Learning to self-regulate multi-dimensional felt experiences: The cases of four female medical students

Figures & data

Table I. Components of the resonance performance model (adapted from Newburg et al., (2002).

Component	Description
The way you want to feel	Refers to the way individuals want to feel in important areas of life from different relevant perspectives (e.g. physically, emotionally, cognitively, and socially, and spiritually).
Preparation	Refers to what allows individuals to feel the way they want while achieving their performance goals. It can include, but is not limited to, cognitive, physical, technical, tactical, emotional, social, or organizational means, strategies, or activities.
Obstacles	Obstacles are both internal (e.g. negative thought) and external (e.g. parental pressure) barriers that prevent individuals from feeling the way they want.
Revisit the way you want to feel	Refers to what allows individuals to reconnect with the way they want to feel after facing an obstacle. It can include, but is not limited to, cognitive, physical, technical, tactical, emotional, social or organizational means, strategies, or activities.

Table II. Summary of Ruby’s definition, experience, and regulation of interrelated dimensions of feel.

Definition of feeling	Internal position or gut-feeling that reflects either when there is something wrong about a situation, or when she is feeling the way she wants.
Desired felt experiences	Overall
“Feeling the way she wants”	Feeling the way she wants is like a high; she is energized by a lasting surge of energy that allows her to feel like she can juggle multiple tasks at once; there is also a feeling of excitement. In her daily life, she wants to feel relaxed, with no internal conflicts or insecurities. It’s a calming sensation she experiences when something feels ‘right’ (sense of clarity).
		Dimension	Interrelation and regulation of dimensions
	Social	Feel/experience a sense of social connectedness with her patients, colleagues and preceptors.	When she feels connected, reciprocally feels motivated (cognitive) to perform and keep moving forward and feels happier (emotional) with what she is doing.
	Physical	Feel in-tune with her body. She feels in control, and can breathe effectively and calmly. Neck muscles feel warm and relaxed, and body feels gelatinous.	When in-tune with her physical bodily sensations, she notes changes in how she feels emotionally, cognitively, and socially. Gives her insight into how to use this physical data to guide her overall self-regulation.
	Emotional	Feel a sense of excitement. Experience a greater sense of empathy with patients, and generally feel happy as a person.	When experiencing facilitative emotions (e.g. happiness or excitement), she feels more confident (cognitive), which is also felt physically, and she is often more motivated (cognitive) to go the extra distance for her patients.
	Cognitive	Feel motivated and “on top of things.” Feel intuitive with a sense of clarity.	When she feels intuitive and has clear, flowing thoughts, she feels physically aware of how her environment, social or otherwise, is affecting her. When she is able to be logical, rational, and intuitive, she feels confident (cognitive) in her tasks.
Undesired felt experiences “Not feeling the way she wants”	At school she feels disconnected with her tasks and has difficulty accomplishing anything. In her daily life and at school, she feels physically tense and cannot relax or experience a sense of calm. She feels preoccupied by negative thoughts, and the ensuing negative emotions tend to cause her to “over-catastrophize” situations, and “wallow” rather than proactively take control and formulate steps to effectively self-regulate. Since facilitative feedback from social interactions play an important role in her self awareness, a lack thereof typically interferes with her ability to gather feel and performance related data on which she relies to prepare for and regulate future performances. She finds herself in a state of amotivation, and feels physically tight in her neck muscles, and heavy in her chest.

Table III. Summary of Emelia’s definition, experience, and regulation of interrelated dimensions of feel.

Definition of feeling	Sees feel primarily as how she experiences her emotions and thoughts and how they are physically manifested within her body.
Desired felt experiences	Overall
“Feeling the way she wants”	Wants to feel confident in her knowledge and execution of tasks, and be able to identify and evaluate what prevents her from feeling the way she wants to regulate herself and her performance. Establishing control is a critical element because when in control, she feels relaxed and at ease and is unaware of physical bodily sensations; flowing from her as if she is on autopilot. It is a holistic experience that she describes as her ‘balance’.
		Dimension	Interrelation and regulation of dimensions
	Social	Wants to feel connected with her patients and feed off that positive energy.	Positive social interactions give a feeling of accomplishment, satisfaction, and motivation (cognitive) to make that extra effort. It is also an important variable in connecting to, and regulating over time, her ‘balance’.
	Physical	Wants to feel connected to her body; feel relaxed in her muscles like she is limber, dexterous, and coordinated; feel light as if her body does not have any weight, especially in her legs and arms.	Taking control of her physical sensations (e.g. through exercise) becomes a regulatory mechanism. It helps her to reflect on, organize, and act-on her thoughts to feel more positive (cognitive); In turn leading to facilitative emotions (e.g. feels happier). Attuning to the physical dimension often acts as a strength indicator, allowing her to be aware of where she is in reference to her “balance”.
	Emotional	Wants to feel, above all else, a love for what she is doing; she also wants to feel happy and content while on her rotations, which she experiences as a light and floating sensation.	In a cyclical relationship, how she feels emotionally influences how she feels cognitively. When she experiences this light and floating sensation, she does not feel any tension in her body (physical), nor does she feel overwhelmed by negative thoughts (cognitive). She feels love (emotional) when she experiences a strong social connection with her patients (social).
	Cognitive	Wants to feel in control of her thoughts, which in turn makes her feel confident that she can actively regulate the other dimensions of feel. She also feels motivated to do more, and seek out new learning experiences.	Thoughts and the way she feels cognitively play a central role in her performance and the regulation of her emotional, physical, and social dimensions. When her thoughts and ensuing feelings change, her emotions (emotional) and physical bodily sensations (physical) seem to follow and influence her perception of social and other environmental stimuli (social). Thus, her ability to take charge of her thoughts and how she feels cognitively (e.g. confident, motivated) is a critical factor in her ability to self-regulate.
Undesired felt experiences “Not feeling the way she wants”	If she is not feeling the way she wants, she becomes more conscious of physical sensations such as muscle tension and a heavy feeling, like she is not in control of her body or mind. Her stomach feels uneasy and her body feels clumsy. Cognitively, she feels foggy, like she cannot see. Emotionally, she experiences frustration, anger, and even fear. Negative emotions bring on more of a heavy feeling and a diminished sense of control. When her social connections with her patients are weak, she loses motivation to be there and devote time to them and their families. Not feeling the way she wants interferes with her ability to effectively regulate her performance, particularly by inhibiting her holistic sense of “balance”.

Table IV. Summary of Marissa’s definition, experience, and regulation of interrelated dimensions of feel.

Definition of feeling	Feel is both multi-dimensional and situational, connected primarily to her state of mind in the moment. There are social, cognitive, emotional, and physical dimensions to it, and every aspect of her life plays a role in the way she experiences feel. She strives to achieve an ultimate feeling as often as possible, which extends from her performance as a medical student, to everyday life.
Desired felt experiences	Overall
“Feeling the way she wants”	Calls her ultimate feeling her “aura”; a feeling of confidence, preparedness, and happiness where she feels almost invincible, and feels motivated to take on new tasks. Her aura encompasses physical, emotional, cognitive, and social dimensions. Experiencing her “aura” is critical in her life because the quality of all her social interactions (e.g. preceptors, friends, patients) depends on it.
		Dimension	Interrelation and regulation of dimensions
	Social	As an intensely social person, she wants to feel connected in her social relationships, more so in her everyday life than at school.	Believing social energy is contagious, as a regulatory mechanism she often draws on this energy from others (e.g. friends) when she wants to connect with her “aura”; feeding her “aura” and giving her a light (physical), uplifted feeling, and sense of enjoyment (emotional).
	Physical	As a key sensation within her ‘aura’, she wants to feel surges of energy, like she is light on her feet but strong at the same time, and feels physically healthy. Allows her to feel invincible; like she has a shield.	Physically feeling the way she wants often has a social source. Positive feedback from her preceptors (social) facilitates these surges of energy, which in turn make her feel more confident and motivated (cognitive). Taking a more active role in her physical regulation, she discovered that exercise allows her to feel physically healthy and able to “wind down” at the end of her shifts; a time to clear her head, reflect on her day (cognitive).
	Emotional	Wants to feel excited and happy, like she is vitalized. This is a central component of her aura.	When feeling the way she wants emotionally, her thoughts seem to be positive and clear and she feels cognitively focused (cognitive). Feeling in control of her emotions gives her the confidence and motivation to take charge by focusing on the task at hand and maintaining positive thoughts (cognitive), and by physically engaging herself and using the resulting surge of energy (physical).
	Cognitive	Wants to feel confident, prepared to take on any task or meet any challenge, and experience an overall sense of accomplishment.	Her cognitive processes act as the center where she perceives, interprets, and reacts to her experiences including social, physical, and emotional data. It allows her to self-regulate effectively by reflecting on past performances and making appropriate adjustments that incorporate each dimension.
Undesired felt experiences “Not feeling the way she wants”	When she is unable to feel the way she wants, she cannot experience her “aura”. She has negative emotions and experiences a high level of anxiety that are often rooted in a lack of perceived control over a situation. Cognitively, she begins to take words out of context and perceives more situations as negative or as bigger than what they actually are. Physically, she experiences a lack of energy, which is detrimental to her performance and overall well being.

Table V. Summary of Sophie’s definition, experience, and regulation of interrelated dimensions of feel.

Definition of feeling	Throughout the intervention process and especially in the beginning, she found it difficult to articulate what feeling was to her, and how she experienced it. Despite being able, in hind and foresight, to identify how she wanted to feel socially, cognitively and emotionally, she was not particularly aware of how she felt in the moment beyond physical sensations, and found it difficult to identify links between the different dimensions of feel. For her, feel was primarily sensed in physical ways, in a reciprocal relationship with her social and environmental experiences; she was thus very in tune with her body in any given moment.
Desired felt experiences	Overall
“Feeling the way she wants”	Wants to feel confident, smart, physically relaxed, and devoid of negative anxiety; which is reflected in normal breathing, a regular heartbeat, and an absence of negative thoughts. Her confidence is deeply rooted in her social experiences with others, and her school performance efficacy. When feeling more physical energy, she feels engaged and motivated, which in turn makes her want to work harder. When she is experiencing high confidence and a sense of flow, she works on autopilot and has few conscious thoughts.
	Dimension	Interrelation and regulation of dimensions
	Social	Wants to feel connected with her social environment at school, especially with her preceptors and colleagues.	Represents a central dimension of her felt experiences. All others permeate from her social experiences. When she feels valued by her preceptor (social), she feels happy (emotional), confident and motivated to do more (cognitive), and feels more relaxed in her body (physical) in that any anxiety she may have does not reach a conscious level, which is when it gets too debilitative to overcome.
	Physical	Wants to feel relaxed, with a regular heart and breathing rate; ultimately does not want to consciously be aware of her body in the moment as this means she is experiencing a sense of flow.	Became instrumental in the development of her ability to regulate herself. She was naturally attuned to physical manifestations within her body, and thus able to use these as a precursor to, or indicator of, her thoughts and the way she cognitively (e.g. focused, confident) and emotionally felt.
	Emotional	Wants to smile and experience a sense of enjoyment in her work. Overall, she wants to feel devoid of negative emotions.	Recognized over time that her emotions played a role in her chronic experience of negative anxiety. Initially a physical phenomenon for her, her experience of somatic anxiety (physical) was rooted in feelings of frustration and anger (emotional) that often emerged in response to negative feedback from her preceptor (social). Since she found it difficult to manage her anxiety once it reached an intolerable physical level, she began to consciously attune to negative thoughts preventing her from feeling confident (cognitive) and a sense of enjoyment (emotional) so she could interject and attempt to regulate them before they physically manifested themselves.
	Cognitive	Wants to feel confident and a sense of flow whereby she is only focused on her current tasks.	To feel confident, focused, and flowing, she became more aware of the influence that her thoughts had in her every day experiences, allowing her to make links to her physical sensations (physical), realizing that her inability to feel relaxed was due to her anxiety. Feeling confident and calm was coupled with low anxiety and tension (physical). Actively engaging herself in an inclusive and supportive social environment at school greatly increased her opportunities to feel confident and focused (cognitive), happy (emotional), and socially connected (social).
Undesired felt experiences “Not feeling the way she wants”	When she is unable to feel confident, she typically loses physical and mental energy, and the motivation to work harder and take “that extra step”. She often experiences negative anxiety which results from an inability to feel confident, calm, and socially connected to those in her performance environment. Unable to achieve that feeling of flow, she “gets down on herself” and finds it difficult to feel engaged in her tasks. When she has high anxiety, she has trouble breathing, her heart rate increases, her hands become sweaty, and she feels dizzy.

Newburg, D., Kimiecik J., Durand-Bush, N., Doell, K. (2002). The role of resonance in performance excellence and life engagement. Journal of Applied Sport Psychology, 14,249–267.

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