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Giving and Receiving Feedback
A Live One-on-One Zoom Course 
6 Category 1 AMA credits pending

Receiving Feedback
As physicians, our greatest fear is making a mistake that negatively affects patient care. The news that they have allegedly performed suboptimally is the source of severe distress. When we learn of such allegations, our bodies tense up, and our minds go into a tailspin which can be a challenge to overcome. This often lasts a long time and severely limits our capacity to enjoy our careers and rededicate ourselves to the care of our patients. 
The stressful nature of this experience is modulated by the feedback Fight-Flight-Freeze or Fawn (FFFF) system, which is triggered when we hear the news that feels like a threat. 
Our primitive FFFF system is a robust, ancient system for keeping our physical bodies safe. It has kept our species alive through threats from faster, stronger, and sneakier predators. 
Unfortunately, as the rest of our brains have evolved, there has been a  faulty integration with the most sophisticated parts of our minds that can imagine past and future scenarios and the ancient FFFF system deep in our primitive brains. It's like a high-end mac book pro trying to integrate with an 8-track cassette player. In this cross-wiring, our FFFF defends not just our physical bodies but our also our psychological selves. Any threat to our self-perception is deemed threatening and triggers physiology similar, although less intense than an actual physical threat. 
This unfortunate flooding of adrenaline and cortisol leads us to think primitively. We cannot access our higher cortical functions, which know we are safe, and does not allow us to receive feedback calmly and maturely. 
Inquiry-based stress reduction (IBSR) allows us to receive feedback with wisdom and compassion. We can see beyond our small-minded and reactive nature by questioning our underlying beliefs of what the feedback means, our impressions of the feedback giver, and our thoughts about our own weaknesses. From there, we can take in the feedback, see where it can serve us, and take appropriate steps to improve ourselves.

Giving Feedback
Giving feedback can be as or more daunting than receiving it. Physicians are often ill-prepared for this managerial skill, and it triggers feelings of stress and negativity. They often dodge giving feedback, possibly taking on additional tasks to avoid potential confrontation. Physicians would rather take on additional tasks than correct those performing them inadequately. 
Again, IBSR can alleviate this fear by questioning underlying beliefs about the recipient, how the feedback will impact them, and how they will be negatively affected by giving feedback. Once these fears are managed, physicians can give feedback with a clear and calm mind. This communication style is the most effective way of delivering feedback and has the highest chance of being received in the manner it was intended. 

Week  1

The stress response  - How the mind reacts under stress.

   Fight or Flight

   The default mode

Inquiry: Receiving feedback: the basics 

Healthy Habits: Morning and evening routines 

Week 2  

Stress Response 2: levels of conciousness

Inquiry: recognizing underlying beliefs of receiving feedback

Healthy habits: Meditation

Week 3 
Get to know your Saboteurs
    How do you show up when you feel attacked? 
     Review of the ten saboteurs
Inquiry: Are your thoughts accurate?
Healthy habits: Self Facilitation
Week 4
Understand your strengths 
    The Sage mind
Inquiry: Giving feedback, the basics
Healthy habits: Gratitude
Week 5
Personal vs Impersonal Mind
   Neuroscience of flow states
   No self, no problem: new understandings of wellness
Inquiry: Receiving feedback 2: Recognizing underlying beliefs about giving feedback
Healthy Habits: Breathwork 
Week 6
Left/right Brain differences
   The left brain interpreter
   Right brain dominant systems
Inquiry: using IBSR in other feedback situations
Healthy Habits: Self Compassion
To enroll please email or call (505) 269-4097
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Marie Wagner Brown, MD
Pediatric ENT Surgeon

Working with Lara changed my life. Her understanding of the mind and piercing questions pull the rug from under my stress and unhappiness. I wish I'd had these insights earlier in my career!

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Katie Lopez, MD

Lara was my lifeline during my lawsuit. She kept me accountable for healthy habits which I still practice! Through her mindset change exercises, I was able to use the malpractice experience to become happier and healthier. 

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Jose Avitia, MD
Medical Oncologis

Lara's wisdom and insights have helped me navigate the stress of my busy practice. I always see things differently after talking to her. 

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