Want to get more focused at work? Try Rafael Nadal's rituals.

When I work as a doctor, being in the right mind set is crucial to be sharp and focused. But sometimes, concentration is more scattered, and performance is not at its prime. It's human. But there may be a way to overcome this.

You may have noticed that Rafael Nadal is executing weird and stereotyped moves during each match. He places his hair behind his ear, pinches his nose, and fiddles with his shorts before each serve. Are those tics from Tourette syndrome?

Of course not. These moves are part of Nadal's routine to make his mind ready for every serve. There are more than ten well-documented rituals he systematically performs before or during a match, which include:

• He removes his jacket while jumping.
• He places his bottles in the same exact position.
• He wipes himself with a towel after each point.

But why is he doing so?

"It’s a way of placing myself in a match, ordering my surroundings to match the order I seek in my head. ...when I do it, it means I’m focused." Rafael Nadal

When Nadal performs his rituals, he gets more focused and performs better in his sport.

There are many other examples of simple rituals we can think of:

• A pilot talking to the plane before takeoff.
• A child rubbing a teddy bear on her cheek to get asleep.
• An athlete who listens to the same song the moment before he performs.

Is there anything we, as doctors, can learn from that?

What is a ritual?

According to the Merriam-Webster Dictionary, a ritual is "an act or series of acts regularly repeated in a set precise manner."

Rituals can be of many different kinds:

• Placing objects in a specific position
• Doing a sequence of moves
• Drinking or eating the same thing in a particular manner
• Having repetitive breathing exercises
• Listening to the same song in the same situation
• Sniffing a given smell

On the surface, rituals may seem similar to compulsions in OCD. Except for this: unlike in OCD, you control your actions, not the opposite. You perform them to get more focused, not to relieve you of unbearable obsessions.

Rituals are actions you do regularly, but unlike habits, you have full awareness of them, and execute them on purpose. Unlike an automatic behavior from your subconscious, you accomplish rituals with a clear intention.

By completing the set sequence, you send a direct message to your mind and body, telling them which state of being you want to evoke to perform a task or activity: "Let's enter the deep focus state" or "Let's toggle the walk-in clinic mode." The more you perform the sequence, the more your mind will associate the physical actions performed with the state of mind you wish to enter.

Have your own ritual

As highly trained professionals, we need to execute complex tasks in which we need our brains to work accurately and flawlessly. If dedicated rituals help Rafael Nadal perform better, the process can help doctors too. You will become more focused at work and visualize better what will be coming up.

Starting a new ritual and executing it regularly to set your brain for a task is simpler than you think. First, pick a repetitive moment in your day when you want to get ready to tackle a specific activity. It can be the beginning of your workday or the moment just before each patient encounter. Then, choose a ritual that will act as the trigger to make you enter the dedicated state of mind.

Suggestions of very simple rituals for your practice:

• Repeating a sentence in your head at the exact moment you get to your workplace.
• Listening to the same song on the way to work.
• Taking a sip of water with your right hand while touching your ear with your left hand before every patient encounter.
• Placing a pen, a clipboard, and a stamp in an unusual position on your desk every morning.
• Going through a short and predefined stretching exercise.

Your ritual does not need to be complex, but I find that the more peculiar it is, the more likely it will be effective. In other words, if it feels weird to perform your ritual, it will trigger a quicker shift to the required mindset.

When you start a new ritual, you will not notice the benefits right away, and it may even feel a bit ridiculous. But please persist in performing your new routine regularly! To get the best results, it's not a matter of what you execute, but rather how disciplined you are performing it systematically. After a week or two, your routine should become your mind's doorway to the desired state.

A good thing to know when you start a new ritual is that you don't even have to think about which state of mind you seek by your particular routine. You just perform it, and with time, your brain will figure out which mindset you need!

In my opinion, the level of concentration that Nadal gets from his routines has contributed to his enormous success in his sport. Whether your goal is to decrease stress, give full attention to patients, or get more productive, rituals can help you too. Not convinced? I can tell you, from my personal experience, rituals can even give you a nice soothing feeling, similar to the one occurring after exercising when endorphins flow in your blood... 🧘‍♂️

So you want to be better in specific situations? Being able to focus at the right moment is key. Pick a ritual that is a good fit for you and repeatedly perform it just before the activity. Do it every time to trigger the state of mind you are pursuing. The process will even make you feel more secure and boost your self-confidence.