Sunday, September 8, 2019

Short of Time? How to Help Ourselves

Shankar Vedatam, the host of NPR Hidden Brain podcast, recently discussed the Scarcity Mindset in the episode entitled Tunnel Vision. Vedatam discussed three scenarios of scarcity: time, food, money.  In each case, the individuals responded in the same predictable way: becoming fixated on the resource that was scarce and failing to consider larger strategies that would help us out of the situation. Whether we are a busy person short of time, a starving person searching for food, or a poor person lacking money, all three scenarios lead us into a tunnel vision (scarcity mindset). The podcast resonated with me because the scarcity of time is an epidemic for professionals like myself who balance clinical, education, and research duties while trying to maintain a work-life integration. Over the past two years, as an assistant professor, I found myself in a quandary. I tried various life hacks, tips & tricks to become more efficient while at the same time trying to figure out what to focus on and let go. In this blog, I explore the forces that shape our time and the negative effects of the scarcity mindset. Lastly, I review strategies that have been studied and tested that work to curb the negative effects while accomplishing our goals. 


When we are in a scarcity mindset, our minds shift our attention to attaining the resource of interest and thereby, we commit two fallacies that damage us even more:

  1. Attentional Neglect: forgetting about less pressing issues
  2. Borrowing: We borrow to meet at immediate need while failing to recognize the costs 

For example, if we have a paper due, we’ll focus on our attention on the paper and forget about the lecture the following week. Many times, we’ll ask for an extension or “borrow” time from our personal/family time. Over time, these “loans” snowball and can lead to dire outcomes (e.g. strained relationship, distance with children, deprived social life). Yet, at the time we take these loans, we can only think about the benefit to address the immediate need and often fail to recognize the cost (e.g. divorce, arguments, etc). In the same way, the same justification leads poor people to borrow at unreasonably higher interest rates (upwards of 800% interest). We may be quick to judge a poor person to taking high-interest loans, yet fail to acknowledge the same dynamics drive the choices we make when we are short of time, and subsequently take loans from the time with our loved ones. If we are constrained, some argue it is better to do the best we can rather than take loans. Shah et al demonstrated that subjects with a scarcity mindset who did not have the option to borrow fared better than those who had the option to borrow. In the study, subjects with a scarcity mindset (who could not borrow) scored more points on a game than those who could borrow. The inability to borrow forced individuals to focus on the task at hand and effectively allocate resources to achieve the outcome compared to subjects who had to option to borrow resources and scored fewer points. So, if we’re short of time and we have an upcoming deadline, the best course is to focus on the project to meet the deadline because we’ll be more resource-efficient and effective with the fixed time. But this is not the long-term solution. 


Why is scarcity mindset so devasting? People with a scarcity mindset had worse emotional and cognitive states than those with an abundant mindset. Huijsmans et al(Huijsmans et al. 2019) found that people in the scarcity mindset reported more stress and lower confidence than those in an abundance mindset.  Lower confidence may hold back people from making bold decisions, taking risks and being more creative. This fear precludes us from opportunities and breakthroughs which would otherwise improve our circumstances. In addition, Shah et al found that people with a scarce mindset spend more energy, performed worse, and become cognitively fatigued faster than those with an abundant mindset. “Cognitive overload” explains the worse performance. Cognitive overload is a state of mind when our attention is wholly focused on the resource, and as a result, we cannot process other concurrent needs. For example,  let’s consider our internet bandwidth. When we’re downloading a large file and it’s consuming most of the download speed, the computer cannot download anything else because there is no bandwidth. In a scarcity mindset, we suffer both psychological stress and cognitive decline. Remember, this is all driven by our mindset. Our minds have become our own roadblocks to progress.
The mechanism of these behaviors was mapped to specific brain regions. Huijsmans et al assessed the neural activities of subjects artificially placed in a scarcity vs abundance mindset using functional MRI and found that scarcity mindsets increased brain activities in regions of valuation and decreased regions of the brain associated with goal-directed decision making. Individuals with a scarcity mindset focused more on immediate needs and less on higher-order planning. 


How can we help ourselves and keep ourselves from entering the tunnel vision of the scarcity mindset? Fernbach et al discussed two strategies that people employ when constrained: 
  1. Prioritization planning: focus on important tasks and let go of less important tasks, which requires us to trade off one goal for another. 
  2. Efficiency planning: stretch out the resources. For example, if we’re short of time, we may consolidate all of our shopping trips into one trip instead of multiple trips to save us time. Another example is coupon clippers who clip coupons at the expense of their time to save money. 
Fernbach observed that people often react with a mix of both. However, prioritization leaves us feeling bad because we are not able to have everything we want while efficiency requires more time and energy. Fernbach gives an example of packing. If we’re going on an international trip and we have to pack a large suitcase, we’ll pack all our items without thinking. If we were told we only have one carry-on suitcase for the same trip, we will be more mindful of what we pack. We may exchange our gym clothes for an umbrella (priority planning) which feels like a loss and/or we may consider packing more efficiency (stuffing our charger into our socks) which requires time and effort. Priority planning requires us to step back and think about what’s important to us while efficiency planning is trading one resource for another.  

In the study, Ferbach found that subjects prefer to employ efficiency planing over prioritization. With efficiency plans, subjects felt like they were not giving up the original goals; in fact, subjects felt efficiency plans was free, but took more time and thought. Overall, subjects reported they accomplished the desired outcomes more and had more savings compared to subjects employing priority plans. The findings suggest that we prefer to trade one resource for another (e.g. more of our time to stuff charger in our socks) rather than tradeoff priorities (e.g. pack our shoes in place of an umbrella).

But efficiency planning only works so far. When our resources are severely constrained (e.g. we have a lot less time than we predicted), then prioritization become critical. Going back to the packing example, if we were given only a handbag to carry on the plane instead of a carry-on, we would pack only our passport and money (and leave behind our clothes). The impact of the strategy employ also depended on how frequently the event would be repeated. Efficient planner rated higher savings than prioritization planners with repeated events compared to one-time events. For example, as a medical student radiology director, I give on average about 12 hours of lectures per clerkship rotation. I can record these lectures for offline use which will take up a lot more time initially, but on the longer term, it will save me time with each class of students that come through.  This would be an example of an efficiency plan saving me more time in the long run. In contrast, I can choose between attending a family wedding or an important radiology conference. For one-time events, priority planning (e.g. attending an important family event) has higher gains for me than trying to do both through efficiency planning. Typically, the outcome of priority planning will differ more from original intention compared to an outcome from efficiency planning.
However,  both strategies are limited and are often insufficient. Fernbach found that people who employed efficiency plans often were late to prioritize when the resource became even more limited. In fact, people started to react dysfunctionally when resource limitation became dire. Dysfunctional responses manifested in two ways: “what the hell” effect and “choking” under pressure.  In other words, people responded by either quickly moving through our tasks (and not be effective or performed with poor quality) or people became demoralized and give up altogether when our efforts seem fruitless. When people employ prioritization and efficiency planning strategies, they react dysfunctionally when the stakes were higher (e.g. less time, less money, less food).

Instead,  Fernbach recommends resource budgeting before consumption. Budgeting is a form of priority planning that can avoid dysfunctional behaviors while maximizing desired outcomes. Budgeting (with planning ahead & resource allocation) work through the following mechanism:
  1. Decrease ambiguity about what needs to be accomplished
  2. Gives a mental reference point to track one’s performance
  3. Provides clarity of the budget (“implementation intention”) and hence, we're more likely to follow through when cued.
  4. Enable consistency. When we pre-commit resources, we are motivated for internal consistency between planned and executed behaviors

Fernbach found that budgeting before consumption has twofold effects:
  1. Increase prioritization behavior 
  2. Decrease dysfunctional behavior
When subjects were told to plan (budget) their time to maximize the most points in the game, they performed significantly better compared to the group who not plan ahead. Subjects shift their strategies to prioritization over efficiency when told to budget/plan compared to the control group. When subjects carried out the tasks, subjects were more efficient. Even more, budgeting impact was far more impactful for subjects who were more constrained with the resource. For high-level professionals who are highly constrained for time and resources (balance patient care with academic responsibilities and family needs), pre-planning plays an even more critical role.

As a junior faculty over the past two years, I have come to realize the most important aspect of staying in control is planning. Early on, I accepted projects and proposals without thinking about how it fits into my schedule, responsibilities and pre-existing commitments. Recently, I tallied up hours I spend on educational, academic and committee efforts and discovered my non-clinical responsibilities probably accounted for 50% academic time (my actual time allotted was 20%). I was constantly borrowing from my personal and family time. I enumerated the hours I spent on meeting with medical students, research projects, services related duties and discovered a major discrepancy between my actual vs. the time I had. Going forward, I dedicate two days of the month for service-related activities & meetings (10%), and two days for research activities (10%). I also implemented an organization software (Microsoft OneNote) to track all my projects and log the time allotted and how I compared to what my target is. I spend 4-5 hours per week on planning activities. Going through these planning exercises has made it easier for me to determine how new projects would fit in with my current schedule, helped me identify potential conflicts in my schedule and improved how I triage new projects/ideas.

In conclusion, we are all short of something (e.g time, money, space, etc) and it’s very easy to fall into a scarcity mindset when we become fixated on the resource we are lacking. A scarcity mindset sets us down a negative spiral that only exacerbates our conditions. Budgeting our resources (e.g. time, money, etc) will allow us to avoid a scarcity mindset and accomplish our desired outcome by helping us prioritize more effectively and allocate resources more efficiently.

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