In this episode of the Wellbeing for Real Life podcast Dr Richard Pile and Dr Wendy Molefi talk about the importance of having a sense of purpose and meaning in life, whether it's considering for themselves or their patients. They discuss the evidence for purpose and faith being good for our health, the concept of ikigai ("reason for being") and how we might introduce the concept into our conversations, personally or professionally.
A video version of this episode is available on YouTube.
Richard is a GP specialising in Cardiology and Lifestyle Medicine, and author of "Fit For Purpose: your guide to health, wellbeing and living a meaningful life". Wendy is a GP specialising in Mindfulness. You can find out more about Richard here and Wendy here.
Fit For Purpose is available from Harper Inspire in paperback, e-book and audiobook format, with Richard reading the audio himself. Find out more here. This podcast has been produced the brilliant team at Monkeynut Audiobooks.
Richard Pile 0:01
Welcome to the wellbeing for real life podcast. Have you ever wanted to live life better, but found yourself baffled bewildered and bored by complicated, confusing and condescending advice? This podcast is the antidote. I'm Dr. Richard Pile: G, lifestyle medicine specialist, and author of Fit for Purpose. Each episode, I'm joined by leading experts, as we explore different areas that affect our everyday lives. This is the wellbeing for real life podcast. Hello and welcome to wellbeing for real life. My name is Dr. Richard Pile and I'm a GP with a special interest in cardiovascular and lifestyle medicine. In today's episode we're talking about purpose and meaning. I'm pleased to say on the show today we have the return of my friend and colleague, Dr. Wendy Murphy.
Wendy Molefi 0:52
Hello Richard. Thank you for having me,
Richard Pile 0:54
Just in case people haven't heard you speak before, could you tell us a little bit about yourself?
Wendy Molefi 0:58
Of course. My name is Wendy Molefi. I'm a portfolio GP, so that means I combine my skills as a GP with other interests such as well being coaching as well as mindfulness teaching so I run courses and mindfulness, and I coach people.
Richard Pile 1:15
So again, an excellent person to have on this particular podcast. One of the things we like to do on the podcast is to is to keep it personal, as well as practical. So I'm going to start by putting you slightly on the spot, and asking you, from your perspective, what you might see as your purpose, or one of your purposes in life.
Wendy Molefi 1:37
That's a deep thought to start with...just dive right in! Okay, so what is my purpose in life, purpose and meaning? Well, it's interesting it's a very interesting question and it's something we're talking a lot more about these kind of things and it's something that comes up as well, in my coaching practice but came back to me. In terms of my own purpose in life. Yes, it has evolved in the past, certainly as I was navigating life and, you know, marriage, children. Good job. So my purpose was to be a good mom, a good doctor a good partner. I don't think things have changed so much from that, but I think over the last few years, it has become even more refined, in the sense that there's a more of a sense of just whatever it is that I put my heart into and want to do it to the best of my ability. Being a mum still be a good doctor which I thoroughly enjoy and be a good partner. So my purpose in life is really to be a good person cliche as it may sound, but be good and give the best that I can, in whatever I put my heart into. Yeah. Does that make sense? That's how it kind of feels like coming out,
Richard Pile 3:19
It does make sense. Absolutely. And of course, in asking you that question, I was kind of putting you on the spot. I doubt there are many people who have one purpose in life, and you've described quite a few purposes, which I guess takes quite a lot of balancing, to try and do and be all those different things.
Wendy Molefi 3:35
That's interesting because it seems like it, but I think over time I have learned to sort of dance together in some sort of harmony if you like they complement each other. I realised that it doesn't have to be this, that or the other. All these things, perhaps I'm not quite finding the right word for it, but I just feel they complement what my meaning of life is what drives me in life, you do like that. Before you jump in now you tell me, Richard, what what is your purpose in life, do you think?
Richard Pile 4:16
Well I deserve that don't I? think I would start a little bit similar to you in that purpose changes over time. And one stage in my life purpose was probably just getting to the end of the day when my oldest was at home with us, and his epilepsy was very severe and going to the end of the day andd all still being intact and holding it together was one purpose, and thankfully life has got easier and better for all of us since then. I would say at the moment, while you'll be unsurprised to hear that actually one of my purposes at the moment is really to try and spread this message that about what it means to be really well. Yes, and the fact that we need to look at the big picture, and that is very much more than just medicine. And I want to share that with not just my colleagues but also my patients as well. Another particular aspect of that, and speaking as a person of faith as well , I think it's important that we talk about belief and spirituality, and how that can for some of us, if not all of us, be an important part of the meaning that we take from life as well. So I suppose right now those are two of the things that are preoccupying me and my wife has commented on the fact that I need to be careful that I don't spend so much time pursuing those purposes that I can't balance all the other things, I'm still a father, I'm still a husband, my kids make music and we're in a band together and obviously if they break America that they will change my purposes.
Wendy Molefi 5:46
Don't forget your friends!
Richard Pile 5:49
My accountant says that doesn't constitute a retirement plan so I'm keeping open mind. We're going back to the subject of purpose in life. Is that a conversation that you often have with your patients or clients?
Wendy Molefi 6:03
Now that's food for thought. Certainly, as a GP, because as you will know the 10 minutes appointment, and more often than not the specific thing to think about, but I think, increasingly, with all these lifestyle related problems, which more often than not stem from stress and psychological issues, there's an opportunity sometimes, not always, I'll be honest, but there's often an opportunity to kind of bring up an element of finding out a bit more about the patient's life. Their philosophy of life. Not as much as I'd like to, but as a coach, you know, as a well being coach that forms the core of the conversation. Exactly, as highlighted at the beginning, whereby I establish the patient , my clients, meaning of life: their values, their whole philosophy. To just see, then, where, how, I can navigate the whole coaching process with them. So it's something that I think is increasingly being used and I certainly as a coach I do use it a lot more.
Richard Pile 7:24
And it certainly seems to me, instinctively to be something that's important. I think there is also increasingly evidence for it which we can get onto in a few minutes but one of the things that I was just thinking about as you were describing that was was the importance of knowing the whole patient. And if I'm really honest when I first started as a wet behind the ears, young, ambitious, probably slightly cocky GP, I probably wasn't as invested in that side of things, I had the model of the consultation in my head, and the boxes that I had to tick and the areas that to be honest I wasn't particularly interested in exploring because that was going to make the consultation very messy and long, and I was going to run late, and it wasn't my job as far as I was concerned to talk about that. But actually, even though there are days when I'm still very pragmatic and don't spend time longer than I have to on a simple consultation, I think increasingly I've seen over 20 years that that's in some ways it's a bit of a false economy, because if you don't understand someone, then that will seriously limit your therapeutic effectiveness as a doctor, even if actually it's not your job be a therapist and the patient really needs to be their own therapy, you need to know them you need to understand them in order to be able to have those conversations and if you're talking at cross purposes, if you have completely different ways of doing life, you either have to find a way to work around it, or at least acknowledge that it exists and and manage it.
Wendy Molefi 8:59
Yeah, and I couldn't agree more. In the sense that we are better placed I guess as primary care doctors to initiate those kind of conversations to be on the lookout, to be able to bring them up. And have you noticed also that, oh, well certainly from my point of view, they tend to be the most rewarding kind of conversations once you've had that sort of consultation, when you explored a little bit more, asked the patient to those kind of intuitive meaningful questions, there's something that moves for me and for the patient, there's a certain connection that then comes out from there when you have those kind of conversations. And it's all very interesting, actually all this purpose in life and having conversations like this but I was also thinking about, is there any evidence that underpins it? I don't know have you come across any.
Richard Pile 9:56
I have been doing a lot of digging in the course of writing my book, and I was pleased to find that what I kind of instinctively thought was probably true does seem to be actually true. Now, there are some caveats here so we don't necessarily have the large scale trials of purpose and meaning in life that we would have for trialling a new medication for diabetes or a cholesterol lowering medication, but there's lots of data out there where that's been looked at in terms of questionnaires and prospective studies and asking people about their life and getting them to rate their sense of purpose and meaning in life and looking at the correlation in we can't necessarily say it's causation but in association with their health and well being. And there are some really interesting findings. We know for example that if you've already had a heart attack or been diagnosed with coronary artery disease, having a score rating yourself highly in terms of purpose in life, significantly reduces your risk of having a further heart attack. Did you know that if you are generally an older person having a higher sense of purpose in life reduces your risk of stroke and of dementia, of cognitive decline. In fact, it's been shown to reduce the risk of an early death from all different causes by having a sense of purpose and meaning. There's enough there I think to really make it an important part of the conversation, and I personally believe out of all the pillars that we talked about in this podcast that actually it may not be sleep and movement and nutrition or connection but probably purpose and meaning in life may well be some of the biggest determining factors which I think is a real challenge for us because those of us who are doctors, we weren't trained to deal with that.
Wendy Molefi 11:38
Yeah, definitely not. Our training doesn't equip us with some of these skills but fortunately, most of us do try and educate ourselves and through life's experiences, we are enlightened, for want of a better word, and we become more interested in these things and, yeah, like you're saying, We don't always have the time to do that, but it's just about having it at the back of one's mind to be open to that conversation. It's really interesting what you just highlighted in terms of research because as clinicians, we're very much driven by knowing that what we share with our patients is underpinned by some form of evidence based medicine study so it's reassuring, from my point of view to hear that we are onto something,
Richard Pile 12:34
I think, in a subset of that evidence that there's a really interesting conversation to be had about faith and belief as well. Now, I should be clear, obviously you can have purpose in life, whether or not you identify yourself as a religious person or a non religious person, but there have also been quite a lot of studies done into looking at the importance of faith when it comes to health outcomes. And certainly there's plenty of evidence out there that shows for example, better coping mechanisms and adapting to long term conditions and serious illnesses or even increased longevity for example in patients with HIV, and reducing again the risk of dying from any cause for people who identify themselves as religious. But interestingly, there are different degrees to which it helps you. There was a big meta analysis done or reviewed by a think tank called Theos and they found that the more deeply-held and regularly-practiced your faith, the greater the impact it had on your sense of well being. If you practice in a community, you were even more likely to do better and of course that's not a surprise based on our previous conversation about connections. But what was interesting was that just identifying yourself as having a belief and saying this is my label, this is my badge I'm a Roman Catholic I'm a Muslim I'm Jewish, if that was just how you normally identified yourself that didn't make any difference at all. And it was how you lived your life and how it affected you that made the difference.
Wendy Molefi 14:01
Absolutely that set of guiding principles, not, I guess, feeds into that common humanity within your community, that induce that sense of connection and gives meaning to life back to purpose.
Richard Pile 14:20
So I suppose the question I would ask you then is: how would you broach that subject with a patient? Let's say that it's somebody that you know well enough. You've maybe had a conversation in the past where they're open to that. I think the challenge for us as doctors is how we address that, whilst not breaking any codes of conduct, not making people feel uncomfortable, not making people feel worried that we might in some way be discriminating against them depending on our own personal philosophies. What sort of conversations do you have around that?
Wendy Molefi 14:52
I guess it's about our own meanings of life, our own sense of spirituality, how we bring it in. It's not always an easy thing to do. I mean I will admit, in the sense that there's always those time constraints, and there's always not wanting to cross lines as well. It's not something that I find easy but sometimes I think as I mentioned at the beginning that when you have that kind of connection with your patient, as we often do as primary care doctors, you know when to talk about certain things because there's times when I've talked with worried mothers whereby I'll allude to my own motherhood issues my own issues with children, and that is reassuring to our patients actually when you share those kind of personal stories and for me it will be honest kind of sharing with patients. So in a sense sometimes if I feel somebody feels stuck, or maybe when I'm stuck and I don't know how to particularly guide them, I just have to just open up the question in terms of what do we think this means, and just see what it opens up and just be tentative about my own thoughts. Especially knowing that this is underpinned by some evidence, it's always a good one or useful one to say actually, the evidence shows us that if you're a member of a community in there some sort of shared commonality, part of a tribe, it improves your sense of well being. And then you try to explore: are you a member of a club? What do you do in your spare time? And then start guiding them. We've already mentioned things like social prescribing and just exploring whether the patient is open to those kind of ideas and nurturing that conversation over time, because we can. You can just explore it all the time. I think that's my thinking. It's a difficult one, I don't know how you would explore it?
Richard Pile 17:09
I think in some of the ways you just described, I thought you gave a nice example of being able to share your experience of motherhood. And I think it's interesting if you think about it. If as a doctor you've discovered an amazing way of getting to sleep, or a really good way of eating, or a brand new form of activity that you absolutely loved, I think most of us would feel very happy to share that with our patients. And yet there is that awkwardness over sharing personal philosophies or religious beliefs, which it it has helped us I don't think it seems logical to do that. So I think you're right, it's about listening and asking questions. If you feel someone is in the right place and they want to talk about it. And also, of course, it doesn't require you as a doctor or healthcare professional to have any particular faith or religious belief. The reality is we all have ways of doing life. Some of us may describe ourselves as belonging to a particular group, others may not. We can at least ask the question, because someone might say, "actually I used to belong to this group, or this faith community, which was really helpful but then I drifted away or I fell out with them or I had an upset in my life that that interrupted it or with the pandemic it has been difficult in the last 12 months." And we can then ask them questions about whether that's something they'd like to explore again, whether it's something they could take comfort from if they'd been bereaved would they like the visit from their rabbi or their or their vicar or someone else, even a humanist chaplain or someone who could support them? I think a good non-religious way of looking at it which I think people might find more comfortable, is the concept of Ikigai. I don't know if that's something that you've come across?
Wendy Molefi 18:48
Tell me more. I can see your eyes light up!
Richard Pile 18:52
It's the only picture in my entire book actually, the ikigai diagram. So, ikigai crudely translated is a Japanese word that means "reason for being" (not an exact translation but thereabouts) and if you type in "ikigai" into Google, you will tend to get a bog standard diagram, which has what you love, what you're good at, what the world needs and what you can get paid for. And if you imagine that as a sort of Venn diagram with those four different circles, the very simplistic concept is if you can have things in your life where those all four circles meet in the middle, then that's the sweet spot you've "found your ikigai" as it were. Now, it's a bit simplistic. It's not true to the original Japanese concept, as you can see if you look at the diagram in my book, but that in itself also talks about things like hobbies, passions creativity relationships. And I think, talking to people about, you know, "what is it that you enjoy in life? What is it that you are good at? Oh, it just so happens that, that's what you do for a job, brilliant, what happens is actually you really hate your job and you don't do that as your life you do that as your work, but it's not ticking any of the boxes in any of the other three areas?" So for example, is there a place for a conversation about whether employment is the right thing. Now I know it's a pandemic, people are going to be facing difficulties, there will be more unemployment but you and I both know that we've seen lots of people over the years who keep coming to us with depression, who keep getting signed off. The real problem is that they need to change their job, or at least some of their roles in life,
Wendy Molefi 20:27
Or even their attitude towards it. Yeah,
Richard Pile 20:31
Exactly. And I think sometimes being able to frame it, you talked about reframing In our previous episode, being able to reframe it and looking at it in a different way can be helpful to some people. I encourage people to go away and think about that, because that's a neutral way of looking at it. I say to them "look, you know, you might not find something, one area of your life that all of those different areas are perfect, but you may find that between what you do and what you get paid for, and what you love about and what you volunteer for in your spare time, that that gives you enough. And maybe you just need to tweak that balance a bit a bit more of something a bit less of something else".
Wendy Molefi 21:11
I think that's really true Richard and something that you said earlier on as well. it's also about, I think it's an opportunity to explore all these other aspects of life that we've talked about in terms of that sense of contentment how people can have that sense of contentment, so that there isn't this need to be doing a million and one things, which, lo and behold, a stress comes knocking on the door or other issues. So it's just about finding that balance, that life balance. I think we talked about constantly isolating things that are just part of life, how you relate to life in a way that fulfils you. So I don't know if you have any little snippets that we can sort of put together and share in terms of how do we cultivate date our purpose and meaning in life?
Richard Pile 22:17
I think it sounds like we're heading towards a Top Tips section of this podcast, doesn't it? So to start off, I would say, think about your ikigai. Actually there's a second part to that so I'm cheating slightly I'm putting two tips into one. I think, take a step back. Purpose and meaning is one of those things, that's very easy to never think about if we don't give ourselves time, because life is busy, and I appreciate different people are in different circumstances, and have lives which are much more difficult and stressful than mine on some levels, but actually setting aside that time to contemplate what is it that fulfils me in life? what do I take great joy from? What do I really not like? Have I got any room that, in terms of manoeuvre there? That will only happen if you give yourself the time so I talk to people about taking themselves on a retreat. Now to some of us a retreat might conjure up an image of wearing a robe and sitting on top of a mountain, which will be great if you can do that, when when travel restrictions permit, but actually it needn't be a week's retreat. It needn't even be a whole day off a week if you can't afford that. It could just be five minutes a day. It might be better if it's half an hour or an hour a week where you just have that time for yourself. If you live alone, you may have some control over that. If you've got a partner and you got a family, you can have a conversation with them about how that time could be protected. Regard it as an investment. You could tell your other half your children, your work colleagues whatever that what a lovely human, what a more lovely human being, you're likely to be as a result of having had time to take stock and then from that think about those areas using an ikigai-type model, and ask yourself if there are there any obvious things that spring to mind. Those would be a couple of things that I would suggest. Can I turn that around and ask you?
Wendy Molefi 24:05
Of course you can , I knew that was coming. I was just thinking it's always important also to just ensure that the basics are taken care of. I think we all know about before Maslow's hierarchy of needs, you know, the sleep, the food, rest, and all the fundamentals. Taking care of security, relationships: all that is taken care of. And before you start as part of the whole process of contemplating this whole process of what does life mean, what is my purpose in life - that sense of self actualization - is it worth it? And I take it even a step further, because sometimes more often than not, there's this sense of, it then becomes selfish, it becomes about you. It should just be broadened, I think, from my point of view, anyway, but then it needs to include others around you. One's sense of purpose, shouldn't always necessarily be just around themselves. I guess it starts from that inner wisdom but it should take into consideration the co-dependence, core relationships that we have with others around us. I think that adds that extra layer of meaning to it.
Richard Pile 25:27
Absolutely. I think thinking more about "we" than just "I" is important and going back to your comment about Maslow's hierarchy, I think that if we don't ever consider the tip of the pyramid, as it were, the self actualization the transcendence (and transcendence, typically is a term which includes things like helping others, in areas of science and faith) if we don't consider that then we're potentially limiting the amount of enjoyment, we can get out of life. Now some might say, well that's, that's fine I'm happy to live my life without ever getting to the top of the mountain. And I know it isn't as simple as that about getting to the top and staying there but actually it is a real extra dimension to our, to our lives that I think can be so enhancing if it's something that we're just able to give ourselves a bit of time to think about.
Wendy Molefi 26:10
One thing I really want to get in quickly as well in all this, although we mentioned in other podcast episodes, is just that sense of kindness and compassion towards ourselves because along with this whole search for meaning and purpose we don't always get it right. We will stumble and fall. It's about knowing that we can get up but getting up with that sense of a beginner's mind, being kind to ourselves, being compassionate to ourselves, which actually, in turn makes it easier for us to be kinder to other people.
Richard Pile 26:40
That is a very positive, and appropriate note to end the podcast on, Wendy. Thank you very very much for your time today I really enjoyed our conversation.
Wendy Molefi 26:47
Richard Pile 26:48
I hope that our listeners have at least as much as we have, and I look forward to speaking together again soon,
Wendy Molefi 26:53
Of course, take care.
Richard Pile 26:56
You've been listening to well being for real life with me, Dr Richard Pile. If you've enjoyed this episode, please give it a nice review and tell other people about it. If you'd like to learn more, my book "Fit for Purpose" is out now, published by Harper inspire and available in paperback ebook and audiobook. You can also follow me on Twitter, YouTube, and my website "wellbeingforereal.life". This podcast was recorded at Monkeynut Audio books. Until next time, Take care of yourself.