John M. Talmadge, M.D.

A Blog Covering Many Topics

The Wisdom of Playing "Small Ball"

About 20 years ago my professional life encountered hard times. Four hospitals where I worked had simply folded and closed their doors under the pressures of managed care and reduced Medicare funding. The costs of practice continued to rise, and economic pressures on families increased as various “bubbles” began to burst in major economic sectors—real estate, technology, oil & gas, and so on. I was driving a car with 275,000 miles on it and no air conditioning. One afternoon I visited a lawyer friend, a fellow soccer dad with whom I had founded the Dallas Inertia FC, a soccer team for middle-aged men, telling him that I needed advice. Quoting a pilot I had known in Vietnam, I told my buddy Hank that I was out of “altitude, air speed, and ideas.” Hank had practiced law for years, and I admired his work ethic and positive attitude.

Hank said that he had been through similar times in his law practice. The solution, he said, involved learning how to play “small ball.” He explained the concept in simple terms. “If you’re not big and strong,” he said, “then you have to be fast, quick, and agile.” If you can’t compete with a big company (like a hospital system), it’s important to find a strategy related to your signature strengths. This conversation took place several years before Martin Seligman at U Penn popularized positive psychology and confirmed much of what Hank was telling me about using the skills and talents that come with our basic makeup.

Always the baseball fan, he described the ascendance of the 1951 Chicago White Sox, a team with weak hitting and very few big innings. Under manager Paul Richards, the strategic focus became speed and strong defense. When you have trouble scoring, Richards declared, you have two options: keep the score low (defense) and advance your base runners at every opportunity (speed). He cited the legendary Dodger trio of Sandy Koufax, Maury Wills, and Don Drysdale. Pitching kept their team in almost every game, and Wills stole over 100 bases in the 1962 season. 

I’ve worked with some professional athletes who describe their success in similar fashion. One PGA pro has a reputation as a “grinder,” one of those golf pros who doesn’t win majors, but who consistently finishes in the money and makes a very good living. “You don’t have to be a world-beater,” he says. “Sure, it’s deflating to the ego when you see what some other people are able to do, but that little white ball doesn’t care whether your name is in the paper. And that paycheck for a 15th place finish turns into cash that’s good at any bank.”

Some people scoff at sports metaphors, but on that afternoon the advice sounded good to me. Over the next two years I changed my approach to practice entirely. I discovered that I didn’t need a big salary or a high-visibility office with a lot of overhead. I realized that seeing someone on short notice (speed) and using creative intervention strategies (agility) produced consistently better results. Beyond the immediate benefits financially, I found professional practice much more stimulating, enjoyable, and satisfying. The principle of small ball brings with it a significant multiplier effect.

In the past twenty years I have never hired office staff, nor have I paid someone else to answer my phone. I used small ball skills to develop highly successful programs for a local non-profit community mental health center. When others noticed our success, I was recruited to the medical school to replicate the strategy in our mental health services for veterans. As a professor in the Department of Psychiatry, I began to teach these skills to young physicians. Our treatment programs have been honored as the outstanding teaching services at the medical center. There are many teachers and practitioners I admire, and I’ve had many experiences of professional envy. When you’re a grinder, or just a good base runner, it’s natural to be jealous of those who are just simply better at the game. What I try to remember is to use the talent I have, not the talent I wish I had.

Few single individuals become rich or famous playing small ball, but prosperity isn’t measured in dollars alone. What counts in life is the importance of what we care about, what we really love, what motivates us to show up for practice. Playing small ball doesn’t mean thinking small or dreaming small. It reminds us that the important step is to show up for practice and to keep our heads in the game, so that good things happen, one day at a time.

Be Positive in 3 Ways

Some intriguing research suggests that positive psychology can help you weather the routine ups and downs of life and also build resilience for times of greater difficulty.

Here are three ways to capture the benefits of positive psychology.

Express gratitude. Speaking (or writing) our appreciation means that we have taken action. Acknowledging the good defends us against circumstances or situations that are not so good. As the research scientists at Harvard say, "When you acknowledge the goodness in your life, you begin to recognize that the source of that goodness lies at least partially outside yourself. In this way, gratitude helps you connect to something larger than your individual experience — whether to other people, nature, or a higher power."

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Language experts refer to a declaration as "a speech act," meaning that by stating something authentically and clearly, we have taken action. A thought, after all, is simply something inside your head, inside yourself. Putting it out into the world can make a difference. Last year I received a handwritten note in the mail, and the writer thanked me for something we had done together almost thirty years ago. She described how our work together had influenced her life, and she added that after that crisis she turned things around and accomplished great things. I remembered how things were, and what happened. What was wonderful, though, was knowing that the time was well invested. Her appreciation certainly made my day. She expressed gratitude.

Set aside a few minutes every day and think about aspects of your life for which you are grateful. "Write them down if you like," say the Harvard experts. "Be specific and remember what each thing means to you."

Leverage your strengths. To maximize the payoff regarding your strengths, you first need to identify them. Professor Martin Seligman of Penn calls these "signature strengths." These are the assets that you count on when the chips are down, when life really matters most. Research shows that many of us lack a useful understanding of our strengths. "If something comes easily to you, you may take it for granted and not identify it as a strength," they say. For example, you may be "good with people," or "a compassionate listener," or "really sharp when it comes to numbers." If you are not sure of your strengths, you can identify them by asking someone you respect who knows you well, by noticing what people compliment you on, and by thinking about what comes most easily to you.

Strengths are closely linked to happiness: gratitude, hope, vitality, curiosity, and love. These strengths are so important that they’re worth cultivating and applying in your daily life, even if they don’t come naturally to you. Our strengths—again according to Professor Seligman—count in five important areas.

  • Positive emotional experiences
  • Engagement in life
  • Relationships
  • Meaning, and the significance of our lives
  • Accomplishment or Achievement
If you're looking for areas of life where gratitude may be appropriate, these five are a good start.

Savor the “good.” Most people are primed to experience the pleasure in special moments, like winning a ballgame or getting an "A" on an exam. Simple pleasures, on the other hand, can slip by without being noticed. Savoring means placing your attention on pleasure as it occurs, mindfully enjoying the experience in the moment. Appreciating the treasures in life, big and small, helps build happiness. (Mindfulness is a state of active, open attention on the present. When you're mindful, you observe your thoughts and feelings from a distance, without judging them good or bad. Instead of letting your life pass you by, mindfulness means living in the moment and awakening to experience.)

Multitasking is the enemy of savoring. Try as you might, you can’t fully pay attention to multiple things. If you’re reading the newspaper and watching TV during dinner, you’re not getting the pleasure you could from that meal — or the newspaper or television program. If you’re walking with a friend on a beautiful path but staring at your cell phone, you’re missing the moment.

We need to live more in the moment. Living in the moment is a state of active, open, intentional attention on the present. When you become mindful, you realize that you are not your thoughts; you become an observer of your thoughts from moment to moment without judging them. Mindfulness involves being with your thoughts as they are, neither grasping at them nor pushing them away. Instead of letting your life go by without living it, you awaken to experience.

Cultivating non-judgmental awareness of the present generates great benefit in terms of health. Mindfulness reduces stress, boosts immune functioning, reduces chronic pain, lowers blood pressure, and helps patients cope with cancer. By alleviating stress, actively focusing on living in the moment reduces the risk of heart disease. Mindfulness may even slow the progression of other diseases as well. And science shows clearly that mindfulness is one of the best antidotes for physical pain.

Research on Mindfulness suggests that learning the skill of "Being in the Now” can actually change the way our brains process information so that there is more activity in brain centers involved with processing positive emotions, and more interconnections between right and left hemispheres and the cortex and limbic systems. Mindfulness training results in improved relationships, life satisfaction, and pain relief.

Mindful people are happier, more exuberant, more empathetic, and more secure. They have higher self-esteem and are more accepting of their own weaknesses. Anchoring awareness in the here and now reduces the kinds of impulsivity and reactivity that underlie depression, binge eating, and attention problems. Mindful people can hear negative feedback without feeling threatened. They fight less with their romantic partners and are more accommodating and less defensive. As a result, mindful couples have more satisfying relationships.

Being grateful and being mindful go hand in hand.