"Why are you answering your own phone?" asked my colleague with an air of critical amazement. "Because it is ringing and my assistant had to step out for a moment." "You really should have your phone covered at all times-it is about protecting your time, using it wisely, and creating balance in your life," my colleague advised. Curious-I never really considered that not answering the phone would contribute to life's balance equation. After all, I would eventually need to engage with a significant percentage of those who phoned. The act of delaying seemed more costly than the act of engaging.

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Teaching others how to manage the complexities and stress of everyday living has become a cottage industry in healthcare. The relationship between extreme and constant stress and the development of illness states is well documented. Therefore, heeding the call to focus on stress management can lead to very positive results.

The notion of balance in one's life is relativistic at best. Balance for some is boredom for others. Balance for some implies a strict proportion of downtime to work. That is, there is work and there is play or relaxation, and they cannot be integrated for true downtime to occur. For others, work and play are exquisitely intertwined as if in a dance where time disappears and pleasure pervades, a state called "flow."

Flow is a concept first described by the psychologist, Mihaly Csikszentmihalyi, who was also a qualitative researcher. He conceptualized that "flow" situations are those in which a person's attention is freely and completely invested in achieving a goal or an objective, "because there is no disorder to straighten out, no threat to the self to defend against. We have called this state the flow of experience because this is the term many of the people we interviewed had used in their descriptions of how it felt to be in top form."1^(p40) Think about the last time you experienced "flow." Whether working with others or working alone, you were totally immersed in the process and your psychic energy was completely invested in the goal that the group or you chose to pursue. Time seemed to fly or be suspended, and there was an extreme sense of pleasure that accompanied the experience. Csikszentmihalyi's research has demonstrated that the more flow experiences a person has, the better the quality of life and level of confidence. Even boring routine work can become purposeful and pleasurable when one is able to consciously focus attention so purposively that the result is "flow." Experiencing "flow" is having a good measure of control over your own attention, where you direct it, and how you make it work. It is what Csikszentmihalyi refers to as disciplined concentration.

For me, attempting to enter "flow states" has become the best form of stress management. Flow is quiet, moving like a slow, steady current that carries you to a goal, even a mundane one like picking up the phone and completing the call. It is unlike riding the rapids of day-to-day experience that has you up, down, and often completely off balance, putting you at risk for negative interactions and even illness. Am I in a constant state of flow? Of course, not!! However, the experiences get more and more frequent as I attend to what I am doing very deeply, like writing this editorial or doing the wash. Flow can be one of the best and enduring approaches to stress management. Go with the flow!!

Gloria Ferraro Donnelly, PhD, RN, FAAN

Editor-in-Chief

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