Risk

When talking about having left my job to pursue a career in entrepreneurship, I often get a comment something like “oh, but not everyone is willing to take a risk like you did.”

A commonly held view of entrepreneurs is that they are risk taker. I’ve even heard some entrepreneurs boast about the risks they took, because they think that is what an entrepreneur is supposed to say.

I beg to differ. I believe that most entrepreneurs (at least the successful ones) are NOT risk takers.

(Fine print disclaimer:  this is obviously a generalization and there are exceptions to any rules).

How I Evaluated Risk

Lets take my story as a case in point.

I believe that my leaving the medical profession and embarking on an entrepreneurial adventure was the LOW RISK option for ME.

Yes, I left a stable, well paid, “prestigious” job.

Yes, I embarked on a path that was uncertain.

Looking at the Upside

The way I weighed the risk at the time is as follows:

(1) I don’t like my job.  In fact, I was existentially miserable. One of my main values is creativity and medicine doesn’t allow for that (apart from research, which I detest).  I was drawn to the creativity of entrepreneurship (creating something from nothing).

(2) As a specialist I would be in one of the top pay brackets, however my earning potential was capped at around about $200,000 per year and limited by my time.  To earn money I needed to expend my own time.  As an entrepreneur my earnings would be uncapped and could be divested from my own time. I wanted to be able to not have to work in order to support myself.

(3) Medicine didn’t challenge me, at least not in the right ways.  To succeed on the traditional path, you need to be good at rote learning, sitting down and memorizing thick text books.  As an entrepreneur, I had unlimited challenge.  My success was totally dependent on my own ingenuity.

So from the top 3 points above, its pretty clear the upside of being an entrepreneur:  I would be catering to my core values (creativity, achievement) and my earnings would be uncapped and potentially not linked to my own time.  So from the upside perspective, it was a no brainer.

The Downside…

What about the downside? This is critical to examine when weighing risk.

The downside of staying in medicine:  I would be miserable, always wondering “what if I had tried”, it would quash my sprit and my soul. Pretty dark.

The downside of failing at entrepreneurship:  I would lose my savings and would need to go back to work as doctor, one of the most highly paid professions.  I knew I would not be sleeping on the streets. (Although this wasn’t really an option for me – I knew that I had this as some theoretical backup, but my motto has always been that I “will succeed or die trying”).

So for me, staying in medicine was HIGH RISK (really!). Entrepreneurship was the low risk path for me, as far as my values and desires go.

I would say that successful entrepreneurs are actually very very shrewd at HEDGING risk.

I will often hear of successful entrepreneurs who are financially free testing new business ideas with very small amounts of cash.

Entrepreneurs are the ultimate hedgers. They actually look at risk very carefully and examine it critically.

Do you have any other examples? What do you think?

Leave a comment below.

Tony Robbins’ Morning Ritual

Tony Robbins, the “#1 Life and Business Strategist”, is one of the leaders in the field of personal development.  Love him or hate him, you can decide by trying some of his practices for yourself and see if they help you or not.  Below is a summary of his Morning Ritual which he does every day.

This morning ritual takes him only between 15 to 20 minutes.  He even does some parts of this during his morning walk. The overall purpose is “to wire [himself] for happiness.”

Morning Ritual #1 – The Cold Plunge

Tony jumps into a cold pool (13 degrees celcius / 56 degrees fahrenheit) for 60 seconds.

He says that there are physiologic benefits to this, but it seems his main focus is on the psychological.  “If I say I’m going to do something, I do it.”

Morning Ritual #2 – “Priming”

 

Explosive Breathing

I’ve found contradictory statements for how exactly Tony does his breathing exercise.

Perhaps the best source is on his website.

Breath in through the nose for 5 seconds.

Hold the breath for 20 seconds.

Exhale through mouth over 10 seconds.

Whatever the time you spend on each phase, he recommends a ratio of 1:4:2. (So if you breath in for 3 seconds, you should hold for 12 seconds, exhale over 6 seconds).

He repeats this cycle of inhale-hold-exhale 10 times.

 

Visualization / Mental Rehearsal

This next section takes 9 minutes, divided into 3 different exercises.  In the podcast Tony Robbins stated that he doesn’t meditate, but these are really forms of meditation.

Step 1: 3 minutes of gratitude

The idea of this exercise is to focus himself on emotions that will cause him to be a better version of himself.

According to Tony, two of the most detrimental emotions are Anger and Fear and he says that gratitude is the antidote to these emotions (“If you’re grateful you can’t be angry and you can’t be fearful”).

He thinks of 3 things that he is grateful for (which can eb people, situations, things).  He makes sure that he really steps INTO the image / scene, and “feels the moment”.

Importantly, he makes sure that at least 1 thing he’s grateful for is really simple. For example “the wind on my face” or “my child’s smile”.  He trains himself to appreciate the little beautiful moments of life.

To drive home the reason for this, he gives the example of astronauts who have been up in space, seen earth as a little ball and come back down to a ticker tape parade. They’ve reached the pinnacle of their lives at the young age of 32, where do they go from here? This was their lifelong pursuit – and they achieved it.  He says that many astronauts face have major emotional challenges when they get back, including alcohol & drug abuse. They thought that the only way to be happy was to go to the moon and along the way they forgot to find adventure in a smile.

Step 2: 3 Minutes of Blessings

Tony imagines life / light / god / energy pouring into body, healing everything along the way. Strengthening him physically.  Strengthening his passion, love, generosity, creativity & humour. He sees any problems he has just being solved.

He then extends this imagery to his circles of intimate family, friends , clients and sends them the same healing energy, imagining them getting what they need energy wise and being healed.

(This is kind of similar to Loving Kindness meditation from what I’m aware).

Step 3: 3 to Thrive

Tony visualizes 3 specific outcomes that matter to him. He SEES, FEELS and EXPERIENCES these outcomes as DONE, as if he has already accomplished these outcomes. He sees the impact that these outcomes have, how peoples’ lives are touched. He feels the joy of seeing this as done and the outcome it causes, he feels it as DONE in his bones and is grateful for it.

 

Source: 

The Tony Robbins Podcast – Episode 11.

Inspiration for further reading:

Loving Kindness Meditation

Wim Hof Method

 

 

The Evidence for Meditation

As you may know in a past life I was a medical doctor. And I am a meditator.  I’ve written previously about my own personal experiences with meditation, but I want to share here some cold hard scientific evidence for (and maybe against?) meditation, since these days medicine is all about the evidence.

I’ve reviewed A LOT of the research on meditation (particularly mindfulness meditation) to date.  I used a combination of Google Scholar searches and Pubmed searches to find studies. In particular I looked for meta-analyses, systematic reviews and randomized controlled trials, which are the strongest levels of evidence (not all “studies” are created equal). Also, the specific studies that I’m including below are mainly from highly reputable medical journals (again, not all “journals” are created equal, and since I’m not a scientific or statistical whizz I’m also relying that the editors of the journal have done a good job of weeding out questionable research).

You can read the Cliff’s Notes of the studies below as well as review the original literature, if you are so inclined.

For those of you who aren’t, here is a really quick summary of all the evidence to date:

(1) Meditation seems to have a relatively strong effect on emotional / psychological well being, especially related to improving feelings of stress, anxiety & depression (even as effective if not more so than anti-depressants and cognitive behavioural therapy?!).

(2) There might be some effect on cognitive functioning (for example, memory).

(2) Might increase positive emotion (not 100% clear).

(3) Some effect on physiological outcomes?  Doesn’t really effect pain itself, but can effect acceptance of pain and functioning with pain.

There is also some evidence that the benefits of meditation can be sustained (which I imagine would be significantly enhanced if the practice of meditation is continued beyond a one-time course or intervention) and surprisingly that even novice meditators can see significant effects, including potentially changes in the brain itself!

The psychological effects of meditation: A meta-analysis.

  • Medium-Large effect of meditation on emotional & relationship issues.
  • Medium effect on attention.
  • Small-Medium effect on cognition.
  • Interestingly, the experience level of the meditator had little impact on the results.

Fine Print:  Published in “Psychological Bulletin”, Reviewed 163 studies (excluded 432 studies), looked at healthy adults.

Meditation Programs for Psychological Stress and Well-being: A Systematic Review and Meta-analysis

  • Moderate effect on improved anxiety.
  • Moderate effect on improved depression*
  • Moderate effect on improved pain.
  • Low or No evidence for effect on positive emotion & attention.

*Interesting side note: from doing quick journal research related to the effectiveness of anti-depressant medication, up to 70% of the “effect” of the drug can be due to placebo (backed up by multiple meta-analyses). And even more crazily, a meta-analysis of anti-depressants vs placebo found that anti-depressants for mild to moderate and even severe depression fell below the threshold definition for a “small effect”! (Anti-depressants showed a small to moderate effect on patients in the “very severe depression” group).

I’m not an expert at statistics, but this evidence would seem to show that for depression defined as mild to severe meditation is MORE EFFECTIVE than anti-depressants! Put that in your pipe and smoke it!

Fine Print:  Published in “The Journal of the American Medical Association / Internal Medicine”, included 47 trials (Randomized Controlled Trials) with 3515 participants, looked at adults with any medical condition.

Mindfulness-based therapy: A comprehensive meta-analysis

  • Large effect on anxiety.
  • Moderate effect on depression.
  • These effects held quite strongly at follow-up (follow up duration varied significantly between studies).
  • In studies which compared meditation to cognitive behavioural therapy (CBT) there was little to no difference in effect.

Fine Print:  Published in “Clinical Psychology Review”.  Reviewed 209 studies with 12,145 participants.

Is meditation associated with altered brain structure? A systematic review and meta-analysis of morphometric neuroimaging in meditation practitioners

  • Found 8 brain regions consistently altered in meditators with small effect size.
  • These included areas associated with meta-awareness, body awareness, memory consolidation, self and emotional regulation & inter/intra hemispheric communication.
  • There is some evidence that even very few hours of practice are required to show some initial changes in the brain.
  • Concluded that “any firm claims about whether meditation truly causes differences in brain structure are still premature.”

Fine Print: Published in “Neuroscience and Biobehavioral Reviews”. Reviewed 21 studies with 300 meditation practitioners.

Effect of kindness-based meditation on health and well-being: A systematic review and meta-analysis.

  • Moderately effective at reducing depression.
  • Moderately effective at increasing mindfulness, compassion, self-compassion.
  • Moderately effective at increasing positive emotion.

Fine Print:  Published in “Journal of Consulting and Clinical Psychology”. Reviewed 22 studies.

Sitting-Meditation Interventions Among Youth: A Review of Treatment Efficacy

  • Meditation amongst both youth and adults has overall small-medium effect size on a wide variety of health related outcomes.
  • Psychological / Behavioural outcomes show moderate-large effect, while physiologic outcomes showed small-moderate effect.

Fine Print:  Published in “Paediatrics”, Reviewed studies involving youth 18 years and younger.

Mindfulness meditation for younger breast cancer survivors: A randomized controlled trial

  • Significant reduction in perceived stress.
  • Did not show statistically significant effect on depressive symptoms.
  • Significant reductions in pro-inflammatory gene expression & inflammatory signaling (WOW!)
  • Statistically significant reduction of fatigue, sleep disturbance, and vasomotor symptoms and increased peace and meaning and positive affect.
  • Intervention effects on psychological and behavioral measures were NOT maintained at three-month follow-up.

Fine Print: Published in “Cancer”. Randomized Controlled Trial involving 71 women who were diagnosed with breast cancer at or before the age of 50.

Mindfulness meditation for the treatment of chronic low back pain in older adults: A randomized controlled pilot study

  • Statistically significant improvement in “Pain Acceptance” and physical function.

Fine Print: Published in “Pain”. 37 adults aged over 65 with chronic lower back pain.

A randomized controlled trial of mindfulness meditation versus relaxation training: Effects on distress, positive states of mind, rumination, and distraction

  • Both meditation and relaxation groups experienced significant decreases in distress as well as increases in positive mood states over time, compared with the control group.
  • Meditation showed a larger effect size on positive states of mind than relaxation.
  • The meditation group also demonstrated significant decreases in both distractive and ruminative thoughts/behaviors compared with the control group (stronger for ruminative thoughts).

Fine Print: Published in “Annals of Behavioral Medicine”. Involved 83 students (mostly female) who reported psychological distress.

Effects of mindfulness meditation on chronic pain: a randomized controlled trial.

  • Moderate effect on “vitality scale”.
  • Medium to large size effect on anxiety and depression, better psychological well being and acceptance of pain.
  • Non-significant effect on pain measures.

Fine Print: Published in “Pain Medicine”.  109 patients with nonspecific chronic pain.

Summary

The research to date shows that meditation seems to be effective at treating depression, stress and anxiety. It can also have an effect on better coping and functioning with pain as well as some evidence for improving cognitive functioning.

While its important to have a look at the scientific evidence, in the end you need to run an experiment on yourself to see if you feel better as a result of meditating, or not.  I found in my life it is extremely helpful and I definitely recommend that you give it a go.

Do you have any other thoughts or experiences about meditation and the evidence for it?

Let me know what you think in the comments below!

 

Further Reading:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4471252/ – this article is quite interesting especially in explaining the different type of meditation practices.

http://marc.ucla.edu/ – mindfulness / meditation program used in one of the studies above.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4630307/ – study on Loving Kindness Meditation.

http://www.ncbi.nlm.nih.gov/pubmed/23541163 – RCT study on effect of meditation on Generalized Anxiety Disorder.

http://www.ncbi.nlm.nih.gov/pubmed/17266067 – “Mindfulness meditation alleviates depressive symptoms in women with fibromyalgia”.