Not every struggle means try harder. Sometimes effort is the enemy.
I once tried to force a procedure.
I will not go into clinical detail because the patient deserves her privacy, but the relevant detail is this: the access was difficult, the anatomy was unfavorable, and after fifteen minutes of skilled and appropriate effort I had made no progress. The correct move at that point, the move the evidence supported and the senior cardiologist would have made without hesitation, was to pause, reassess, and consider an alternative approach. I know this. I knew it then.
I tried again. More effort. Different angle, same energy, same fundamental assumption that harder would eventually become successful. It did not. We eventually resolved the situation by the alternative approach that should have been taken twenty minutes earlier. The patient was fine. My ego required a brief and private recovery period.
I tell this story because it is the cardiologist version of a universal problem. The default of the achiever, the controller, the person who has been rewarded by effort their entire life, is to apply more effort when the current effort is not working. This default is so thoroughly embedded that it does not feel like a default. It feels like virtue. It feels like not giving up. It feels like the right thing to do, which is, in many circumstances, precisely what it is.
Except when it is not.
Tara Brach, the psychologist and meditation teacher, has written about what she calls “the trance of unworthiness”: the state in which a person is perpetually striving toward a sense of adequacy that the striving itself prevents from arriving (Brach 2003, Radical Acceptance, Bantam Books). Her argument is not anti-effort. Her argument is that there is a quality of effort that is actually self-erasure wearing the costume of self-improvement, and that this quality of effort produces diminishing returns precisely because it is driven by the conviction that the current self is not adequate to the task. You strain harder because you are convinced the adequate version of you is somewhere just beyond the next achievement. The adequate version never arrives. The straining never stops.
This is rated Early on the Honesty Scale: Brach’s framework is primarily clinical-philosophical rather than experimental, and the empirical support for the specific “trance of unworthiness” construct is limited. However, the paradoxical intention literature in psychology, which is experimentally better grounded, supports the related principle that certain attempts to force a state can reliably produce the opposite state (Seltzer 1986, Paradoxical Strategies in Psychotherapy, Jossey-Bass). The best-known example is sleep: trying harder to fall asleep is one of the most reliable ways to remain awake. The effort activates the very alert system whose deactivation is required for sleep to occur.
In the laboratory of my own clinical life, I have observed several domains where more effort reliably produces worse outcomes.
The first is in patient communication. When a patient is resistant to a lifestyle change that I, as their cardiologist, know to be necessary, the instinct is to present more information more persuasively. More evidence. More urgency. Better explanation. The data on motivational interviewing, which has been replicated across many clinical contexts, suggests something uncomfortable: that the physician’s effort to convince often entrenches the patient’s resistance, while the physician’s effort to understand the patient’s ambivalence consistently produces more behavior change than persuasion does (Miller and Rollnick 2013, Motivational Interviewing, Guilford Press). The effort to push produces more immovability. The effort to listen produces more movement. Solid rating.
The second is in creativity and problem-solving. The neuroscience of insight, which is an active research area with good foundational studies, suggests that insight solutions, the “aha” moments, occur more reliably when the problem is given a rest period after initial effortful work: the unconscious processing that continues after the conscious effort stops produces novel connections that the focused effort does not (Dijksterhuis and Meurs 2006, Social Cognition, DOI: 10.1521/soco.2006.24.4.469). Early rating: the insight literature is real but not fully replicated, and some specific claims about unconscious processing have not survived replication in stricter designs. What is more robustly established is the simple observation that sustained cognitive effort produces fatigue that impairs performance, and that rest restores performance.
The third, and the one that is most relevant to this movement of the book, is in nervous system regulation. As covered in the preceding chapters, the nervous system that is chronically under stress does not respond to the instruction “calm down.” Trying to force calm is an effort that activates the very alert system the effort is trying to deactivate. The only approach that works is one that bypasses the effortful pathway: slow diaphragmatic breathing, gentle movement, reliable social contact, physical rest. These are not effortless. But they are a different kind of effort, the kind that goes with the grain of the body’s design rather than against it.
I have a phrase I use with my patients when I am seeing someone whose relentless effort has become the problem rather than the solution. I say: the river does not go faster because you push on the water. The river knows its pace. What you can do is stop spending energy on the pushing and use that energy for the swimming.
Sometimes the river just wants you to stop swimming and float for thirty seconds.
There is also the question of what you do in the pause. The common instruction is: do nothing. This is almost always unhelpful for the person who is genuinely over-striving, because the instruction “do nothing” becomes another task to be done perfectly. The actual instruction is simpler: do something that has no outcome, no metric, and no one watching. In Sengera I used to sit by the stream that ran behind the upper part of the village, not fishing, not doing anything with the water, just watching it move. My father Raphael did not ask what I was doing there. He seemed to understand that some activities organize themselves without needing to be organized. I did not have language for this at the time. The language I have now is: the nervous system can only downregulate in the presence of activities that carry no threat of failure. Sitting by a stream carries no threat of failure. Neither does walking without a destination, or cooking without precision, or reading something that you will never be tested on. These are not luxuries. They are the maintenance of the human system.
I have met too many accomplished people who have eliminated every activity from their lives that has no measurable output. They have, in the process, eliminated the very practices that would allow their output to be sustainable. This is not a productivity problem. It is an ecology problem. The land that is farmed without rest eventually stops producing. The person who is worked without the space for purposeless activity eventually stops producing original work and begins producing competent imitation. You can often tell which one you are reading.
The cardiac physiology image I return to in this context is one of the most useful I have. Afterload is the resistance against which the heart must pump. When afterload is chronically elevated, the heart hypertrophies: it gets thicker and larger as it compensates for the resistance. This looks, on an echocardiogram, like strength. It is not strength. It is a compensation that is slowly degrading the heart’s function. The treatment is not to make the heart work harder. It is to reduce the afterload, the resistance. Once the resistance is reduced, the heart does not need to work as hard to do the same work, and over time it can remodel back toward its natural state.
You have been hypertrophying. The thickening has looked, to everyone watching, like strength. The question this chapter is asking is not: are you strong enough? You are. The question is: what would it look like to reduce the afterload, the internal resistance that has been requiring all this compensatory work? Not the ambition. Just the resistance.
A Mirror
Identify one area of your current life where you have been applying more effort and seeing diminishing or reversed returns. What does that effort feel like in your body? (Listening for: the felt sense of counterproductive effort, the physiological signature of straining in the wrong direction.)
Is there a problem you have been working on for a long time that has not responded to more effort? What might happen if you set it down deliberately, for a defined period, and returned to it later? (Listening for: the reader’s willingness to experiment with effortlessness, the possibility of the insight gap.)
What is the difference, for you, between effort that feels generative and effort that feels like you are pushing on a wall? (Listening for: the reader’s capacity to distinguish healthy striving from effortful self-punishment, the internal compass that distinguishes these.)
When did you last achieve something important by doing less? Can you describe what that felt like? (Listening for: existing experiences of effective non-effort, the counter-examples the reader can access from memory.)
If stopping were not giving up, just stopping, what would you stop doing first? (Listening for: the thing being maintained by effort alone, the activity or behavior whose continuation depends on will rather than genuine direction.)
Letter from Dr. Job
Subject: Where to stop trying
I have never been naturally good at stopping. The training in medical school and residency selects against it. The culture of high achievement selects against it. The internal monologue of someone who was once called ekerentane, the unwanted child, and who spent thirty years building evidence to the contrary, selects strongly against it.
But I have tried to force procedures that needed rest. I have tried to convince patients by volume of information when what they needed was to be heard. I have pushed on problems that solved themselves during the flight home when I stopped thinking about them.
The river does not go faster because you push on the water.
This week, I want you to identify one thing you have been trying harder at without progress, and I want you to give it three days off. Not forever. Three days. Put it down with intention, not with defeat. See what happens in the space.
The answer you have been looking for may already be present. It is simply waiting for you to stop making enough noise to hear it.
— Job