well as you. Maybe that's so, or maybe it's not. You could teach the person to whom you delegate, then allow him or her to do it. Perhaps some of what you do could be stopped altogether or done more efficiently. What will you do just for you today, this week, this month?

How can you change things that seem to be overwhelming? Start by thinking about what you want, imagine what your life might be like if it was going well. Visualise your ideal life. Find a quiet place, perhaps listen to some peaceful music, and daydream. Imagine yourself in the life you wish for and notice with all your senses what is going on, how you are behaving, what you are saying, who you are relating to. See yourself, as though you are watching a video, actually in the life you want. Not only watch, but notice how you feel if life was going well for you. Experience those feelings as you imagine. After a while, open your eyes and before you forget write down what you thought about. You have the basis for working towards the life you imagined. The next step is to start to verbalise your dream. Talk to your colleagues, your friends, and your family about what you want. Discuss possible ways to make a start towards those things. Remember, however, that you know already what has to be done, by you, to start the process towards your ideal. Don't say “I couldn't do that because I know what so and so will say.” You don't know until you speak to them. And when you do speak to them always start by saying something complimentary. Follow this with the thing you want to ask (the “meat”), and then close the conversation by saying something nice again.2 The more you talk about how you would like it to be, the more you explore ways that you could begin to make it happen, the more likely it is to become reality.3


Do you spend too much time not doing anything because you have to make the right decision? Do you spend too much time wondering whether to do this or to do that? You can wonder forever, and nothing will change. The reality is this: you may or may not make the right decision. You will never know which it is until you try. The choice is about staying where you are (your comfort zone) even if it isn't what you want, or taking a big leap of faith into another place (your discomfort zone) with a chance, a possibility, it may be a great improvement. Life is full of uncertainties. Have you ever thought you planned for every eventuality and then something completely unexpected happened that altered everything? You may want to know the practical “back up,” just in case what you do doesn't work out. You may want to ask yourself, “What if... happens?” Ask yourself, “What if I don't do anything about this?”

Eventually, if you want to find a way forward you have to take that chance. You have to do something different and take action. You have to be like the bird pushed from its nest and trust that when you take that leap into the unknown, you will fly.

All the thinking about what you want and how you could achieve this is part of the process of preparation, so that you recognise that time when there is a window of opportunity to take the first step. When you are considering the pros and cons of what you want to do you may feel that you can't let colleagues down, so may want to wait until this or that is in place. Make sure that these considerations have a time limit; there probably will never be an ideal time. So set yourself a time limit for what you want to do and plan back from that. If you want to achieve something in six months what do you have to do by the end of this month? How do you have to prepare the “soil” for the change you want to experience? What seeds have to be sown now to germinate and blossom in the future?


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