Meet the Coach Testimonials Physician Growth Framework Self-Coaching Program Resource Hub
← Back to all posts

Holding Pattern

by Dr. Tonya Caylor
Jan 09, 2026

This is Week 4 of a 5-part series exploring those moments when you care deeply about an issue, and nothing you do seems to move the needle.

So far, we’ve looked at three different approaches to that situation: • Week 1: Redefining success when outcomes aren’t changing • Week 2: Navigating real constraints rather than fighting them • Week 3: Acceptance without endorsement, stopping the extra emotional shock when predictable dynamics repeat

Each of these approaches helps in different ways and sometimes after you’ve tried them, you’re still left here. You show up. You try again.  There is a phase that comes after that.

And it’s uncomfortable.

Nothing is actively changing. You haven’t found a clear path forward. You haven’t decided to leave. The situation you care about hasn’t resolved, and the discomfort hasn’t lifted.

This is the middle space.

When that happens, many people feel a growing pressure to decide something. To exit. To pivot. To declare a direction.

This is what I think is one of the hardest places to be: the middle space.

The Middle Space

One of the clearest signs you’re in this space is the rush to clarity, the urge to decide, declare, or exit, not because the answer is clear, but because the discomfort of uncertainty itself feels so big.

Years ago, when I was feeling that same rush, a wise friend said to me, “I wonder if you’re creating a false sense of urgency for yourself.”

When I really looked at it, she was right. There was no specific reason I had to decide right then. I still use that as a quiet self-check when the pressure to resolve things starts to spike.

That check-in is key.

The middle asks something different of us. It asks us to stay present without forcing resolution. To remain engaged without numbing. To resist the instinct to relieve discomfort by making a premature move.

It's not passivity. It’s a strength that holds your values without forcing an outcome.

The Tragic Gap

Parker Palmer calls this space the tragic gap, the distance between what is and what we still believe could be.

The work of the tragic gap isn’t fixing the tension or rushing to resolve it. It’s learning how to hold it without becoming cynical or unrealistically ideal. Here is a short clip of Palmer describing this idea, because he gives language to more clearly understand.

Video link: https://www.youtube.com/watch?v=rq0aeKCB41g

Holding Pattern

A physician I once coached said, very plainly, “I have to leave. Leadership doesn’t value me.”

In the same conversation, he also said, “I love everything about my job.”

His patients. His learners. His sense of purpose. His national opportunities.

He wasn’t conflicted about the work itself. He was conflicted about one set of relationships.

Rather than trying to fix leadership or talk himself out of leaving, we held both truths up together.

  1. It’s rare for someone to genuinely love nearly every aspect of their work and yet he did.
  2. It’s also painful to feel undervalued by leadership.

 

Both were true.

Over the next few weeks, he stayed in that tension and quieted the instinct to resolve the discomfort.

He anchored more firmly in his purpose and values and how they were being used in the daily work. He clarified what mattered most to him. He noticed how much of his fulfillment came from places untouched by leadership dynamics.

Nothing magically resolved. But the urgency to escape softened. He wasn’t staying because he felt trapped. He was staying because rushing an exit would have cost something he wasn’t ready to give up.

He chose to remain in the tragic gap until there was a clear reason to change or until the tension resolved itself.

What This Is and What It Isn’t

Staying in the middle space is not about tolerating harm or denying your worth. It’s not about gritting your teeth and enduring something unhealthy.

And it’s also not about forcing a decision just to relieve the pressure of the middle discomfort.

The middle asks something quieter yet harder: staying present without rushing an outcome.

For some people, staying here eventually clarifies a long game. For others, it clarifies a graceful exit. (We’ll talk about those next week.)

Reflection

  1. Where in your work or life are you feeling a rush to clarity, even though no real deadline exists?
  2. What might change if you allowed yourself to stay in the middle a little longer, without forcing a decision?

 

Responses

Join the conversation
t("newsletters.loading")
Loading...
Planning the Unpredictable
As my move out of Alaska gets closer, I find myself increasingly reflective. There is something to the  saying that life is what happens while we’re making plans. Nineteen years ago, I finally gave in to my husband’s persistent suggestion that we go “look” at Alaska. We stepped off the plane, fell in love with it, and moved here three months later. I could never have predicted where that decisi...
Pick Up the Phone
A couple of weeks ago, I was juggling multiple time-sensitive projects when someone began doing work which I felt was mine to do, that I wanted to do, and in an order that made no sense to me. I initially reacted from momentary frustration. Becoming a coach does not uninstall the old neural pathways. Under the right conditions (low on sleep, skipping workouts, doing too much), they still know e...
The River Gets Wider
Just prior to marrying my husband, his dad handed us an article torn from a magazine. It used the imagery of two rivers coming together to describe marriage. The gist that stuck with my young mind was:1. Don’t be shocked by the rapids. They’re a natural outcome of two forces merging.2. Marriage will have twists and turns, rocks and islands to navigate, but given the right conditions, the river ...

Joy in Family Medicine – Stories & Reflections

Lessons, lightbulb moments, and honest reflections from life inside and outside medicine - served with a side of perspective.
Footer Logo
Terms Privacy Disclaimer Contact us Login Personal Code of Ethics
Powered by Kajabi

Stay Connected


Join my mailing list to receive free weekly tips and insights!