Resiliency Toolbox

    Resiliency Toolbox

    Mount Sinai Emergency Medicine

    Lara Vanyo, MD; Chair

    Randy Sorge, MD     Angela Chen, MD

    Three Prongs to Resiliency Training

    • Mindfulness
    • Stress awareness
    • Adaptive strategy



    1. Countdown from 10
    2. Physical focus: meditation while stretching, walking, exercising, self- massaging
    3. Imagery: imagine yourself in a place you find relaxing
    4. Mindfulness: pay attention to sounds around you

    These can be done when one has a moment of patient-free time, particularly prior to an anticipated stressful event, for example, while:


    • Washing your hands
    • Printing papers
    • On hold on the phone
    • In traffic
    • In the elevator
    • Standing in line
    • On public transportation


    Mindful eating:  Eat slow, Concentrate on taste, texture, Think about where this food came from originally

    Body Scan:  Full meditation with concentration on body from head to toe


    Online Videos for mini-meditations:

    From Embrace Changes

    For Difficult Times: A 2-Minute Meditation

    Stress Awareness

    “The Battery”

    1. Draw a 2 column chart – what drains your battery and what charges it
    2. See how this changes over time
    3. Think about this throughout the day – e.g. this patient’s anger drained by battery but this patient’s appreciation charged it

    Negative automatic thoughts

    1. Be aware of and fight off thought distortions, such as: “it’s my fault,” “I’m a fraud”
    2. It’s easy to perceive situations as negative in hospital atmosphere


    1. Coping mechanisms
    2. Catharsis through jokes and ER community

    Adaptive Strategies

    Appreciation journal

    1. Each night, write down 3 things you are thankful for OR three things you did well today
    2. See how these change over time
    3. Important to go to sleep on positive note
    4. Do this with your partner!

    Letter to yourself

    1. Write out your goals and milestones you’d like to hit
    2. Why are these your goals?

    Word play

    1. Words which may be perceived as negative – consider how you can shift them toward positive meaning (for example surrender, intolerance, discrimination)


    1. Listener does not comment or give advice
    2. After story, both teller and listener write down what the teller experienced and how they felt about the story