Can ‘Cosmic Insignificance Therapy’ Help Doctors Financially?

In the grand scheme of things, what we do really doesn’t matter. That’s a very simple way to sum up “cosmic insignificance therapy.”

Part tough love and part glorious release, depending on how you choose to look at it I guess. But when you dig in more, it’s not as gloomy as it initially seems. In fact, it kind of gives you permission to just enjoy and live your life. And I think it has some nice corollaries to our finances as well.

What Is Cosmic Insignificance Therapy?

I was first introduced to this concept in the book Four Thousand Weeks: Time Management for Mortals by Oliver Burkeman.

One of the main tenets of the book is that we will never be able to do everything. Our to-do list will never go to zero. We will never reach a stage where we are “on top” of everything in our lives and can just relax and do nothing. And in fact, even if we could reach that point, it wouldn’t be all that fun.

Once we accept this truism, rather than fight against it, we can sit back, choose the most important things in our lives, and do those things. We can also then start to enjoy — yes, enjoy — the problems that come into our lives that we get to fix.

Cosmic insignificance therapy fits nicely into this whole motif. It basically says that within the whole history of the universe, we are but a dot in time. We all have huge egos and think what we are doing is the most important thing in the world. That egotistical predilection provided a nice survival advantage to our ancestors — but it also makes us feel that we constantly need to do everything we are doing or else the world will collapse.

But it won’t.

If I don’t write this post by my self-imposed deadline, the world will keep spinning. This blog will stay active. Despite the fact that at times it feels like I need to do it…or else…

And that’s not a super helpful or productive feeling. But at least, in the case of the blog, it centers on something that I am really passionate about. The problem is that often those feelings center on stuff that, if we are honest, is not even that important to us. But we still feel the need to do it, and do it urgently.

As type A physicians and professionals, we all can relate to a similar feeling. It’s stressful.

But there is good news: cosmic insignificance therapy can help relieve us of this burden.

What we achieve in this one life will be immensely meaningful to us. And our loved ones. But to humankind and history, it won’t matter that much.

With that perspective, why would we focus any of our energy on anything other than creating a life full of personal purpose, passion, and love? Why would we focus on things that feel urgent, but in the long run don’t matter?

I find that to be a powerful new way to look at things!

How Does Cosmic Insignificance Therapy Relate to Finances?

To me, exploring this connection made a lot of sense. For one, I am interested in and passionate about personal finance, financial well-being, and financial freedom. Second, I believe that a lot of urgent but not long-term important things we “must” do relate to money. And freeing ourselves of this burden can help open the door to a life of self-driven meaning.

There are two ways to look at money through the lens of cosmic insignificance therapy. In my mind, one is much more helpful than the other.

1. Nothing matters so spend it all

This is definitely the path of less resistance. It seems almost natural to say, “OK, if this doesn’t matter in the long run then I’m just going to blow all of my money now and forget about the future!” It sounds very similar to some of the misunderstandings around the “Die With Zero” philosophy.

Sounds fun. And it nicely counters the delayed gratification that all doctors feel.

But there are some pretty big holes in this logic. For starters, the whole concept is espousing that what we do doesn’t necessarily matter much, long-term and in the grand scheme of things. But what we do still matters a lot to us and our loved ones, and it’s our responsibility to live our lives in coherence with our personal meaning.

And if you blow everything so that you have no nest egg for the future, you are really going to struggle to live your life in a personally meaningful way. You will also put a lot of stress on your children and others in your life.

Nope, this doesn’t jive.

So, how then should we reconcile cosmic significance therapy with our financial lives?

2. Be more financially intentional!

Of course!

If the whole point of cosmic insignificance therapy is to align your life with what is personally meaningful while discarding anything else, despite how urgent it might feel, then the financial corollary is to do the same thing with your money.

In life, we need to be intentional with our time. Spend more with the kids instead of answering that “urgent” work email that can wait until tomorrow or maybe doesn’t even need a response (even if that will give you an uncomfortable feeling at first). This allows us to curate our ideal lives.

In finance, we need to be intentional with our money in a similar manner. Create more savings so that you can take a great vacation if that’s what you care about. Invest so you can reach financial freedom and practice on your own terms. How much you spend versus save and invest is up to you. And just about anything is fine — as long as it aligns with your personal goals and meaning.

In fact, I would argue that it is very difficult to fully align your time intentionally without first aligning your finances intentionally. Because financial freedom gives you freedom over your time.

If, in the long term, what we do doesn’t matter nearly as much as we think it does, why would we spend a dollar or second doing something that won’t advance us towards our passions and purposes?

And that brings up an important final piece of the puzzle…

Which is that it is OK to use means to an end.

One thing I had a hard time reconciling with cosmic insignificance therapy is that, even when we are more aligned with our individual meaning, there are still some things in life that just need to get done. Whether we like them or not. And how can that not be mutually exclusive to what we are talking about here?

Well, after some internal debate, I’ve determined that this is OK and doesn’t destroy the whole concept. Because as long as the means you are performing lead to the ends that you want for your life, that’s all good. Medical school is difficult. Did I want to learn the Krebs cycle? No, not really. But it brought me closer to the personally meaningful life I am living now. So that jived.

However, if I was just in medical school to please my parents while my true passion lay somewhere else, that would be a waste. It would all just be cosmically insignificant at the expense of our personal significance and autonomy.

For instance, I gather a huge amount of personal fulfillment and meaning from helping patients with breast cancer restore their form and function after mastectomy. However, if I wasn’t passionate about this, it would be OK for me to focus my time and money elsewhere, knowing there would be others with that passion to fill my place.

A Last Caveat

Cosmic insignificance is also not an excuse to be selfish or think only of yourself.

Going back to our earlier discussion about “spending it all,” cosmic insignificance does not mean you should throw caution to the wind and indulge any immediate hedonistic needs at the expense of long-term goals or happiness.

Because what you do matters. In the short term. But probably less so in the cosmically long term.

You still should care about what you do and how you live your life. But just be more intentional about making sure it aligns with your actual goals and values!

Jordan Frey, MD, is a plastic surgeon at Erie County Medical Center in Buffalo, New York, and founder of The Prudent Plastic Surgeon.

Looking to improve your financial well-being? Check out Frey’s online course, Graduating to Success, a comprehensive and interactive 12-module course that helps doctors achieve personal, professional, and financial success during and after their transition from trainee to attending. Or read his best-selling book, Money Matters in Medicine.

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