Three Things You Didn’t Know About Your Schedule

Over the last two years, I have played over 700 games of hide-and-seek. 
Since our son’s first birthday, my husband and I have played this game with him every single evening before bath time. The other day, we realized our son is now almost three. For almost two years, we have been playing the same game. 
Hide-and-seek is not the only routine in our home. Our son’s meal and nap schedule changed alongside his developmental needs, but each day we are following essentially the same schedule. 
I have witnessed my son’s appreciation for these anchoring points throughout the day. I think it allows him to know what to expect, and how to direct himself in his play and other activities. I have also noticed how deviation from his routine can cause him to feel overwhelmed and act out (e.g. I remember an instance at a birthday party when we didn’t leave in time to reach home for his usual bedtime…). Recognizing that life will not always conform to his needs, my husband and I are teaching him how to adapt and function in these situations. However, we generally adhere to his routine; he has shown that he just does better when he knows what to expect. 
The observations about my son’s daily routine got me thinking about our lives as busy physicians. We have the opportunity to create schedules for ourselves, yet often we do not. We may establish broad schedules that include major daily events, but which lack direction for how to tackle smaller tasks. 
Inadequate scheduling results for innumerable reasons. Maybe we think we want to live spontaneously. Maybe we want to be flexible for others. Maybe we feel like lacking a schedule won’t matter because life is too eventful and unpredictable to control what happens in our days. Or maybe we are simply too preoccupied with cruising along the path that we thought we should take, forgetting that we are in the driver’s seat and in control. 
Regardless of the reasoning for not establishing a schedule, I propose that there is value to creating a plan, scheduling the action points, and developing the skill of persistence. When you make a plan and then create a schedule of result-oriented tasks – whether for organizing your day, a specific project, or anything else – you are helping yourself in the following three ways:
1.    You are deciding what is most important in each moment, and why. 
In the age of information, our brains must process so much more data today than in the past. Part of the reason we feel overwhelmed is because there is literally so much more happening in our lives. We are not only in contact with more people due to globalization and spikes in population, but we are also exposed to more information that we must learn. Furthermore, we are tethered to our devices, which are constantly asking us to absorb, process, evaluate, and make decisions in both our personal and professional lives. This is exhausting. What’s worse is that it can make us less efficient in what we do. When you decide what is most important, you are helping your brain to narrow its focus – and it will love you for it. More importantly, you will love yourself for doing it because your heightened focus will help you get more done. 
 
2.    You are developing confidence and a sense of direction. 
Confusion and indecision commonly stem from the thought, “How will that happen?” When you have a plan and schedule, you eliminate the question plaguing your brain by answering exactly how something will come to fruition.  Following through on your plan and learning from the experience will create evidence against your belief that things will not get done. Armed with this evidence, you can approach future challenges with heightened confidence in your ability to achieve your goals. 
3.    You are seeing your goal as if it is done. 
Imagine being able to plan something and knowing without a doubt that you have taken care of it. Now accept that this can be your reality. If you schedule something on your calendar, respect the time you need to give to that activity, and meaningfully show up to complete the task. When you do this regularly, your scheduled goals areas good as done. 
Think about a specific, realistic goal you want to accomplish this week.
Make a plan for how you will get it done. Think about all of the obstacles you will have to overcome, and how you will overcome them. 
Put each of these action points on your calendar and follow through. 
After you have completed each item on your calendar, complete a self-assessment. Did the plan work or not? Why? If needed, come up with a new approach and try again. 
You may not accomplish your goal by the end of the week, and that’s okay. If you did what you set out to do, keep your mind focused on the tasks at hand, and remember to learn from each of the things that didn’t work. You are on the right track.
If you are persistent in creating and sticking to a plan as discussed above, you will accomplish your goal, and you will learn so much in the process. 
If you weren’t able to follow through on each of the tasks you laid out, one reason may be that you were distracted. (More on distraction later this week – stay tuned!)

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How Can You Have More Time? You Do More of What Matters

In the recent weeks we have discussed both how a scarcity mentality and how we view time as finite can cause us to feel like we don’t have enough time. 
 
 
This week I will introduce the concept of priorities. 
 
Priorities
In Laura Vanderkam’s TED talk on How To Gain Control Of Your Free Time, she speaks about the idea that the thought of “I don’t have time” often means “It’s not a priority.” 
Let’s look at this example. You are working in the hospital and you have 15-20 people on your service. You are rounding on them and then need to sit down to chart and put in orders. If someone came by and asked you to grab a coffee, you would not go. You would either decline, or schedule for a future time. However, if all of a sudden you hear a Code Blue being called, you would run to the bedside of the patient who needs you. In this latter example, you will have chosen to make that coding patient a priority over every other patient and administrative task you had planned for that morning. You will have chosen to spend your time differently than you originally had planned, because there was a new priority.
When we say we don’t have time, if it means that we have not prioritized certain activities, theoretically there should be no problem. This is because if something is not a priority, it shouldn’t matter to us if we are not making time for it. 
Interestingly though, we are so often left feeling resentful, frustrated, or bitter about our sensed lack of time. The reason for this is that we are dissatisfied with how we have prioritized our lives. 
One of the ways in which to get to the root of the “lack-of-time” problem is by answering for ourselves FOUR questions:
            1. What are my priorities?
            2. Why am I not living in alignment with my priorities?
3. How will I need to think differently in order to realign what I want to be doing with how I am spending my time?
4. How can I think differently in order to feel better, if I am living in alignment with my priorities, but I am still unhappy?
 
“We don’t build the lives we want by saving time. 
We build the lives we want, and then time saves itself.” 
~ Laura Vanderkam
Do the Math
In the TED talk, Vanderkam also shows how we have enough time by actually doing some math. 
There are 168 hours in a week. Assuming you get 8 hours of sleep per night, this leaves 112 hours in a week. I do believe we have enough time, but I see a problem that physicians have, especially those in training or in jobs with above-average work hours. 
If you are working a 60-hour work-week, you will have 52 hours left each week.
If you are working an 80-hour work-week, you will have 32 hours left each week. 
In this last example, which is common for residents and physicians in certain subspecialties, this means you will have 4.5 hours each day. If 2 hours are spent on getting ready for the day and travel, this leaves you with 2.5 hours each day. You may spend 1-1.5 hours on food preparation and meals. This leaves you with about an hour each day for another chosen activity. If you have kids – there you go. (In the example where you are working a 60-hour week, you will have about 3 more hours each day.)
Our training and jobs often require that we are working above the average number of hours. Therefore, given the math, I think it is important for doctors to have their priorities straight.
So, I do recommend completing a time diary like the one Vanderkam mentions in her video. You can do one to see how you spend your time each day in general; you can do one specific to your time at work to see if you can be more productive; you can study the evenings at home to see if your family and dinner time is really being maximized. Take an honest look at how you spend your time and then decide if you want to continue that way.
At the request of my own coach a couple years ago, I did this when I was working on improving my efficiency in the office, to study where I had developed inefficiencies and given in to distractions during the day. My goal had been to get out of the office sooner at the end of the day with my notes completed. I knew at that time that if I was spending my time on anything but productive work during the day (even if it was for minutes here and there), I realized I would be sabotaging my own goals. Examples of things I had noticed and decided to change:
            
·       Extended conversations with patients that weren’t contributing to my relationships with them or patient-care
·       Unplanned conversations with office manager or staff that interfered with administrative time
·       Checking my email during unplanned times during the day
·       Allowing interruptions to my work due to an “open-door” policy
·       Taking breaks to get food in the break room, including stress-eating
·       Complaining to myself about how long the day was
This process was eye-opening for me, and I know it will be for you too. Being able to objectively see what was happening and then tackle the problem head-on was empowering. 
So what are the action points for this week?
1. Determine your priorities and assess where your mind is at using the four questions above. 
2. Complete a time diary of your day or week in order to objectively take account of how you are spending your time. For each action or activity, including any time you spend thinking or daydreaming, note the time spent. Ironically, this itself may take some time, but it will be valuable information for you. 
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If you’re starting to see how coaching can make a difference in your life and want to take things to the next level, sign up for a free 25-minute mini session with me to see how you can make the changes you are looking for. It all starts with a single call.  Schedule with Ashwini Nayak, MD

How to Slow Down Time

One of the first things Steve Chandler discusses in his book Time Warrior, is about the power of seeing time as nonlinear
Choosing how you think about time, either as linear or nonlinear depending on the situation, is going to change how you view your life. It will free you up if you can open your mind to thinking about it in a nonlinear way when the time is right (no pun intended). I’m going to introduce the concept here in the most basic way that would apply to us. 
Linear time — In this model, which is how we as humans usually think of time, time is a single line, point A to point B. To make sense of time we think of ticks of a clock that pass by (seconds, minutes, hours), and which we can’t get back, ie. we can’t go back in time. This helps us to understand aging and evolutionary processes. Events happen in relation to this ticking clock and there is no looking back…
Nonlinear time — In this model, we think of time more as a huge web of interconnecting lines. The top down view is that everything is in existence at once, but that what we feel as passage or movement of time is actually a series of choices that we make. At each junction of intersecting lines in the web, a choice is made, and this is how time passes. 
There are plenty of times in life when you need to think of time in a linear way in order to function in our world. You can keep this construct as a frame of reference when it is helpful and practical to you. 
But thinking of time in a linear way can sometime be problematic – 
Linear time: 
-we can convince ourselves that there isn’t enough time
-experiences feel and appear finite
-each moment of time is finite
-the passage of time is out of our control and it feels like things go by way too fast
-there is an idea that the journey will come to an end

 vs.

Nonlinear time
-there is infinite time
-experiences are more fluid and continuous
-we can slow down time (there is no finality to each moment)
-we are in control of time by the choices we make
-when does the journey end??
I know this is probably different than what most have discussed, but I think it will be a core concept to understand as we think about time management, because time management will not be about how we control time, but about how we make choices (think) and how we choose to act in the time we have.
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P.S. If you are a physician mom who is interested to get your work done faster, get more done in the time you have, and plan a life where you do what is most meaningful and important to you – all so you can carve out more time for yourself and your family – then join my mailing list HERE to get more tips and strategies this month of March, which is all about time management. 
If you’re starting to see how coaching can make a difference in your life and want to take things to the next level, sign up for a free 25-minute mini session with me to see how you can make the changes you are looking for. It all starts with a single call.  Schedule with Ashwini Nayak, MD

The Best Way To Start Any Relationship

Whether I am coaching someone else, coaching myself, or approaching any relationship, one of the most valuable skills I have been taught is holding the space. 
Holding the space means having awareness and the ability to set aside your judgements or opinions about yourself and the other person. 
Holding the space means being able to maintain focus and be present with the emotions of the moment, yours and the other person’s, even when the intensity of life challenges this and tries to distract you.
When I had not known how to hold the space, I always tried to fix problems – problems in the system, other people’s problems, and my own problems. I was in a rush to make things better, based on what I saw the solution to be, and I didn’t see what was going on right in front of me, what others needed of me. In other words, I missed what I may have needed in a moment to be the best that I could be; I missed how a patient needed me to truly help them; I may have missed the critical, subtle cues from my family, of how I needed to serve them. 
When I didn’t know how to hold the space, I resisted or reacted to the way I was feeling. For example, instead of feeling acceptance and compassion for the experience of the person in front of me, disappointment over medication nonadherence or not seeing progress in a patient’s A1c would lead to an inwardly handled frustration which would wear on me. Or, I swept under the rug the feelings of the moment, only to find them resurface later when I least needed them. 
By holding the space, I give myself room to breathe. Whether I am trying to support myself, or help someone else, I give the signal that I am there to care in whatever way is needed. I don’t try to rush to find a solution, but rather am patient with myself and others, trusting that we will make the changes needed when the time is right. By not judging myself or others, my mind is clear and open to seeing all the possibilities and solutions in front of us. I am able to process the myriad of emotions that come up when dealing with human problems and human life, and because I process these emotions (rather than fight them with willpower or react to them unproductively, compounding the negativity) I am less drained at the end of an encounter or the end of the day.
By holding the space, I am more capable of expressing the love and compassion that I have for myself and those that I serve. 
This is the place to start.

Are You Feeling Overworked? Then Read This.

This post is for everyone identifying as being overworked. It is for those who feel like they are giving, giving, giving to their jobs and career, only left to wonder, “Where is this leading?” It isfor those who feel resentful for working so hard, and inadequately compensated for their effort. 

 
I am reading “The Soul of Money” by Lynne Twist. The lessons in this book regarding our relationship to money are giving me insights into other areas of life – so much so that I wonder if a large portion of what creates human unhappiness really centers around the idea of scarcity. I’ll be discussing this concept in this and some of my upcoming blogposts.
 
Twist describes three different myths related to the idea of scarcity. She begins with:

There is not enough.
 
This statement is a simple and accurate explanation of what scarcity is. Merriam-Webster dictionary also defines scarcity as “deficient in quantity or number compared with the demand.”
 
The trouble begins when we start to believe that scarcity is a natural and real part of our daily existence. Additionally, we must question the origins of scarcity – when are our own “demands” creating scarcity in the first place?
 
For our discussion, I will put aside examples of scarcity that suggest a true threat to survival. Almost everything else is fair game for consideration. So, let’s start with a common example: how much we choose to work.
 
When we take an action, such as choosing to work, we have made a decision. In any decision we make, it is reasonable to expect that we should be happy with our reasons for making that decision. One of the reasons that we choose to work is our need to earn money. Money is required to purchase basic necessities – food, water, shelter, basic clothing – because for most of us, acquiring or cultivating these items independently or within a closed community is not practical.
 
Then, for most of us, wanting to live a socially engaged, creative, more interesting, or an improved life requires money. Money also affords us other enhancements, such as phones, the internet, recreational items, larger homes, organic food, higher education, and opportunities for travel. The list can be endless.
 
This is not leading to a judgment of anyone, myself included, who may desire more than the most basic necessities of life. I have learned to respect that each person has the ability to want what they want, and that this is okay.
 

However, I do want to encourage you to question why you want what you want, and why you are working as much as you do in order to secure these things for yourself. Then relate it back to this question of scarcity, and check: Are you worried that you won’t be good enough, or that you or your family will suffer, or that life won’t be good enough without all the things you desire? Consider each item, big or small.

Many people not working hard and long just for the joy or the challenge involved. They are doing it to make something moreof their life – thinking that it isn’t enough as is. Many times, people are blind to this cause, this driver of their suffering.

When scarcity mentality is the cause of overworking, and an individual is blind to that cause, there can be a negative result. Self-imposed demands to produce more, create more, and earn more, can lead to persistent dissatisfaction because the individual is never really fulfilling their real need. Why? Because the ultimate need they are trying to fulfill is to fix the feeling of deficiency. But solving for deficiency by acquiring more is not the solution – our human mind, carrying the belief that “there is not enough” will always get in the way, and make us feel like something is missing. Moreover, the act of overworking creates other deficiencies in our lives – lack of time for ourselves, lack of time with our kids and families, and so on. In a way, this proves the original belief of there not being enough, creating a cycle.

 
The solution then is to find the remedy not in what we do, but in how we think. We must overcome our belief that “there is not enough.” When we do this, we are well-guided in our decisions in how we choose to spend our time, including in how we choose to work. This is part of the key to finding the true “balance” (fulfillment) that we are all seeking. When we work in a way that fulfills our internal purpose in life (not too much and not too little) and are guided by the joy of the pursuit rather than the hope of happiness in our future acquisitions, we are given exactly what we need through our work, including time and space for the other things that restore us.
 
Explore what would happen if you believed that you did have enough – money, time, energy, love, etc. What would your world look like through that lens? What would you continue to include in your life? Where would you devote your time? What would you give up forever?
 
 

Mom Guilt Part 2: Four Steps To Taking Back Control

I keep returning to the topic of mom guilt because of its continued presence in my life. I want to share a recent realization I made while self-coaching myself on this topic. I believe I have found the answer to my mom guilt – perhaps it will be the answer for you, too. 
Not long ago, I wrote a post on mom guilt (read How To Be The Best Mom). In it, I discuss how our judgements about ourselves cause us to feel “mom guilt.” This guilt is largely unnecessary and causes us to be less present with our kids. When we acknowledge that we’re not perfect, that this is okay, and that we are still bringing so much love to our children, we can help ourselves to reduce the intensity and impact of this guilt. 
Even though I regularly practice this different pattern of thinking, I found it difficult not to feel guilty. On days my son would cry when I dropped him off at daycare, I felt guilty leaving him in tears (even though I knew that one minute later he would be playing happily). Conversely, on days that my son was ready to go play on his own the minute I dropped him off, I felt guilty thinking that he didn’t need me anymore (not true at all). Interestingly, the guilt presented itself in these strikingly different situations. 
What if the guilt is part of the reality of being a mom? What if fighting this guilt is just making it harder?
I am sure there is some biological explanation for why I feel this way – I want to make sure my son is safe, healthy, and cared for. Perhaps, too, there are feelings that will inevitably come up for moms that care about their kids simply because they are moms that care about their kids.  
Two More Solutions: Language and Acceptance
Language
In our effort to put a label on this experience, we refer to this feeling as “guilt.” 
On the one hand, naming the feeling “guilt” can be helpful. Guilt can be a signal that it is time to make a decision – Is what is going on in this situation good, or not?
Other times (arguably most of the time) calling the feeling “guilt” can be unhelpful. Guilt may needlessly trigger unsubstantiated concerns – Is there something wrong with this situation? Is there something wrong with me?
Feeling guilty may cause me to question if I am being a good mom when that isn’t in question at all. If anything, the fact that I feel guilty is probably a sign that I’m a good mom because it shows that I actually care about my child and my role in his life. 
Take the example of deciding how much to work as a new mother. Who is to say whether working full-time, part-time, or staying home is the right decision? Each scenario comes with its own pros and cons. Maybe our time would be better spent not deciding which scenario is best, but rather choosing which path to follow, and making the best of it. Guilt will probably present itself in each of the scenarios, so it is not an indicator of something having gone wrong. 
Acceptance
What if I invited the mom guilt along for the ride? Knowing that it will show up from time to time, and that it’s only a sign of me being a mom, I could just let it be there. 
Not resisting it. 
Not fighting it. 
Not avoiding it. 
Then, I could go on about my life. The guilt may speak up in protest occasionally, but I will already have my prepared response and thus maintain control over the guilt, rather than letting it control me.
Below I have summarized the four things that have helped me immensely in managing mom guilt:
1.  I realize that I don’t have to call it mom “guilt” because doing so suggests to my brain that something has gone wrong. For now, I’ll just call it a “feeling” because this helps me look at it more neutrally. 
2. I understand that this feeling is not a sign that anything has gone wrong, but rather a sign that I am a mom that cares about my child. 
3. I understand that this feeling will probably be there in many situations throughout my life, and so I accept it as part of the experience of being a mom. It’s coming along for the ride, but I’m in the driver’s seat.
4. I recognize that I can change how I think about myself and my role as a mom in order to actively reduce the intensity and frequency of the guilt that I feel. 
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If you’re starting to see how coaching can make a difference in your life and want to take things to the next level, sign up for a free 25-minute mini session with me to see how you can make the changes you are looking for. It all starts with a single call.  Schedule with Ashwini Nayak, MD

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Reflections: Be Your Biggest Fan

It’s easy to develop a habit of striving for perfection, people-pleasing, and apologizing for who you are. 
But this is so exhausting. It’s exhausting to let your mind spin out, to constantly hold yourself back from doing something, or to try to be someone you aren’t. 
It’s exhausting because it doesn’t get you anywhere, and you become stuck in this negativity about yourself. 
Instead, be your biggest fan. 
It is so much more fun
So much more energizing
I think about how my husband and I encourage our toddler as he learns to navigate the world and learns the things that most of us adults take for granted. 
There are a lot of high-fives and jumping up and down. We’re constantly saying, “Great job!” And when he has a slip-up, or something seems hard, we remind him that he is learning and that it’s okay. We remind him that we are there to help him. It’s so fun to motivate him, encourage him, and to show him that we are there for him to fall back on.
Be there to catch yourself when you take a fall. Bring positive language and energy into how you treat yourself. If it feels funny to do this just remember no one hears you but yourself!
Part of the happiness that you desire will come from living an authentic life. Your authentic life. This means you have to love yourself first. 
So be your biggest fan. 

Reflections: Create a Special Moment

When you take time to thoughtfully create a special moment in your life you are not just doing an activity. The planning itself teaches you to approach your everyday life from a new perspective. Suddenly, something that you may have done routinely becomes an opportunity to create joy.

In this thoughtful planning —

1. You think about who you are and what you enjoy – INTROSPECTION

2. You tell yourself that how you spend your time matters to you – PRIORITIZATION

3. You make a commitment to yourself – SELF-RESPECT

4. You show up for yourself and others – ACCOUNTABILITY

5. You learn to live in the present – MINDFULNESS

6. You become aware of your thoughts – REFLECTION

7. You take control of creating your own joy – SELF-SUFFICIENCY

8. You realize that you can create your own joy at any time – SELF-CONFIDENCE

Soon, you will learn that you can approach each daily activity as an opportunity to create joy.

You will develop the habit of creating happiness.

Reflections: Living in the Present

It seems so obvious that we should live in “the now.”

After all, the only time that we are truly living life is in the present.

Why is it so easy then to get stuck thinking about the past and the future?

In one way, it’s easier. It’s so much harder to be present with what’s going on now – it requires you to deal with life head-on. The emotions, the people, yourself–it’s intense. It’s so much easier to remove yourself and delve into the past or the future… or is it? Thinking about the past and the future can easily lead to feelings of worry and fear…

I know that there is a time and purpose for remembering, just like how there is a time and purpose for dreaming.

But if all you do is think back on the past, you become stuck, you don’t move forward.

And if all you do is think about the future, you don’t make it happen.

The key is to make the past and the future work for you. Live now and see who you are and what is meaningful to you. Rewrite your past to create the image of your identity now. Dream of your future self so that you become that person now.

Living in the present requires you to see things as they are.

Take an honest look at yourself and what is going on in your life.

In the present you find happiness, but also sadness.

By learning to embrace it all, you experience a rich life. After a while, you look forward to that, and that is real happiness.

Choose Your Own Adventure — This is Your Life

Have you realized that every single decision you make can impact your future
The time that you choose to get up in the morning could determine if you hit the green or red lights on the way to work and whether you make it to clinic on time. 
Choosing to wear a certain favorite outfit may foster an unexpected surge of confidence, prompting you to say hi to an apparently random person in the elevator – only to find out later that this person is the key connection between you and your dream job. 
Then there are the possibilities that we can’t even begin to imagine in our minds. Choosing our careers, marrying our spouses — what would have happened if we had chosen something, or someone, else? 
We hold the power to control our futures with every decision in our lives, yet most of us feel so out of control, like we have no say in how our lives will unfold. This is simply not true. 
Do you feel out of control? If so, I challenge you harness the power that is already within you and choose to believe otherwise
Remember the Choose Your Own Adventure books? (The ones where at the end of each chapter you were given two choices of what to do next.) You created your unique journey as you made your decisions, not knowing what the next pages would bring.
Our lives are like a complex version of those books. The only difference that I have noticed is that we aren’t always skilled enough to see all the choices available to us. In turn, we are not always deliberate about inserting ourselves into our own lives, and taking the control to create our own journey
Of the choices before us, the most powerful are those that concern our thoughts in the present moment. Why, you ask? Using the cognitive model I have discussed in previous blogposts (which demonstrates how our thinking directly impacts the outcomes of our lives), we can predict what will happen for us. The model can give us insights into our lives by forecasting the feelings we are likely to experience and the nature of the relationships we will have, as well as illustrating how our choices can influence the world. The things that matter to us most as we think about creating a meaningful and happy life are all within our control.
Now, after you have made each decision, there may be many downstream effects that are beyond your control. You may argue, “Then what’s the point? I may never really know where my life is headed.” 
The point is this: What if in fact you could envision where you would be in twenty, thirty, or forty years? What if you could see yourself in this place so clearly that there was no doubt in your mind that you would arrive there just on time? If you believed this, you could create that life. 
You have the power to envision your future, to use it as your guide, and to use it as a framework for giving meaning to the events of your life. Each decision you make is an attempt to intentionally guide yourself toward the goals you set, toward the life you want to create
I agree, you won’t know the outcome of each decision, because certain things are outside of your control. And can I guarantee that you will get exactly what you were looking for in the end? No. But if you don’t participate in your life at every given opportunity, you don’t even have a chance. No one cares about your life the way that you do.You have to claim the life you want.
So, with your visions of who you want to be and where you want to be in the future, trust that everything is happening in your life for a reason. See that you have power in every life-shaping choice to make your own decision. And when you have to let go and deal with what life throws at you, see each experience as teaching you something new, propelling you forward to become the person you were meant to be, and toward the life you were meant to lead.