Mental health issues have become even more felt in this time of the pandemic. With social isolation along with the uncertainties surrounding us, we can’t help but feel even more depressed and anxious. Diving deep into this very timely topic, Patrick Veroneau brings to the show Dylan Roberts from the Coast Guard Academy to shed light on the silent struggles many are facing with their mental health. Dylan talks about his journey through depression and suicidal ideation and how he was able to overcome them. He shares some of the things we need to do to have those tough conversations and develop the coping skills to deal with some of the difficult moments that come and go. What is more, Dylan then lets us in on his upcoming book, where he gives a peek into his own struggles and reminds us that it is okay not to be okay. Everyone is fighting their own battles. What all of us can do is by being kind to one another because kindness has a ripple effect with no logical end.
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Dylan Roberts: His Story On Overcoming The Stigma Behind Mental Health
In this episode, I’m going to talk to an individual I’ve known for many years. His name is Dylan Roberts. He’s from the Coast Guard Academy. I brought him on here to talk about his journey through some things that I didn’t even know that he was going through in his life. It’s around depression and suicide. In this environment that we’re in now, I think it’s so important. Whether it’s adolescents or adults, what are some of the things that we need to do to be having those conversations and developing the coping skills to be able to deal with some difficult times? Whether you know somebody directly or you know somebody that knows somebody that is going through this, this impacts all of us. I hope you stick around and read this inspiring conversation that I was able to have with Dylan. Let’s get into it.
Dylan, I want to thank you for being on the show. This is one of those episodes that can never be told too many times. I know we’re going to talk about some difficult things around suicidal ideation, depression and a lot of emotions. It’s important because at the age that you’re going to tell your story that had happened and there were many kids that are going through struggles and so many parents are struggling as well with how to address this.
Thanks for having me. It’s a pleasure to be here and share my story in the hopes that it can help others. I’m a first-class cadet at the United States Coast Guard Academy. I’m a few months away from graduating and commissioning as an officer in the United States Coast Guard. I graduated from Cape Elizabeth High School in 2016. In my senior year, I applied to the United States Coast Guard Academy. I received a conditional appointment pending a medical review. In my senior year, I find out that I’m getting medically disqualified due to suicidal ideation, depression and mood disorder from an incident that happened when I was fourteen years old.
When I was fourteen, I tried to commit suicide. Fast forward, I spent a year of my life at Marion Military Institute in hopes to get a medical waiver to prove that the stigma of what happened when I was fourteen years old isn’t going to define me for the rest of my life. I applied to the Merchant Marine Academy. I got medically disqualified from there as well. While at Marion, I got a temporary medical waiver to the Coast Guard Academy. They said, “You’re accepted, but it’s not permanent. You still have to prove yourself.”In my freshman year, I did well. I made it through Swab Summer, which is the equivalent of boot camp. We had to commission physicals for graduation. I got a full medical waiver for commissioning so that I can commission into the United States Coast Guard Academy. It’s a journey of my perseverance and trying to overcome the stigma of mental health, suicidal ideation and depression from things that happened when I was a teenager and in high school.People are only willing to go to the depth that you’re willing to go to. Click To Tweet
That journey from the time you graduated from high school and going through the Coast Guard Academy is a story in and of itself in terms of how you persevered and didn’t let this define who you are. I’ve had the pleasure of knowing Dylan for many years. Back to when you were in junior high. You are a good-looking kid, a great athlete and well-liked by other kids. When I now know what was going on for you as a sophomore in high school, it’s even more of an alert for all of us like, what might be going on for somebody on the outside and how we look in terms of what’s going in for this person on the inside can be so much different. You certainly are one of those. With that said, the question that I think about, and I’m sure many do, especially parents in terms of how can we help, is there anything that you would go back to and say, “This was something that started to create this sense of unhappiness to me?”
I lived a normal life growing up. I have two happy parents. The misconception is that maybe you’re looking for what’s wrong or assuming that something’s wrong, but it can be in normal life too. I had two older brothers. They’re both smart, incredible and two great parents. What happened to me is when I was in eighth grade, my brother graduated high school. I was watching graduation. That was the first moment when I realized that my brother wasn’t going to be there for me anymore and that he was going to be going off to college. It’s that instance and also, that following year, my grandmother passed away, and I was very close to my grandmother.
Within six months of each other, the change of my brother leaving from home and experiencing the first person in my life to pass away for when the first thirteen years of my life growing up feeling invincible, I didn’t know how to deal with the passing of my grandmother. It was my dad’s mom and he didn’t show a lot of emotions to it because my dad doesn’t show a lot of emotion. I didn’t know how to cope with it. I didn’t know how to go on without even having my other brother in day-to-day life because we were close with each other. I wasn’t accepting change. I was diagnosed with seasonal depression.
In the fall, when the days get shorter and living in Maine, I suffered hard. I started having these feelings and I didn’t know how to cope with them. I was trying to keep up and stay in my social group. I felt like I was getting burned out, like a firecracker. I’m feeling every decision I was making at fourteen years old was so significant, the pressure to do good academically and to perform athletically. In my freshman year, I tore my hip flexor halfway through the season and being like, “Why me? Why did that have to happen to me?” I wouldn’t say it’s one major thing, but it’s a lot of little micro things that build-up to all these feelings and not knowing how to deal with those.
When you look back on that now, were there points where you’re like, “I know something doesn’t feel right, but I’m going to push through this.” When was the point where you were like, “This is more than I can handle?”
The point when it was more than I could handle was when I was a sophomore when I decided that I was going to make the decision to take my life. Leading up to that, my parents and I hadn’t been getting along. They’ve been headbutting between each other, maybe at me too, being defiant against my parents. Them saying, “No, you can’t do something.” Me pushing and saying, “Why can’t I do it? What’s wrong?” I’m fourteen years old and then comparing, “My friends can do this. My friends can do that.” My parents are laying down the law and I remember one night, my mom and I got into an argument. I went to my bedroom and said, “I can’t take this anymore.”
That’s when I made the decision that I wanted to take my life. I was successful. My mom found me unconscious on the floor. I tried strangling myself. I tied knots around my neck. I tied multiples so that I knew I wouldn’t be able to on time before I went unconscious. My mom thankfully found me because I texted my older brother and said, “I love you. Thanks for all that you’ve done. Thanks for always being there for me.” He texted her, but she came into my room, and that’s where she found me laying on the floor and unconscious. She called 911 and I went to the hospital. At the hospital, they said that there’s a voluntary program and that I would be going to a psychiatric hospital at Spring Harbor.
It would be a great opportunity to help with my depression and coping skills. It’s a way to take myself out of the elements that I’ve been in. It was a two-week pause button. Most times, teenagers and adolescents are in there for a month or more. I was only in there for two weeks, but it allowed for time to pause, to stop and let me be myself. I didn’t have my phone when I was in there, so there were no distractions. I began to learn coping skills. I was with a bunch of other teenagers that felt the same way that I felt. We got to talk about it in round table discussions, then learn and develop coping skills and understand how to deal with it.
Is there one thing that, as you were in there, start to create a shift for you?
A lot of it was the pressure that I was putting on myself. The relationship with my parents because I’d never told my parents that I’m depressed. I want to kill myself. I did it. It was learning to be able to have those conversations with my parents. That came in time because we went to family therapy. This was voluntary, but we knew that it was essential because it was what was going to help our family and help us because there are some communication gaps. Being the youngest of three, my mom and dad raised my older brother and middle brother, and then here’s me. They’re trying the same techniques that worked for my two older brothers, and it’s not working. Thinking of a DISC profile, we’re not all the same personality types and you can’t interact with us all the same way.
Understanding that for my parents and for me, feeling comfortable to have conversations with my parents because they’ve visited me twice while I was there. I got to talk to them. That was the first time that I’d seen emotions from them. That was something new for me because my parents didn’t show emotions. My mom told me growing up, “My job isn’t to be your friend. My job is to be your parent, to raise you right, and put you into this world as a gentleman.” That is an example of my mom and my dad isn’t one to show emotions. He is a career firefighter and he just got through things. He got over it. It was how it was. To start to see my parents showing that emotion and showing that compassion towards me, I felt that I could reciprocate it in the same way.
Your mom’s saying, “I’m not here to be your friend. I’m here to be your parent and to develop you.” As you look back at that moment, how did that come across to you? Being told, “I’m not your friend.”
It was hard because I wanted more from my mom to have a closer relationship but at the same time, I understood that when she did things, it was for my future. I can’t say that I understood that but looking back now, I understand the things that my mom did and what she said to me and the purpose behind it. One of the biggest lessons that they taught me was that you’re entitled to nothing and things in life aren’t just going to be given to you. That was something that I had a hard time with going to Cape Elizabeth, where my friends would be driving cars.
Their parents would buy them a bunch of things and I’d be like, “My friends have a car. Why can’t I have a car?” She would tell me to go out and work for it. I didn’t like that answer. At that time, I wish that maybe she would have been my friend, but I know that it would be hard too because that’s never been the side of my mom, even though I felt that growing up, I was more of a mama’s boy. She wanted to always lookout for the best interest of me, whether I knew it or not.
It is hard. As parents, we’re not given manuals on how to do this. She did the best she can. I can see that struggle of your mother wanting to say, “I’m not your friend. I’m here for a bigger purpose,” but not that she didn’t want to be close to you, but it’s the way it happened. As you look back on this, were there signs or signals that you were trying to give to your parents or those around you to say, “I’m struggling now.” If you look back on it now, where there are behaviors or things that you were doing that were ways for you to say, “I need help.”
Not really, and the reason why is because it’s hard to tell somebody that you’re struggling. Especially now, in this day and age, everybody wants to say, “I’m okay. I’m good. How are you?” “I’m good. You?” It’s that lack of depth. I don’t want to say that it was a problem back then, but people are only willing to go to the depth that you’re willing to go to. I didn’t want to be the one going to that depth first. As the youngest of two other brothers and having parents that were very stern, but I don’t want to say emotionless, but in that facet, I didn’t want to be the one to be like, “I’m struggling hard now.”
The only thing that I can think of is that I would become defiant with my parents and maybe short-tempered. I would storm off if I didn’t like something that they said and be like, “I can’t wait until I can get out of this house. I can’t wait until I can graduate.” Especially in writing my book, Keep Pushing, a lot of the book is talking about the reflection of how I wish I could have been closer to my parents and been more thankful for the lessons and the things that they did for me and the lessons that they gave to me.
The next piece of this, when we talk about not wanting to talk about some of these things, here you are in two weeks, you’re gone out of your normal mix. What was that like for you going back to school? I’m sure there were a lot of questions around like, “Dylan, where have you been? What’s going on?” How did you handle that?
It was hard. I remember the first day walking back into school and feeling like all eyes were on me. I’m feeling anxious. I’d never been one to feel anxiety. I felt so much anxiety and my heart pounding because I didn’t know what I was going to say when the first person asked me, “Where have you been? Where are you for the last two weeks?” Because I was on sports teams. I was a part of a lot of formal and informal activities and clubs at school, the excuse I came up with was I was on a hunting trip. I didn’t have phone service and I completely lied to my friends. Until November 2020, I didn’t tell any of my closest friends what had happened to me. I did not want to be a part of that stigma of mental health.
I did not want people to think of me differently or think that I was weak because I did that. I didn’t want to tell anyone. I didn’t tell any of my teachers. The only person that knew was my Health teacher and the social worker at school so that I could go back into classes because I’d missed two weeks of classes and they waived that for me. I told my Health teacher and one of the things that she told me, especially knowing my struggle because I had her in class. We talked about suicide and mental health, and I felt comfortable going to her. She told me, “This too shall pass, TTSP. Whenever you’re feeling down or having a hard day, remember this too shall pass. The school day doesn’t last forever.” I looked to go through that. Pretty soon, things blew over, and there was the next new thing to worry about or new drama. I went back into the rhythm of it and I felt like I didn’t have to tell anyone so I never did.Whenever you’re feeling down or having a hard day, remember this too shall pass. Click To Tweet
Was that your mantra too, as one of your coping skills, is to be telling yourself, this too shall pass?
Yes. I still use it to this day because you’re not going to be stuck at that moment forever. There are going to be hard days since I was fourteen years old, but I knew that emotion or those feelings that I would feel aren’t going to last forever. Knowing that time keeps moving and time is the best healer for whatever you’re going through.
This isn’t this fairytale ending where all of a sudden you do two weeks, you are able to leave early from the hospital and you develop these coping skills. Life gets back in the way of this and my guess is you’ve developed additional coping skills or ways that have allowed you to continue to build on that. Is there anything in particular that you look at now and say, “This has been one of those building blocks for me?”
To go off the first point is that I was struggling again during baseball season. I got hit by a line drive right in the head, and I got knocked out with a concussion. I was out for my sophomore baseball season. One day I was struggling and one of the coping skills that I had was outreaching with my dad. I texted my dad and said, “I’m struggling.” He picked me up from school. We got ice cream and went to the beach. This was a big moment for me in terms of my dad being vulnerable to me, understanding and learning the value of vulnerability.
My dad told me he wasn’t sure what I was going through, but telling me this story that when he was nineteen years old, he was in a serious relationship with a girl and she ended up breaking his heart. He said, “I was upset for weeks. I didn’t even want to get out of bed. I didn’t want to go to work. I didn’t want to do anything. I thought she was the one but had she not broken my heart, I would have never met your mother. I wouldn’t have these three amazing boys. Whether I knew it or not at the time, it was the best thing that ever happened to me because I have you. I’m proud of you.” That was the first time that my dad was vulnerable with me because I had no idea of that story. That was him telling me he’s proud of me. I hugged him. I was like, “This is the most incredible feeling.”
I know for a fact that my dad would’ve been proud of me and other moments growing up, but for him to openly say, “I’m proud of you,” was more than I ever imagined. It’s just not words that came out of his mouth. That vulnerability taught me to be more vulnerable and how I mentioned before, people are only willing to go to the depth that you’re willing to go to. I wasn’t the one that had to go to that depth first that day. That was an incredible moment. Always taking time for myself in the day. I started doing yoga. I like to work out a lot and I value nutrition, food and making sure that I’m eating well and drinking a lot of water. Also, getting myself out of an environment when I can feel myself going downhill and I could be going to hang out with a friend or going to the gym and working out or going for a walk, but if I feel myself getting down on myself, getting out and changing scenery.
One of the other things you mentioned is you’ve written a book and that’s going to be a whole separate show. We talked about when that book finally launches and we’re going to speak specifically to that. Part of that must be writing. How did writing fit in for you in this process?
It’s tremendous because for me not to want to tell my story or share it with other people, I felt that writing was a way that I could get it off my chest without feeling like I needed to tell somebody, but getting out there. Even now, if I have a bad interaction with someone or I’m feeling frustrated, I’ll get out of the line with a piece of paper and write. I’m like, “I feel a lot better now.” I’ll crumple it up and throw it away because it’s a way for me to express myself, even if it’s just to myself. By doing that, it’s awesome. That’s why I started writing my book. I never plan on sharing it, but the reason I started writing it informally was because it helped me when I was drained or burnt out to write away and think of nothing else.
There was a process there. At what point did you say or did somebody else read one of them and say, “This would be something that other people should hear about?”
I had the privilege of being on a Fast Response Cutter out of Miami Beach and that’s for the Coast Guard. One of the crew members, he’s a father. He had a son that at my age, when I was 12 or 13, started feeling depressed and going through suicidal ideation. He told them that he thought about suicide. As a parent, he had no idea how to handle that and what to do. This was my first vulnerability for me to go to that depth first. I told him about my experience and how I overcame it and what I felt like I needed from my parents at that time. Hearing him talk about how important that was and be like, “I get it because I felt lost but to have you talk to me and to share your story.” He broke down.
It was incredible because it was a big realization of you want to be a parent and you want to be a good parent, but at some point in time, you got to hug your kid, your son or your daughter and tell them you’re proud of them with no repercussion. It’s like the report card. The report card saying, “When you get a bunch of A’s and B’s back, and there’s one C, and as parents, you tend to focus on that one C getting that up instead of praising them for all the A’s and B’s that they get.” The purpose of praise is to tell people what to do more of. Sometimes we do it backward, but telling him and seeing the impact that I had on him, made me feel comfortable to share one more time with one more person that was struggling.
We talk about vulnerability. This is the first opportunity you have to tell that story. I have to believe that you had to go outside of yourself to want to do that, but you saw somebody else going through that and you knew that needed to happen. You mentioned you didn’t tell your friends until November of 2020. That’s got to be a vulnerability as well. How did they take that?Every act of kindness has a ripple effect with no logical end. Click To Tweet
When I told my story for the first time, I was telling it, not for me. I was telling it for that shipmate, to help him as a father. Coming up seven years from when it happened and getting that medical waiver permanent so that I can commission, I decided that I was going to share a piece with my closest friends. I was talking to them and said, “When we were going through high school together, something happened to me and I never shared it.” I sent them the piece. Their first reaction was, “It is your obligation to share this with other people because you have no idea the impact that it’s going to have because I had no idea that you ever went through this, that you were ever suffering from depression or suicidal ideation.”
That one confidence boost to know that they’re not judging me. They don’t think any of me, but in terms of me being vulnerable and courageous, they’re standing up for me. I decided to share my story and published it. When I did, my heart was pounding when I press send. Shortly after I submitted it and published it, I got a response back from somebody that I didn’t know. She said, “Thank you for posting the words that I never had the courage to do so myself.” All of a sudden, my inbox is full of vulnerable stories that people had gone through. I didn’t know them, but going back to people are only willing to go to the depth that you’re willing to go to, when I went to that depth and made my story public, it had a ripple effect.
Every act of kindness has a ripple effect with no logical end. It’s the same thing with vulnerability. These people that have their stories kept inside for so long now have that first person that they feel comfortable to share it with. They didn’t even know me, but it was because I decided to share my story too. That’s when I decided that I needed to make all the writing that I’ve done over the last couple of years into a book. It was my obligation to share it just to help one person because it’s not about me anymore. It’s not my story. It’s in helping people understand that it’s okay not to be okay. A lot of people suffer. Fifty-four percent of people know someone that’s been impacted by suicide and 10% or more of people in the United States have thought about committing suicide.
The numbers are only increasing and growing. The amount of stories that I heard back in terms of a husband, a wife, a brother, a sister, son or daughter that committed suicide after reading my story, I’m at a loss for words because it’s heartbreaking. Fortunately, I’m on the other side of that and my mom saved me but to either bring assurance or where peace of somebody reading that story, but also for somebody that is struggling to know that it’s okay not to be okay and not to feel that you need to keep it to yourself, even though it took me seven years to tell my story.
You are telling your friends and everybody has their journey on this, but I would think it opens you up to all of those people that your friends are saying, “I wish I had known that I could’ve done something to help you out at that point.” There were many people around that care, but maybe don’t know what to do, but want to do something. The other piece I think about when you talked about vulnerability, going to that level, it sounds like that’s almost what your dad did too. He became vulnerable in a place that wasn’t his nature but to tell a story about it, he went to that level first to be able to make you more comfortable.
That’s why when a parent, mom, or dad can go to that level first with their son, then there’s going to be more communication. Let’s go there. One of the things growing up that there was a big shift in my high school years was the paradigm of trust. It started off as sticks and carrots with my mom and my dad. I didn’t necessarily care about pleasing them or making them happy. It was more so, I’m going to do what’s best for me or I’m going to go here because I want to go here or I’m going to go with my friends. There was that lack of trust. I want to say that at some point, I lost it because I knew that I couldn’t go hang out with my friends on a school night until 10:00 PM because I had a curfew. To lie really quick and tell my parents that I was coming home or that I was working on schoolwork when I wasn’t, instead of feeling that I could be honest and tell them, “I want to hang out with my friends another hour longer,” because I knew that wasn’t going to be okay.
After that whole incident, trust shifted to where I didn’t want to disappoint them. When I told them stuff, their reaction where they otherwise would have usually got upset or got mad at me and be like, “No. You can’t do that.” They were like, “Why did you feel like you wanted to do that?” I felt a lot closer to my parents. It was almost like I want to be back by 9:00 PM because I don’t want to disappoint my parents because I know that they trust me. I don’t want to lose that trust. It’s such a fine line balancing as a parent.
This is the story that my parents told me. You want your child to be able to call you when they’re in trouble because they know that you’re going to be there for them and you’re not going to scream at them or yell at them or tell them that they’re grounded. At 15 or 16 years old, if you’re at a high school party or you get drunk with your friends, are you going to take the chance to drive home or are you going to say, “No. I know that my mom might be disappointed, but I know that she’s going to be there for me and I can call her. I feel comfortable calling her to say, ‘I want you to pick me up,’” or if I’m uncomfortable in the situation that she’s not going to rip my head off.
We’ve had that conversation with our kids of saying, “We don’t care where you are. We’ll come to get you. We’ll have a conversation about it later on, but it won’t be at that moment. We want to bring you home safely.”
Having those types of conversations as a teenager, there’s a shift where you don’t want to defy your parents anymore. You don’t want to disappoint them because again, going to when my dad told me he was proud of me. When he tells me he’s proud of me on the baseball field, it makes me want to work that much harder because there’s nothing more than a child wants than the praise of his parents. When I got my parent’s praise, that was the best thing I could’ve ever asked for.
Somebody being angry with you does not have the same sting as somebody that says they’re disappointed in you. It hits on such a deeper level, disappointment versus just somebody angry and yelling at you. As we wrap things up here, two thoughts come to mind. One, if there are younger kids that may be reading this that are struggling, what would you recommend to them?
Don’t worry about fitting in. It’s better sometimes to stand out than fit in. There’s so much pressure nowadays to fit in and to stay up with the latest fashion. Second, you don’t need to have it all figured out. That was one of the things too. I compare myself to others, feeling that maybe somebody else had it more together than I did and that would get to me. I said, “What am I going to make in my life?” That was frustrating. One of the things that my dad told me was, “Don’t compare yourself to others. Focus on what you have right in front of you.” That’s the biggest thing for me is to know that you don’t have to have it figured out.There’s nothing more than a child wants than the praise of his parents. Click To Tweet
People figure it out at 30, 40, 50. At sixteen years old, you need to learn. It sounds crazy enough, but we think that every decision has such a big impact at sixteen, but it doesn’t. Know that this too shall pass, TTSP and times of great healer if you’re going through something. My last point is to make sure that you love your parents because they’re trying to figure it out just as much as you are. They didn’t have a prior life before this where they could tweak their parenting skills and then come into this world and say, “I got it all figured out.” Whether or not we realize that, they’re trying to figure it out. There was this statistic that I saw that roughly 90% of your in-person time with your parents by the end of high school is over with. Value that time with your parents and know that they’re trying as hard as you are.
I’m going to ask you to imagine putting on your parenting hat for those that might be reading that have kids, that maybe are aware or not aware of this, what would you say to them?
Discipline only goes so far. By the time I was sixteen years old, I could block it out and my dad would get upset or yell at me. There are a bunch of different techniques and tactics. I’m not a parent, but there’s a podcast called The Knowledge Project. There’s an episode The Kids Are Worth It. I listened to that and I thought it was important, but the balance of trust is that the ability to have conversations and be vulnerable as a parent with your kids so that they’re vulnerable too. They’re not going to come to you and tell you all their problems openly. That’s not going to happen. Whether or not you think it is, it’s not. Be vulnerable and try to spend time with them. Tell them that you’re proud of them. That’s the biggest one.
The purpose of praise is to tell people what to do more of. Focus on those A’s and B’s and congratulate them for their efforts. Don’t be so hard on them because whether or not you know it, your praise and the words that you say as a parent sticks with a teenager. We’re growing up in different times, even as you mentioned too, for your oldest son and youngest son going through high school, even though it’s only eight years apart, they’re completely drastically different. To know as a parent, reflecting and using maybe the same techniques that your parents used to parent you not going to work.Don’t worry about fitting in. It’s better sometimes to stand out than fit in. Click To Tweet
Sometimes you got to keep trying different solutions, but you can’t try the same thing over and over and expect different results. Know that there are different ways to talk to your kids. If you have 2 or 3 kids, they’re not coming off a factory line identical. They have different personalities and you can have an interaction with your oldest and it’s going to be different than your interaction with your youngest son or daughter, and knowing that they want and need different things because they’re not the same person.
Dylan, it’s been an honor and such a privilege to have you on this show to talk about such an important subject. I am looking forward to our follow-up from this, where we’ll talk specifically about your book too. Thank you so much.It’s been a pleasure being on the show. I appreciate it.
About Dylan Roberts
Dylan is a 1/c cadet at the United States Coast Guard Academy studying Business & Management. His area of study is focused on leadership and financial management due to his desire to lead others and interest in the stock market, investment banking, and venture capital.
Dylan chose to attend the Coast Guard Academy because of his desire for a unique and structured college experience while also having the opportunity to serve his country upon graduation. The Coast Guard Academy’s management program is accredited by the internationally recognized Association to Advance Collegiate Schools of Business (AACSB). Dylan would like to pursue an MBA and someday get his CFA certification.
Dylan is currently serving as the President of both the Investment Committee and Financial Club. They actively manage a portfolio through Goldman Sachs on behalf of the CGA Alumni Association. In addition, they collaborate with Navy Federal Credit Union and First Command to create financial opportunities for the Corps of Cadets.
Dylan trades short-term positions in stocks and options using both technical and fundamental analysis. His goal is to read at least one book per week. The topics he read consist of investing, leadership, Stoicism and Buddhist philosophy, psychology, behavior studies, and business.
Dylan currently holds a Secret Security Clearance.
While the empire comes first approach may have worked in the past, it’s not going to get where we want to go in the 21st century. We need a new model which disperses power and not collect it. Joining Patrick Veroneau on today’s podcast is Kevin Hancock, the author of The Seventh Power: One CEO’s Journey Into the Business of Shared Leadership. Patrick and Kevin dissect the concept of shared leadership, highlighting the importance of having every individual share their voice in order for any organization to succeed. Tune in to learn more about this new leadership model.
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Shared Leadership: Celebrating Individual Voices With Kevin Hancock
In this episode, we’re going to talk about leadership and the importance of voice, not the leader’s voice, but the leader allowing other people to have a voice. My guest is Kevin Hancock, who is the CEO and President of Hancock Lumber, as well as the author of the book, The Seventh Power: One CEO’s Journey Into the Business of Shared Leadership. On this episode, I talk not only to Kevin about his book, The Seventh Power, but we also talk about how a diagnosis for Kevin of spasmodic dysphonia prevented Kevin from using his own voice, and relying on those in his organization to elevate their voices. What he found in that experience was how important it was to have other people be able to share their voices for an organization to succeed. Why don’t we jump into that conversation?
Kevin, I want to thank you for taking the time to be on the show. I enjoyed so much reading your book, The Seventh Power. One of the quotes that you had in here that I pulled off said, “Our growth only ends when we call off the search.” To me, this book seems as though it’s an outline for that search, as well as a roadmap in terms of the seven lessons that you’ve outlined here, and some of the great stories. I was hoping you could start out by giving the readers an opportunity to hear what was your motivation for writing this book?
Thanks for having me. It’s always a pleasure to be with you. The motivation for writing the book, it’s become clear to me that we need a new leadership model for the 21st Century. The leadership model that dominates goes back thousands of years. It’s that ‘power to the center, command and control, the empire comes first’ approach. While it might have worked 100, 200 or 1,000 years ago, it’s not going to get us where we want to go in the 21st Century. We need a new model that’s about dispersing power, not collecting it and making other voices strong. I believed that. I’ve been practicing that within my own company, but I felt something bigger was at play here. I set out on what turned out to be a series of adventures, as you pointed out, Patrick. It took me from the Navajo Reservation in the Arizona desert, all the way to Kiev in the Ukraine, looking for some clues about what this new leadership model might look like and might be about.
You’re not just somebody that wrote a book, you’re walking the talk. You come from experience in terms of this needing to re-look the model that was being used, command and control.
The backdrop, as you know, Patrick, about a decade ago, I acquired a rare voice disorder called spasmodic dysphonia that made speaking difficult. I’m the CEO of a lumber company in Maine. We have 560 employees. Our mills do business all over the world. Quite quickly, I had to find a different approach to leading that didn’t include a lot of talking. That led me down this path of sharing leadership bit by bit until it became a broad vision of everybody can lead, every single person in this company leads us.Leadership is an inside job. It's about working on ourselves and modeling and mentoring what it is we want to see. Click To Tweet
When power is dispersed and leaderships share an organization’s performance, it could expand exponentially. That was the vision I had. I’ve spent the last several years trying to fulfill that within our own company, and our performance took off including most importantly to me the employee experience as defined by the employees. We have been the best place to work in Maine for several years. I had seen firsthand what was possible through my own work. I felt though this was bigger than a lumber company in Maine and my own experience. That’s what pulled me out into the world to do more research, which became the basis for the book, The Seventh Power.
One of the powers that you talk about is culture, which is what you spoke to is you’ve created that culture. One of the other powers though that I resonated with me was around change and where it’s created from within. To me, that is something that seems to be the piece as I’ve seen it often that’s been missing in regards to impactful and durable leadership change. It does need to start internally. I wonder if you could speak to that.
That is where it starts. That was my big epiphany or tipping point. When I was a younger manager and leader, I thought that leadership was about paying attention to what other people were doing. What ended up happening, however, with my own voice condition, which started to force change upon me. The pattern I started to see, which is the most powerful change I could create was from me changing. The entire orientation of leadership to me needs to be flipped. My primary job as a leader, as I got a line from Gandhi, “Become the change I wish to see in the world,” and to focus more on getting myself–right, and trusting that when I do that, that starts to create the cultural conditions for others to do the same. The short idea there is leadership is an inside job. It’s about working on ourselves and modeling and mentoring what it is we want to see.
There was a quote that I’d used for many years that was attributed to John Quincy Adams. It was, “If your actions inspire someone to do more, dream more, learn more and become more, you’re a leader.” What I love about that was there’s nothing in there about a title. It’s about your actions. Your actions inspire people to do those things. It speaks to what you’re saying. In doing a lot more digging on that one quote, you’ve come to find out that it’s attributed to Dolly Parton. I love it even more because if you think about when’s the last time you heard something bad said about Dolly Parton? She always seems to be on the right. Her actions do inspire people in many different ways. To me, it’s even more fitting. It speaks to what you’re saying, this idea of, actions are what inspires us. Those come from, “If I’m not comfortable with who I am internally, how can I ever be there for other people?”
The big push within our organization with our managers has been to encourage them to pay a bit more attention to themselves and a bit less attention to others. When I say attention, I don’t mean a lot of focus and energy. We have to show up for everybody around us, but when you want to change something, all you need to do is sit down, close your door and look inward and work on yourself. That’s an empowering concept too. Think about it this way, in that older, traditional model, where someone else has to change for my world to get better, think about how limiting that idea is, how debilitating that idea is. The power I need is beyond my control. The whole concept of this leadership model in my book is the power you need is sitting right inside you. It lives within you.
I did an episode very early on where I talked about the most important leadership tool that I thought you might be able to possess is a mirror to look at yourself.
There is a music passage in my book at the end of one chapter from one of Michael Jackson’s songs. The line I took, “I’m looking at the man in the mirror and I’m asking him to make a change.” That’s a brilliant mind.
We hear a lot about mindsets right now. Growth is fixed. The fixed mindset is that belief that it’s other people that are at fault here. The growth is about saying, “How do I change things? What do I need to do first?”
In fairness, to help people think about this in a different paradigm, the 24/7 connectivity of social media and television media has made people feel overwhelmed and less in control. If you sat and watched the news all day, you would feel a loss of control. One of the things I’ve push though and I talk about in my book is the world in real life is more manageable than the world through a screen. When you shut that screen down and focus on what’s in front of you, the ability to control, impact and influence what’s in front of you is greater than we might think.
All we can do is if we build out what we’re talking about, I’ve concluded that change is a three–step process. We change the world first within us, then beside us. As a result of the change, we created within us, it impacts people beside us, which then impacts people beyond us, within, beside and beyond. You’ve got to have the discipline, the fortitude and the insight to know where to do the work. It can be scary to realize, “I’ve got to start with myself.”
I will often attribute that back to intentional vulnerability where I have to put myself in that position of being vulnerable. If I want things to change, it requires me to do that. To me, that’s the greatest sense of courage or demonstration of it. When I make myself vulnerable, it speaks of my greatest strength and not a weakness.
I try to talk openly about this within our company. I’ve never seen a weakness or a problem within our company that I could not trace it back to me. Something I could have done or didn’t do that could have helped influence a different outcome. For example, Patrick, we had a situation at one of our stores a couple of years ago that I was disappointed in how things were handled. Five or six of us came together as managers. What I ended up doing on the meeting is I went in the room, and talk about the list of things I felt I had done or had not done to contribute to that poor outcome. Spontaneously, everybody in the room did the same. We made so much progress. The only thing that happened in that room is everyone talked about what they could have controlled, meaning within them, what they could’ve done differently to helped create a different outcome. When you’ve gotten that vulnerability, it creates a whole different culture. The only finger pointing ever turns inward in that example where I’m pointing at me.
When I hear you tell that story, it reminds me of the work done around psychological safety. There was an environment there where people felt as though, “This is okay to talk about deficiencies or what we didn’t do well, or my responsibility in this without feeling as though I’m going to be punished or retaliated against or ridiculed,” whatever it might be. There’s a safety component there that’s created.
That makes me think about, for me, the mission of all of this, the goal or the outcome. I articulated that in a form of a question, Patrick. What if everybody on Earth felt trusted, respected, valued, heard and safe? There are about 7 billion people on Earth. Let’s say, pretend all 7 billion of them now felt trusted, respected, valued, heard and safe. What might change? Everything like change. The root of all evil lies in the absence of people feeling trusted, respected, valued, hurt and safe, and not judged, honored exactly as they are, which makes me think of one of the big lessons or chapters in the book, which is dedicated to this idea that listening is for understanding, not judgment.
There’s so much talk about listening and the importance of it. The critical question there is why are we listening? The conclusion I’ve come to is we need to be listening simply to understand. It’s meeting people where they are at that moment and understanding where they’re coming from. When you give up judgment, the world gets so much lighter. It’s much easier to interact with people when you stop trying to be the judge of what’s happening.
I love how you broke out each of those. I will often think in terms of valued and heard, when people don’t sense those, you either run into experiences or situations where people disengage. They pull back or they engage in ways that are unproductive to the group, the society, wherever they are. We’re living that right now, and I truly believe that, where people don’t feel valued and heard wherever they are. Some people pull back and other people act out in ways that are unproductive as well. We see one of those two things happening. Your chapter in there on the power of listening, I believe it’s a superpower. We need to learn to listen to understand. There’s a curiosity that we’re not listening to try and have the right response, but we’re listening to try and see it from the other person’s perspective. I would agree with you, I see too much now that we listen to undermine, and not listen to understand.
That’s a great way to put it. In any group, people are going to be cautious about sharing their true feelings unless they’re confident that it’s safe. Think about the power of this. What if you had a company where everybody that work there could say what they honestly thought? I gave a talk centered on this, Patrick, you’d love it, to manufacture a company a couple of years back. I had a gentleman who worked there who waited to talk to me afterwards. He said, “I loved that vision. I’m going to tell you, the last time I said what I thought around here, I got sent home for a week.”
It’s funny, but it’s not funny. People have learned that you can’t say what you actually think in many cases. What unproductive ways of human capacity and potential of the truth lives in all voices? I write about this a bit too. You think about a picture of a faraway communist capital, a monolithic parade where everyone’s marching and chanting in unison. That’s not alignment. That’s intimidation, force and fear. That is not alignment. Alignment comes from the diversity of thought. That’s where alignment comes from when everybody feels like every idea is valued. That’s how you create support for decisions and outcomes.Change is a three step process: we change the world within us, beside us, and beyond us. Click To Tweet
Back to your story about that person that came up to you after and said, “I got sent home for a week.” I think about that and I speak to it now in the work that I do is saying that even if I wasn’t the recipient of that, it’s set a ripple effect because other people saw what happened when I spoke up. They learned through that to say, “I don’t want to be like Jim. Jim’s no longer here when he spoke up, so keep your mouth shut.”
That’s exactly what happened. An important point that we talk a lot about with our managers is the pivot point is how you respond when someone says something that you don’t totally agree with. What we’ve tried to do here at our company is get over the need to respond at all. Here’s what I mean by that. We’re talking about a subject and you, Patrick, make comment in a huddle with a lot of employees. My general response is going to be this, “Patrick, thanks so much for sharing that.” That’s it. I don’t need to qualify what you said. I don’t need to validate it. I don’t need to denigrate it. I need to honor that you were willing to say it. You already said it. The fact that you said it makes it powerful. Once people start to see we’re not searching, there is no right answer, people will start to speak with their authentic, true voice. The irony of my journey is I had to lose a piece of my voice to end up on a mission of trying to honor everyone else’s authentic voice.
There was a story that you told in here when you were in Kiev about how that whole thing transpired in terms of how you found out about that in the beginning. I was shocked to hear the number of people that were involved in this in Ukraine. I never had thought about it, Holodomor. There was an interview you have with a woman. I was wondering if you could speak to that because I will tell you, as I read that, I welled up. If you think of the life that we’re living now about how difficult things are, and then you read this. It puts things in perspective in terms of our spirits, what we can handle and still move forward.
I’m glad you’re asking me about this, Patrick. One of the core things in my book is that throughout human history, leaders, those who had the most power, have overreached and abused it. They’ve gone too far, which has consequences clearly for those who they overreach against, but also ends up collapsing the empire. The leaders get greedy. They go too far. I wanted to write about an example of this. I came across a true historical story of the Holodomor in the Ukraine in the early 1930s. The Soviet Union had formed against all odds about a decade before Stalin had replaced Lenin, and had come to power. The Soviet Union was rolling out its first five–year collective plan. The Ukrainian peasants weren’t going along. They were used to their independence and running their own farms. They had some of the most productive farm land in all of Europe. It was the breadbasket of Europe. Stalin and the Soviet Communist Party in response to this recalcitrance, decided as crazy as it is to say as horrific to respond by starving the Ukrainian peasants to death.
The communists went door–to–door, took all the food sources, goats, pigs, wheat, everything, and blockaded a large section of the Ukraine for about 24 months. As the breadbasket of Europe, about 7 million Ukrainian citizens died of starvation, which Holodomor translated means forced starvation. I got it in my head, and this is a lumberman from Casco, Maine, that I would go to Kiev in the Ukraine and interview a couple of the last living survivors of the Holodomor. I ended up connecting with the Holodomor victims’ memorial in Kiev. I made plans to travel there. They took me out and we interviewed one gentleman, Mykola, one woman, Hanna. I simply recorded their stories, honor their stories. They both were born around 1925. They were old enough to have remembered the Holodomor and yet still be alive now. Both are in their 90s. I have a big chapter at the end of the book about that story with the subtheme being overreaching has consequences.
What gives me goosebumps in that story was given these two individuals a global voice for their story to be heard. To tag onto the end of that, that’s an example where corporate leadership needs to have the old model of corporate leadership, which was about staying in your lane, keep your head down or worry about your own product or service. While we’ve got to be exceptional at that, the world needs something bigger and broader for corporate leadership now. We need corporate leaders to get out of their lane to think about their roles more broadly and to engage bigger topics like, “What if we lead differently?” That’s what the book is about.
That story to me is powerful and I hope people will have a chance to read that because one of her lines was, “I’m still around.”
It was surreal, Patrick. We’re on the eighth floor of a Soviet–era apartment complex. The elevator has got 8 million wires sticking out of it as we turn up. I spent two hours with her. I asked her thoughts about Stalin. She paused and she said, “Stalin is dead and I’m still here.” She slapped her leg and had a big laugh.
For those that are reading and in leadership roles who might be saying, “I don’t have the time right now to develop or to focus on developing leadership, or to work on my team or my organization to focus on the importance of leadership.” What do you say to that?The truth lives in all voices. Click To Tweet
I would say I’m sure you can prove you’re right. Anyone who wants to be too busy for that will easily be able to. Anyone who wants to fight time to prioritize it will easily be able too.
Kevin, I have appreciated this so much. I love reading your book, and the time that we’ve been able to spend together, I have a great deal of respect for you. Thank you for that.
I’m always honored to be with you, Patrick. I appreciate the way you give a louder voice to important leadership ideas. Right back at you.
Psychological safety is important especially in the environment that we’re in. Even if the workplace has experienced seismic shifts in terms of what is going on, employees should still feel safe to take risks and be vulnerable in front of the team. To shed some light on this topic, Patrick Veroneau is joined by the Co-founder of Aristotle Performance and Managing Partner for North America for System 2, Neil Pretty. Neil collaborates with leaders to create high-performance learning environments. If you’ve ever wondered what psychological safety is or why it is important within organizations, communities, or homes, for that matter, then this is an episode you’re going to want to stick around for.
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Psychological Safety And Its Value At Work With Neil Pretty
On this show, we’re going to talk about psychological safety. If you’ve ever wondered what it is or why it is important within organizations, communities or homes for that matter, then this is an episode you’re going to want to stick around for. My guest is Neil Pretty and he’s an expert in this area. He’s the Cofounder of Aristotle Performance. He’s also a Managing Partner for North America for System2, which is a global consulting group focused on a more humane organization and the creation of better outcomes. Psychological safety is important especially in the environment that we’re in. There’s so much power from this. I hope you will stick around and gain some great insight into this. Let’s get into it.
Neil, thanks for being on the show. We had an opportunity to talk about a topic that is so important. As we come into 2020 here, the workplace has experienced seismic shifts in terms of what is going on. As it relates to your focus, expertise, and something that I certainly have a great interest in, as it relates to organizations is around this concept of psychological safety. I was hoping we could dig into that and your background in it. How do you think this is changing as we come into this decade or this era of 2020?
Thanks for having me on, Patrick. I appreciate that. As we come into 2020 and as you asked that question, I can’t help but think of a challenge that was put forth to me several months, which was to write an article on what modern leadership needs that’s different from the past. My response at that time is that it’s no different at all. We went through a period of time of command and control, but what made good leadership 100, 200, 500, 1,000 years ago makes good leadership now. It is the kind of leadership that makes people feel that their whole self is welcome and they have something to contribute. Psychological safety is about, can you bring your whole self into the workplace?
Our leaders create the conditions and our organizations were designed in a way to enable that so that people can show up as their whole selves. What has changed is that the economies that we work in and the way organizations make money is dependent on how well people communicate with each other. Psychological safety is ultimately a thing that seems intangible. We all have that moment where we didn’t speak up or we didn’t say something. An example was shared in a group call with some of the global leaders in this field. A CEO got up and thanked his team for buying this other company. The purchase was good and it was doing well, but they’d never actually bought that company and nobody corrected him because they were worried about the consequences.
It’s even something so simple as that. I’ve worked with an organization where somebody didn’t speak up in a meeting and it costs them millions of dollars because of one error that one person didn’t speak up about. The consequence is go home. Now we’re living in our homes and working from our homes. There is this extra pressure to make things okay at work. This psychological safety piece feels intangible. It’s rooted in our human biology. The chemical responses in our body that happen when somebody says something mean, nasty or makes us otherwise not feel like we’re part of the group.
I would think the whole safety piece of this is really important. You mentioned biological. One of the things that I have found interesting, and this was probably months ago at this point and believe me, I am so into this idea of psychological safety. It makes complete sense to me. From the outside, somebody that doesn’t understand this. It’s equating this with snowflakes like you’ve got to be soft. If you need psychological safety, suck it up. You’re not toughen up. We need cry rooms and all this other stuff. What struck me was a couple of months ago, I was watching a National Geographic show and it was about a motorcycle gang in Florida. One of the higher-ups within this motorcycle gang had flipped or had gone as an informant.
When they were interviewing him, he said, “I decided I had to leave the organization because what I was finding was this well-organized gang that we were a part of was less tolerance for people having different views. People were being killed because they were questioning what the gang was doing.” He thought at this point, “I didn’t feel safe.” For me, psychological safety hits everybody whether it’s organized crime or if you’re in prison. There is that biological component where we need to feel safe.
There was a quote from a board member to Elon Musk that said, and I’ve shared this with lots of people, “No one comes up with a good idea while they’re being chased by a tiger.” I take it one step down and say that we also know that being part of a group is inherently better than being alone because alone, we’re more likely to be chased by a tiger. We will sell our dignity and our ideas, we will let go of all of those things to be part of a group because there is such a deep-seated need to be part of a group. Organizations work more and more in teams. That’s our group. Performance in an organization happens at the team level. We’ll notice that you go from one team to another team. Once high-performing and everybody’s fully engaged and switched on, then you go to another team and it’s a completely different dynamic. We will always be tacking upwind against human nature as leaders and as organizations, but this is one of the most foundational things of the human experience. It’s a desire to be part of the group. Does anybody remember high school? It starts young and it’s part of our human experience to want to be part of that group.
We’re looking at coming out of 2020 at this point. Let’s use March 2020 as our start point. How have you seen the shift from a more remote workforce as being impacted by psychological safety? What does that mean in this environment that we’re in?The economies that we work in and the way organizations make money is dependent on how well people communicate with each other. Click To Tweet
The thing that I have noticed the most is groups having almost inexplicable explosions or breakdowns. Somebody shows up at a meeting, they say something and the whole thing falls apart. Everybody is at each other and whatnot. When you dig down to what’s going on, it’s that person was having a moment in their lives because they have seen too much news that day. It got to them that day or something happened at home and it got to them. They weren’t given the grace by the team to allow them to have their moment because we’re all imperfect. I’ve found that those moments are more frequent because people have been inundated with things that caused them to feel fear. I almost think of it as your cortisol is already up at 70%. It doesn’t take much for it to push over that threshold of now you need to have a fear response with your team. That’s what I’ve noticed as more of these random events have shown up, and the team not knowing how to handle it because they are also amped-up already.
When you say that, I immediately think of these disagreements that may have happened in the workplace. Even those disagreements are in my house now. I can’t even separate that anymore in terms of a disagreement with the group of colleagues at work. That now might be in my living room at this point because I’m working remotely.
I had this thought several months ago that maybe people choose their life partners as the people that they can recover from work with the best. You’ve been most of your life at work and it’s like, “Why not choose the person that helps you recover from that the best?” Now you’re in it with your partner. I’m at home all the time and my wife is downstairs. We have to create boundaries and read social contract with each other. What’s okay? What’s not okay? When is it okay to make noise? When is it not okay to make noise? All of these kinds of things. That’s a lot of extra stuff to juggle. For leaders who are already underdeveloped and underprepared by their organizations have another bag put in their lap. It’s a lot of extra stuff for people to navigate when it was already tough to navigate.
There seems to be a misalignment between leaders’ expectations and behaviors, and the new realities of those that they need to follow them based on this environment. That’s what I hear you saying as well.
When you say that, I think of the misalignment between organizations setting the stage for their leaders, and leaders setting the stage for their people. A specific example is someone I know who was asked to do an OKR session and develop OKRs with his team. Ultimately, he was told, “This is the KPI. Go figure out how you’re going to do the KPI, not create an OKR.”
For those that might not know, what is OKR?
Organizational Key Results.
The KPI is?
It’s the Key Performance Indicator. When he walks into this room and everybody goes, “Why are we here?” He’s like, “Because the boss told us to be here.” It’s not because there’s value around creating OKR. He was not given any kind of guidance for how to facilitate a meeting. What were the guidelines around what was expected was different from the espoused values, live values, and all these different competing factors. Ultimately, it was met with significant levels of apathy because everyone realized that this is another way to measure us, and not another way to engage us or bring us onto the team or improve our lives. He was left holding back without any help from above.
This brings me to another thought. We look at engagement numbers for the last two decades, which have been right around a third of employees within an organization are engaged. What does that look like now?
It has to be significantly lower. I hear in conversations with people how apathetic they are because as long as they do what they’re told, they feel like they’ll keep their job. Organizations don’t thrive but having individuals who are there to just do their job so they have a job. Organizations thrive on people that care about what they’re up to. Amy Edmondson’s work has a 2×2 where one access is psychological safety and the other is performance accountability. With low-performance accountability and low psychological safety, there is apathy. As performance accountability increases, people become more anxious. With less performance accountability and more psychological safety, there is comfort. If you have both performance accountability and psychological safety, that’s when people are in the learning zone. You can create whole organizational structures that increase and enable a learning zone, which is where you have the highest performance. What organizations and what people tend to do is they’re apathetic. They realize they’ve got to pick with the pace, so there’s performance accountability that’s attached to them.
People are on performance improvement plans and all these things, and then their anxiety goes up. Because people can’t live in anxiety all the time, they try to go back to comfort. If it doesn’t work, they go back to apathy. They end up in this cycle of apathy, anxiety and comfort. They’re swimming around in this without accessing greater levels of psychological safety. They break through that wall and develop into a sense of belonging, a sense of wholeness with their team, and they don’t feel engaged. When people don’t feel engaged at work, they don’t feel like they have meaning. People don’t learn from that. They don’t contribute from that. They are not giving what they have available to give to the organization.
The environment that we’re in now, I’ve seen quite a bit of it and had conversations around this, people are feeling very scared about the security of their jobs. If I don’t have job security, if there isn’t psychological safety, I’m not one that can have that conversation. I’m concerned about my job because it’s almost like the fight, flight or freeze. I’m in the freeze place where I’m like, “Maybe if I don’t say anything, they won’t notice and I won’t raise a red flag like a question that they’re not thinking of themselves.” I had this conversation with a rep in the pharmaceutical industry because that’s an industry that now their reps aren’t getting into hospitals or medical offices. You have thousands of reps across the US that are at home and had been at home since March 2020 wondering like, “How long can we do this?” Zoom calls aren’t that effective in that environment. How long is this going to go on? There’s not a lot of conversation around that. There’s a lot of stress and concern about job security.
I think that fight, flight or freeze response is that psychological safety response. You have this primed pump with all the stress so you dare not make a mistake. What’s ironic about that is this is the perfect time for organizations to be making mistakes. They have a great excuse to be making mistakes, learning and developing what works and what doesn’t work. A lot of people say the same thing, “Zoom doesn’t work for this.” It doesn’t work the same. Once you’re in that place where you’re worried about job security, anything that you can do to say, “This is why it doesn’t work,” is almost another way to protect yourself against trying something new and failing. Saying it doesn’t work protects you better than failure and allowed you more than failures.
I’m going to see if we can get on track here. We know that from Gallup research it says that 70% of my ability to stay with a company is not directly related to the person that I report to or that manager. First, we have to have a manager that agrees that psychological safety is important. If that manager is reading this, what are some of the things that the manager can do to promote an environment of psychological safety?
Number one is listening and practicing good listening. Developing coach-like skills. Being able to ask good questions and be present with the people that you’re with, and be with them for however they’re showing up. People are showing up sometimes charged and get easily triggered because of everything else that’s going on in the world. Being okay with that and accepting that that’s part of the reality that you’re going to have to manage as a leader. Holding space for inquiry, questions, and getting people to talk. One of the most clear indicators of a high functioning team versus a low functioning team is the difference between what we call a hub and spoke style conversation or a zigzag style conversation. Being able to not have a conversation where the leader asks a question and somebody answers, the leader asks another person a question and they answer, that goes around in circle. That’s a hub and spoke style conversation. You cannot have that conversation.
You need to have that conversation where members are asking each other questions. There’s general inquiry around what’s going on and how things could be different or better. One of the questions I often ask my team is, is the idea that I brought forth to everyone not any good at all? Part of that is the goal of being humble and inviting dissenting opinions into the room, and setting the stage for people to question me. That’s a critical thing for leaders to do. Amy Edmondson’s work has a leadership tool kit in it of set the stage by participation and respond productively. The part where that breaks down the most often is in responding productively. Do you give someone a side-eye? Do you make it hard for people?
To share a story about that regarding Zoom, I worked with a CEO who was pretty good at getting mad at people. He would get mad through Zoom. Every single person on the Zoom screen thought he was mad at them, so the whole team suffered his wrath equally. What was going on was that he was getting upset with the individual and not giving them any way to make it better. This is one of the other suggestions which is to be specific about feedback so that it’s actionable and it’s not targeted at the individual. When you praise people, praise the individual for who they are, how they show up, and what they bring to the table.
From a manager standpoint, when I hear you talking about that, I immediately go to the need for that person to go first. As a leader, I need to show vulnerability to be able to get this group to feel as though they can do it too. If I’m not going to put myself out there, the group is going to hold back and say, “I’m not going there. I’m not saying this.”Curiosity is the foundational root of learning. Click To Tweet
You’re bang on. Leaders have to go first and the challenge for leaders is that they’re often scared. One of our colleagues did a study that revealed that one of the most impactful things for the people in her study for the leaders was the fear of being labeled a micromanager. Their fears of how they were going to be labeled by their team changed how they wanted to behave in a way that was destructive to the team. You asked about my experience with psychological safety. My experience is rooted in experiencing human conditions. What it’s like to be thrown into different environments? How are people going to respond? It started with my first leadership position at thirteen years old where I sat down with my Army cadet section. We all sat in a circle and I said, “How do we want to be as a section?” I was promptly stood up, taken outside, stood at attention and screamed at because that’s not how things are done in the Army. Leaders often suffer that. It might not be visceral or obvious but leaders suffer that. That impacts teams and it takes a big level of comfort with yourself as a leader to be able to push through that.
I find it fascinating that you say that. You were thirteen and you’re being hauled out because that’s not the way it’s done. I immediately go back to three different high-ranking military officers, one in the Navy and two in the Army, that I’ve had on the show. All three of them spoke to the fact that they had legitimate authority. They had the title to be able to tell somebody what to do, but that was what they used last because they knew that it wasn’t going to get real buy-in from people. You’ll do it because I said so but it won’t look the same as if you want to do it. If I can get you to want to do this, it’s going to elevate all of us. It’s going to look completely different. They had that competence in themselves to know I shouldn’t have to tell you what to do. If I ask you involvement type of questions, approaches and behaviors, we’re going to end up in a better place.
What’s interesting is you keyed onto the next level, and these military officers know it at a subterranean level within themselves as well. In that same study that I referred to where managers were afraid of being labeled a micromanager, the issue was that because of that, they didn’t establish authority. Because they didn’t establish authority, they had to use their power from title to manage the team.
It’s like this paradigm shift.
It’s completely different, and authority is such a different thing to wield in power. If you were to take away all titles, the natural leaders would rise to the top and some toxic ones but that’s a whole other conversation and a pretty small portion of the population. Most people are “toxic” simply because they’re not skilled or feel able to establish authority.
If we shift things down and look from an employee standpoint, who wouldn’t want to try and create an environment about more psychological safety unless you’re somebody that’s part of a team that’s a bully, or somebody that wants to keep that sense of control over the group. How do you recommend as an individual trying to have this level of psychological safety promoted as part of your team? That’s going to be much more difficult.
It is in a lot of ways much more difficult. People talk about everyday leadership like, “We are all leaders.” Not everybody is a natural leader, but there are things you can do that can make your team feel more stable, secure and able. As leaders, we have the biggest impact on that, what’s okay to say, what’s not okay to say, and having members established boundaries like, “That wasn’t cool.” It is a good way to approach and establishing healthy boundaries between people and what’s okay on the team. It’s being in a relationship with each other.
I worked with a team where the people had worked together for six years, and one gentleman did not know that the other guy’s daughter had autism, for example. He had no idea after working six years together that his colleague had a home life that was quite challenging. He had to learn all these different things from the daughter that had this. It was an interesting dynamic as a result because they didn’t know each other. They simply didn’t know each other so they couldn’t have honest conversations. They couldn’t be vulnerable with each other, so there was a breakdown between members.
Getting to know people, especially over Zoom, having that water cooler time. I often suggest that team members set up slack time with each other where they go for a walk together on the phone because they’re not on that video call where they have to use extra calories to read what’s going on over the Zoom screen. Walking the same direction, people tend to solve problems that way. Getting in a relationship with each other is something that can build that comradery regardless of what the leader is up to. Leaders often will follow soon and be like, “This team is different.” They can be nudged in the right direction that way.
We’re like icebergs. We see about 10% of each other and the other 90% of who we are sits below the water. I will jokingly say that the only way you find out what else this person is about is you have to stick your head in the water. That oftentimes takes work and it can be painful to do that. I do believe that when we have a better understanding of who we are like in this situation, what if this is somebody that maybe leaves early on certain dates. You didn’t know why and now you find out that it’s because of physical therapy or some type of event that they have to go to for one of their kids. It changes how you view that person because it’s not as though this person is a slacker. This person has other obligations that need to be taken into account. It’s so important.
As you say that, I can’t help but think that those people are usually the ones that are the most committed to their job. Here is this other team members often going, “What a slacker.” Studies show that those people that have those obligations often do the most work because they’re trying to make up for that time. They take it home with themselves and stuff like that. You have this breakdown in a relationship but not a breakdown in performance.
Often, we fall back to our unconscious biases when that happens. I just make a value judgment on you because it’s the easiest thing for me to do as opposed to taking the time to understand what is going on. That becomes more difficult in this environment if we’re working remotely. We’re starting to see the real value of the water cooler conversations and what that provided around belongingness and connection.
A mentor of mine, Darren Jacklin, said to me once, “You can say anything to people in the relationship because you have the relationship to make mistakes.” That stands true. Time and time again, we talk about psychological safety. The examples are all these massive issues like Wells Fargo, Volvo and Boeing. They’re catastrophic but it’s often the sarcastic comment that’s catastrophic for us personally that has the most impact. A team I worked with had a sarcastic comment that was made between two members. The one guy took it personally and they didn’t talk to each other for six months.
We have worked with teams where members didn’t talk to each other for five years, and they had to talk through intermediaries. Those are the moments that affect organizational outcomes and people, and that sarcastic comment was made. On the other side, there was an individual who didn’t give him any grace, didn’t give him any leeway. You mentioned icebergs, and we talked about KPIs and OKRs. That will get you down to the surface level of the water when it comes to performance, but there is an iceberg of opportunity below the surface that psychological safety helps access. That’s that collective knowledge that’s accessed through that portal that changes how organizations function and how they go home. Even down to the point where a lot of people go home for medical reasons, and call in sick and they stopped doing that.
You mentioned a verbal example. Somebody says something sarcastic. I think about the nonverbal so if somebody’s in a meeting rolling their eyes when somebody else says something. Even if that person doesn’t see it. It still signals to the rest of the group that this is not a safe place to go against the grain, or to think outside of the norms here, or to throw up new ideas because this is what happens when you’re not looking. I could be that person that’s getting the eyes rolled. It’s almost like we kill the goose. That’s it and we never know about it. It never comes to the surface. It’s just you know what happened. I’m not coming with an idea anymore.
You’ve drawn something that this is a moment for leaders. As a leader, you’re in the room and one of your members rolls their eye. What do you do? It’s critical to bring that, “John, you rolled your eyes. What’s that about?” Exploring it with some curiosity instead of anger, frustration or reprimand. You can explore that with curiosity. Curiosity is the foundational root of learning.
It takes a very confident leader to be able to do that without being worried about getting derailed or sucked into a conflict themselves that’s going to end in an unhealthy way.
I always ask, what is the muscle you’re reflecting? Those managers were scared of being micromanagers. The muscles they were reflecting was their fear, and their fear was reflected in their teams. The managers who reflect the muscle of like, “This is terrifying for me but I know that it’s in service of the team. I’m going to do it anyway. Here I go.” They are showing to their team that it’s okay to push through that wall, and expect the other person on the other side of that question is going to respond like an adult because you’re treating them like one.
As we wrap things up here and we’re talking about psychological safety, if there was one behavior that you think is one that is most valuable here, what would that be?
I might say sarcasm. Partly because of my journey, but partly because I’ve seen a lot of damage from it on team. Some people don’t get the joke. Some people get the joke and don’t like it. Sarcasm is almost always at the expense of someone else, and saying something that’s sarcastic or even otherwise is somehow at the expense of someone else. Not their idea, not their thoughts or their question but who they are is very destructive. We have a society that sees it as natural to be joking and have fun. It is quite disruptive. Leaders and members of teams will often try to use humor to break the tension, but that sarcasm is often reflected by some insecurity that we see in ourselves. It’s getting people to reflect on why they feel a need to be sarcastic, and also maybe shift a behavior that is commonly destructive for the team.If the first step seems too big, make the step smaller. Click To Tweet
You answered what I thought or I’ll ask, what is the most damaging thing to psychological safety? I would be curious, what do you think is the skill or behavior that is probably most important for developing psychological safety?
When it comes to developing psychological safety, it might sound a bit weird, but getting teams to do the check-in, bringing your whole self. The act of inviting people to do a check-in. The check-in isn’t just like, “I’m Neil. I checked-in.” It’s like, “This is what’s going on for me.” Those teams that have individuals who show up at some points in time, and they’ve had too many cups of coffee, and they’re wired. They’ve watched or read too many news articles, or they spend on Instagram all morning and they’re flustered, or they got an email from someone outside or inside the organization that’s set them on a different path in their day.
If you can take two breaths for each person in the meeting to say, “I’m Neil. I have too many cups of coffee. I’m a little wired. My kid was running around. My energy is anxious and stressed out.” If I’ve brought myself into the room that way, people know a little bit more about me. They know a little bit more about how I’m showing up. They can have the opportunity to reflect on that. If I say something that’s a little bit cut short or a little bit sharper, he did say he was a little bit wired. It can build some buffer around how we interact with one another, as well as demonstrating that we want to bring our whole selves into work.
When I hear you make that suggestion about checking in, it reminds me of a group that I’m involved with. I’m not a facilitator anymore for them but as a group, we used to have to go around and do a check-in before we met with families that we were helping. It was called the Center for Grieving Children. The whole point of doing the check-in was to release anything that I was dealing with that would prevent me from being present in the moment for the group that I was with. As I hear you say that, there need to be small steps for that to happen where groups feel like I can check-in. The power in that of if I do have things going on, if I can bring that up to the group before we start, maybe it does provide an opportunity for me to be more present and let go of that. Also, the group understands where I’m coming from, and that I might not be 100% here but now at least you know why. That’s great.
What I’m hearing from your response is that not only is it a place to bring up what you don’t want but to bring up energy that you do want. I had a meeting where someone said, “Hold on. The energy here is low and tired. Why don’t we try to access some of the energy we had in this other meeting? What would it be like to do that?” We simply spent one minute each, and five minutes later, how we were all in the meeting was different and the results were amazing.
It’s the small shifts. That’s the important thing here that we talk about. Psychological safety or a lot of this stuff is not about making these major 180-degree changes. They’re tweaks and small things that could be done that will make such a difference as everybody I know looks forward to exiting 2020. What’s 2021 going to look like? Is it going to be more of the same? What are we going to do to change it? We can start doing that now.
I often say to people, “If the first step seems too big, make the step smaller.”
On that note, I want to thank you for taking the time and sharing your expertise in regards to psychological safety and how to bring it to life within organizations because it’s important. If it’s done there, I look at this as we need this everywhere in our personal lives and the communities. When we have psychological safety, we’re richer for it. Thank you.
Thank you very much, Patrick. I appreciate it.
About Neil Pretty
My experiences in life, at work and as a leader of hundreds of teams across numerous industries has provided a deep understanding of the human condition and what it takes to produce results. The realization that psychological safety was the most influential factor in effectiveness and results was confirmation of what my experience had taught me.
As a result of that journey the goal is to provide opportunities for people to feel more empowered and enabled at work and in their lives and for business to thrive as a result has become a focus of my daily efforts as well as my entrepreneurial pursuits.
This is the most complex problem facing leaders and organizations today. How do you make the whole greater than the sum of its parts? How do we make human nature work for our organizations instead of against them? How do you tap into the talent that is currently underutilized?
Everything in life is a series of conversations. How well a team interacts has the greatest impact on how well they perform. Psychological Safety is the simplest way to measure, track and improve those interactions.
Simple metrics and simple changes consistently provide access to an iceberg of opportunity and human capital that is hidden below the surface. These initiatives and interventions can take teams and organizations to a whole new level of performance where their people are their competitive advantage.
There is so much missed opportunity, squandered talent, and so many teams that are teetering on the brink of sink-or-swim. I want to connect the dots for people at all levels, and help them showcase their talents while translating them into high performance results.
I spend my time collaborating with other leaders to develop strategies and initiatives that achieve these goals.
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Unlike desires or dreams, our thoughts and feelings don’t reside in our minds alone. The body holds your physical health and your ability to function. But the mind houses your spirit and your motivation to function. On today’s show, Dr. Krishna Bhatta is with host Patrick Veroneau to talk about how the mind and body are closely connected to improving one’s mood and overall health. Dr. Krishna shares his journey on how intermittent silence changed him and how this had been a useful practice in his daily life. He shares how slowly practicing, same time (for 10 mins), same place for certain weeks or months, you will start to open new doors and work from the inside out.
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Intermittent Silence: How To Achieve Self-Mastery Of Body And Mind With Dr. Krishna Bhatta
If you have been exploring different ways to incorporate meditation into your daily lifestyle, then this is the episode for you. My guest is Dr. Krishna Bhatta. He’s the Chief of Urology at Northern Light Eastern Maine Medical Center. He’s also the Chairman and Founder of Relaxx LLC, which is an app on meditation and specifically, one of the models that he’s created is called Intermittent Silence. I’ve been using it and I love it. The conversation with Dr. Bhatta was one that I enjoyed. In this environment, if you’re looking for different ways to improve your own wellbeing, then this is a great episode for you. Let’s get into it.
Dr. Bhatta, thank you for being on the show. Dr. Bhatta is the Chief of Urology at Eastern Maine Medical Center, but also created a meditation app. He’s in the meditation space. There is some uniqueness to what he is promoting, the model that he’s developed. I was hoping that we could talk about that, Dr. Bhatta.
Thanks for having me. It’s great to be with you. You have been in the leadership space at least in Maine that we know of. It’s great to connect with you.
This is such an important component. We had an opportunity to talk prior to this. In regard to the leadership development that I’m involved in, I think very much about this idea that it needs to start from the inside out, which is much in line with what your app is trying to provide individuals. I was hoping you could go through this idea in regard to your app, which is Relaxx, and this idea of intermittent silence and how do we do that?
Let’s start with the app. We can talk about the components of the app, and then we can talk briefly about intermittent silence. There are three major components or three elements that we are born with. Normally, when people talk about any spiritual progress, they talk about mind and body, enhance the mind, enhance the body. We have come up quite a bit as far as body and mind. We exercise and we do comfortable house and comfortable living. We have done a lot with our body and our mind. We go to our universities, colleges, and we have high standards that we become great doctors, scientists, and leaders.
There is another element in our life that we come with which we ignore. That’s where the problems happen that even though you’re successful in body and mind, you still are prone to depression and burnout, because there is another element which I call the flame, which represents your individual personal consciousness. There is a piece of consciousness in you that stays with you even after your body dies. That flame is an important factor that continues to represent you in some form or the other. That is the basic concept. The practice of intermittent silence and meditation comes there.Chakras are work centers of energy in the body that are all connected. Click To Tweet
What is the impact of intermittent silence as it relates to the flame?
The flame is the one which the code restraint, and you want to know your consciousness. You want to experience that and the silence by resting your brain, and by being in what’s happening in the surrounding. You’re journey to the inside starts with that. It’s only ten minutes a day practice. By slowly practicing at same time, same place for certain weeks or months, you will start experiencing new doors start opening. More than that, you can also use after that from the inside out. You can create a theater or an atmosphere inside that silence where you can experiment on things that you want to work on. If you want to work on congruence, one of your instinct. You can work from inside, not just imposing it on your mind, which is good to have that. You can create a conditioning by training yourself, but if it grows from inside you, then it becomes yours forever.
As the practice of intermittent silence, to do this is a short amount of time too. Is it about ten minutes?
Yes, ten minutes a day.
Could you walk me through what is that process? I did it myself. I’ll give you my feedback after I’m done.
I like to know that from you. It’s four components of intermittent silence. The first one is close your mouth. When you close your mouth, you’re without words. You stop communication. The whole department of communication, and expression, and words processing that happen inside your brain, all those neurons and associated fibers get rested. That’s the least benefit of that, then you close your eyes. When you close your eyes, everything that’s associated with visual pathway, optic neurons, and everything that is associated with observation gets rested inside your brain. There is a silent listening. Silent listening is listening to any sound and all sound around you, but not trying to analyze that or process that, just silent listening. The fourth one is watching your thoughts silently. Let your thoughts pass by and let it transit. These are the four basic steps of this thing.
All the brain cells and neurons in your brain will thank you. We say that 86 billion neurons for that ten minutes of rest. As we were talking, in the beginning it may be uncomfortable. We are not used to an inner journey. We are not used to being silent. You want that ten minutes to go away in three minutes. That happens. That’s expected, but once you cross the limit that’s uncomfortable and restless, it creates a space inside which you can do wonderful things. You are observing outside and you are expressing outside. Instead of doing that, you can create your own bubble or theater inside you. The expression that if it goes inside, internalize it. You can have a situation where you can only have positive thinking. You can create some obstacles if you want to, but you can create a positive imaging as well.
Let me tell you a story about a patient who I was going to do a prostate surgery, cancer surgery. He told me that he wants me to read a book before I do the surgery. He gives me the book, I read the book and the book was by Vincent Peale, Positive Imaging. It’s a nice book. I thought, “I’ll read the book. Why does he want me to read the book?” This guy had been practicing for a week before surgery. Every night he will lie down and imagine that he’s on the surgical table and I’m operating, and everything is going well. This is the power of positive imaging. In this period of silence, once you have practice and you have done your ten minutes, you can create that theater. Whether it’s the leadership course you’re going to give, or you are going to give an interview. You can do the whole thing in your personal space and then act it out. Eighty percent or ninety percent of that will be the same as what’s going to happen. I used to do surgeries. If I’m going to do a big surgery, I’ll act it out. When I go, I’m well controlled. Sometimes things will go this way or that way, but at least 90% of that has been rehearsed.
It’s interesting you talk about that too, because whether I’m working with athletes or leaders in organizations, the successful ones take that to heart, especially athletes about visualization and expectation. You need that first if you want to elevate yourself. That ability to go inside and develop this sense of expectations is important. One of the unique things about your method though is breathing through your nose the whole time and keeping your mouth closed. As a morning routine, I will generally try and work on breath for a short period of time. I’ve always been told to breathe through the nose and not through the mouth. Why is your approach to close your mouth the whole time?
It’s more to do with communication expression so that you can internalize it and master the air and rest your thing. What you are saying is, what is the difference between meditation and intermittent silence. When you say meditation, it’s a huge area. There is guided meditation, breathing meditation, and mantra meditation. It’s like going to Himalayas. When you go to Himalayas, it’s vast, 1,500 miles of spread. When you go to Himalayas, you need winter gear, hiking boots and warm clothing. You need to acclimatize yourself or need oxygen if you want to go higher. All that thing is packaged in intermittent silence. In any meditation you want to do, you have to deal with your thoughts. You have to deal with sounds that you’ve got listening. You have to deal with your observation power. Observation also includes mindfulness. You need this package for any meditation you want to do. If you want to do jogging meditation, you won’t close your eyes because if you close your eyes, you may not know where you are going.
If you are doing breathing meditation, that part you can modify. Once you have the hang of silence, because all the guided meditation, they take their mind and they guide you. There’s nothing wrong with that, but you need that silent period. That’s where you experience the depth. It’s like going to the source, but once you get to the source, then find the force. That part is not mentioned by many people. Most people will take you to that silent place and there’s a comeback. Once you go to that silent place, there is a lot of energy there that we can be useful in your practice in daily life.
I experienced that when I did that for the ten minutes. What was interesting is as I started, I listened to you and then you were gone. I was like, “It’s all silent here. There’s nothing.” In the beginning, it was a little uncomfortable. There was no instruction, no silent music in the background. It was just silence. I jokingly said before this that I didn’t realize that my house, even at 5:00 or 5:30 in the morning, was as loud as it was. It’s the different noises, the radiator or the house settling, or my stomach rumbling that I never paid attention to before. As I came out of this and was trying to focus on letting those thoughts continue to drift by, I kept getting caught up in thinking about the process and questions that I was going to ask you when we had this interview and trying to let those go. After finishing, as it relates to the model that I’ve been doing a lot of work on for another client, I came up with a whole different approach to what I was going to do. I looked to that space that I gave myself. It provided me a great sense of energy after I was done.People who can teach others leadership and other things are born with a high energy level. Click To Tweet
That brings me to the inner conversation. There are two kinds of inner conversation. One is what you just mentioned. Something came up from there and it happens like my whole intermittent silence came like that from my meditation, the whole process. I then tried to formulate it and structure it. That is one type of inner conversation. The other kind of inner conversation is that you want to brainstorm on something, you take that particular thought, and now you have a space. You have created a place where after you have listened to the sound and everything else, you can create and say, “I’m going to experiment this or experience this,” then do a brainstorming. One is the thoughts come directly that you never anticipated and never thought. The other is you can also use it as a brainstorming session or honing in some skills, one of your twelve questions you can work on. It can be a powerful tool.
I found it very powerful. I can’t wait to do it again. Who knows? Maybe I’ll do it at some point too. Is there a reason why you mentioned trying to be consistent in terms of when it’s done and where it’s done?
They said the best time is either the dawn, sunrise or sunset, because the universe’s energy changes at that time. The whole point here of doing same time, place and technique is somehow you will find after a week or so that your body is looking for that, it’s waiting for that. It’s strange but it does happen. When you get up in the morning, you feel like breakfast. Your body, your whole space, it seems like everything becomes aligned that way. I find it helpful to do it the same time, same place, and same routine.
One of the things that I saw on your website that I found very interesting is you talked about mind as friend. In my own experience and the work that I do, and from what I see outside is that many times, those minds aren’t their friends, and how important it is to have your mind as your friend. What does that mean and how does it impact?
I started saying that because people started calling it names like monkey mind or something. I said, “Come on. This is going to be with you. Whether you like it or not, your mind is going to be with you for your life. You can’t get rid of this so why not have a friendly relationship?” Mind has two components, minding and mindfulness. The minding part, sometimes you can say, “Come on, stay out there. I’ll come back to you.” You also mentioned about energy body and food body. We have food body, which is we eat healthy, and food translates into body fitness, but there is also another layer of the body, which is energy body. We sometimes feel goosebumps, sometimes you feel that way. The Chinese call it chi and the Japanese call it qi. There is a lot of meditation in Relaxx app with chakra meditations. Chakras are work centers of energy in the body and they’re all connected.
The whole point is when you do exercise, you are healthy. You feel different. The same way, once you start creating and conserving energy, you feel like you are living at a higher energy level. The higher the energy level, the more peaceful you are. Some people are born with higher energy. People who can teach other people leadership and other things, you are born with a high energy level. There are people who are not. They should work on that because if you live at a lower energy level, the more irritable and sensitive you are. It’s important to work on the energy level consciously for leadership, entrepreneurship, medicine, whatever. It’s generally a good idea.
I would love people to have an opportunity to go on and try your app. You mentioned chakra, that there’s a number of different examples on there or options for people to meditate in different ways, not just in regard to intermittent silence, but there are other things on there that are valuable. Go to the App Store, it’s Relaxx, and your website is Relaxx.org.
There’s download link on that there.
I downloaded the app and tried it. It will become a regular part of what I do. I enjoyed it. I hope other people will take the opportunity to do that.
Thank you, Patrick. It’s great to know you. We can talk about how we connected sometime.
I know we have more work that is going to be done together in terms of a couple of clients that I have mentioned about having you come in and do this talk again. I appreciate this. The universe has sent us to each other for this type of work. Thank you for that.
Wishing you all the best.
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It’s probably fair to say that most health leaders are genuinely concerned about making healthcare better. However, not all decisions coming from above translate well into practice from the patients’ perspective. Tom Dahlborg never realized this until he found himself on the other end of the stethoscope. When he became a patient, he saw how some of the decisions he once taught made things better didn’t make things better at all and sometimes even led to outright harm. Since then, he has become a huge advocate for patients’ welfare. In his second book, “From Heart to Head & Back Again,” he takes a walk along the memory corridors, back to the time when he was in the patient’s robe and shares how that experience impacted his view on what should be done to make the system become a better one for the patients. The task that Tom takes upon as his own is nothing short of herculean, but he believes it can be done if we go back to the core values of healthcare – which is the intrinsic motivation to care, love and be kind to one another. Listen in as he shares this powerful message with Patrick Veroneau.
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From Heart To Head And Back Again: Making Healthcare Better From Both Sides Of The Slate With Tom Dahlborg
Thank you for joining me on another episode. My guest is a repeat guest, Tom Dahlborg, a good friend of mine as well, an author, as well as the Executive Director for the Michigan Center for Clinical Systems Improvement and a huge advocate for patients. That’s what we’re going to talk about. His second book, From Heart To Head & Back Again, talks about his own journey as a patient in the healthcare system, what that looked like and how it impacted his own mission and view of what needs to be done in terms of being advocates as a patient for ourselves. Also, how to help other people in the system to make sure that we’re providing the best possible care we can for them. I hope you enjoy this episode. Let’s get into it.
Tom, thank you for being on the show. This is such an honor. This is number two for you being on the show. You were on in regards to your last book. I know we’d had a conversation in regards to this book coming out. I couldn’t wait to have an opportunity to talk to you about this, From Heart To Head & Back Again: … a Journey Through the Healthcare System and what an important time to be having that conversation. As we jump into this, I’d love to hear what was going through your mind when you first decided to go in this direction with this book?
I had been working in health care at that point about halfway through my career. I was still fairly young and thought I knew a lot and thought the things I was doing as a “health care leader” was making things better. It wasn’t until I became a patient. I got to see the other side of the slate, the other side of the picture, that it became clearer to me of what flames of good are in the healthcare system that we have to continue to fan, and also where those opportunities are. I’ll give you a specific example. At that time, I was building quality based incentive programs. Now it’s called value-based purchasing or pay for performance. I was building these programs thinking, “I’m doing the right thing. I’m helping things move in the right direction.”
Quite frankly, what I found as a patient was that these incentives didn’t work. I’ve written about this since that time of how studies have shown that you cannot incentivize someone to care. You cannot incentivize someone to love. What you do when you do incentivize people, you’re removing that intrinsic, “I want to do good. I want to help.” Creating these extrinsic drivers to do the right thing. It’s so contrary to what we want. As a patient and being married to a nurse and as a “health care leader” at that time, what I thought I knew and what reality was were two different things.
It took me a while to recognize that quiet place, process and think about, contemplate, “How can I help turn the tide? How can I undo some of the damage I helped to create to try to help others, be it the physicians, the nurses and all the folks on the front lines, the patients and families and others? How do I help recreate a system that’s going to lead to goodness for goodness sake, not caring because I got paid to care?” I started the journey and this was back in 2015 of, “I’m going to go to that place of sharing my own story,” meld that to my observations and the stakes I’ve made. Some opportunities I saw it maybe helped a little bit to try to tell a compelling story and lead to betterment within the system.
When you talk about your story, what is this? What did happen?
The bulk of the story, I was working in military healthcare at the time. I’m not a military person myself, but my family is. I wanted to honor my family and took a pathway to engage with a healthcare institution in May. During that time period, I got very sick. I was told I would never work again and to get lined for a heart transplant. I was that person that went to the pain clinic and they said, “Here’s your menu of narcotics, would you want to stop?” This was back in 2001. What’s the old saying, “By the grace of God, I did not follow a path leading to the addiction.” We think about the opioid epidemic now, a lot of this because of the broken system. I lived through that system luckily or through blessings and being married to a nurse. I didn’t fall through that full path.
As I went through that journey of illness, where I had to resign from my position as COO for a military healthcare organization, I was that person that initially thought, “I got this. I’m a health care leader. I know the CEO of the hospital. I know the head of the Cardiology Department.” It didn’t matter. I was incredibly sick, scared and vulnerable. Every day, I looked in the mirror and saw a lot of the brokenness I was part of. That was hitting me in the face in addition to be having three young children and my bride and thinking I was letting them down the entire time. You have all these emotions. You have this vulnerability, and it didn’t matter who I knew I was scared.
The journey is through that. Those flames of good that helped me get through and also identifying those opportunities that we need to make better because I was a health care leader and I’m married to a nurse and I couldn’t navigate. We couldn’t navigate to the best of the ability that we should’ve had or could have had. The system is that broken. There’s goodness in it. There’s also brokenness. I wanted to, again, highlight the good, use the term celebrate the good within the system and fix those opportunities.There is goodness in healthcare and we need to celebrate that. But it is also a broken system that needs to be fixed. Click To Tweet
When you’re thinking back to yourself in the system, you’re somebody you know how to navigate, or at least you think you do. Where do you think for you the biggest challenge was in the beginning for this? Where you’re saying, “This needs to change.” It’s almost an a-ha moment for you it seems.
It was. I’d say the biggest a-ha was looking in the mirror and gone, “You don’t know what you think you now,” and having to relearn, re-see and look through. We talk about empathy, look through other’s lenses, look through the lens of that nurse in that emergency department, looked at the lens of that technologists in the X-ray department, look through the lens of the physician, look through the lens of the other patients. It was these opportunities to see differently, from other angles, from other perspectives. That was the a-ha to say, “Tom, you don’t know.” When I was full of ego and hubris and said, “I got this. We can manage this illness.” I had no clue. I’d say that was the biggest piece of it.
Add to that, when you think about Deming and the 94/6 Rule, which is all about 94% of brokenness is system related and 6% is people related or person related. As a leader, what do we typically do? We go and we blame people. We don’t look in the mirror and fixed system. What we need to do is it’s both and. It’s like, if it is a person issue, you deal with that appropriately. Sometimes it’s coaching and mentoring and sometimes it’s not. You also have to fix the system. That was the other a-ha was the level of brokenness of the system, including the financial drivers within the system that were leading and continuing to lead to that and escalate the brokenness.
You bring up an interesting point because I think of that often in regards to you might be thinking a physician doesn’t have time yet they’re being directed. They need to see so many patients within a certain time slot. It becomes very difficult. I remember hearing this back to my days when I was in that field as a pharmaceutical rep is having a physician say, “What do you do with the patient that comes in?” It’s their fifteen minutes and they’ve got two minutes left and they drop this major issue that they’re dealing with. Maybe it’s depression or anxiety that they didn’t even say anything. You have two minutes, what do you do with this? Do you say, “Time’s up, what’s next?”
It’s such a great example. The physician primary care physicians sticking with them for a while, and they’re on average obligated to generate 30 RVUs, Relative Value Units per day. For a lay person that means, an average office visit, they need 30 of those per day. If they were all average offices, so we know they’re not. That means you’re triple booked every fifteen minutes. I have on a maximum of five minutes. Don’t understand the patient prior to walking through that room. Don’t understand it and contemplating next steps post visit. Don’t connect at a human level with that patient, that family not being positioned to listen. Now, thinking about malpractice, putting that hat on for a moment, I’m now well positioned to make a mistake and to do real harm in not only am I going to harm somebody else, that’s also going to come back at me with a malpractice lawsuit.
This is the broken system that physicians are thinking about all the time consciously and subconsciously. This is going through their minds. When I talk to physicians, nurses and others, they say this is what keeps them up at night, knowing that they are going to hurt somebody because the system is not broken and trying to get through the day, try to see as many people as possible because access is also an issue. They want to try to hit on that mark and get as many people in as possible. Normally, they don’t have the time to do it all and they don’t have the system in place to do it all.
Yes, there are some bad doctors and bad nurses. Just like in every walk of life, what I’m finding is most, if not more than most wonderful people that are burning out because the broken system in that burnout leads to disengagement and leads to harm, harm to them, to patients, families and to communities. These were the things that I saw through my own journey, and a different lens that I hope this book is going to help to number one, call attention to it, and then give some practical opportunities for people to make a difference themselves.
For those that are reading that might not know there’s a term that’s used called HCAHPS. It’s like customer service surveys in healthcare. That has a financial impact on the institution because they get paid based on those.
I was in Cleveland Clinic years and years ago. They were recruiting me to work in the patient experience space as a leader within Cleveland Clinic. They said, “What’s your experience with HCAHPS?” I told a story about being a transport aide in a small community hospital and about connecting with this elderly person. I had gotten to know this person because I was wheeling her around the hospital for the last couple of weeks. She called me Tommy. One day I was bringing her down for her treatment for cancer and I wheeled her down there, she puts her hand on my hand. She goes, “Tommy, please don’t leave me. My family’s not here and I’m scared.” I radio up to my transport department and let them know that I need to stay with, I’ll make up a name, Mrs. Smith for the next X amount of time.
They allowed me to do that. That’s patient experience. That’s customer service. That is caring and loving within the healthcare system. I’ve told that story to the folks at Cleveland Clinic. They looked at me and they said, “What about HCAPHS and the financial ramifications of that?” I was like, “Cleveland Clinic is amazing. They’re a great organization.” The people I was talking to was so caught up in the financial drivers, associated with numbers, with metrics, they forgot the heart of what we’re trying to do here, the heart of healthcare. Hence the title of the book is bringing that heart back in and remembering that we’re to care and ideally, we’re here to love and focusing on metrics. Financial drivers to get people to care, it’s doesn’t work. What we need to focus on is positioning people so that they know they’re cared about and they’re loved so that they can then share that love and that caring with others.
Tom, think of how many times that scenario plays out now where families aren’t even allowed into hospitals. I had to go to the emergency room. I’m admitted to the emergency room since I sliced my finger in high school, but getting wheeled in there and going through an intake and Cindy, my wife being told, “You can’t stay in here, basically we’ll call you.” That was it. It was not a pressing issue that I was dealing, but I think of all those people that maybe this is it. That’s the last time you’re going to see this person and how scared the family member is, but also how scared the patient is of leaving, thinking, “I’m on my own,” which is what you said this woman said.
I share in the afterword of the book, the impact of the pandemic in the space of caring. I highlight a couple of a good friend of ours whose two family members died alone. One of them in a nursing home or a nursing facility and the other one at home. When we think about the pandemic and how we’re trying to keep people safe, when you think about quality improvement, you have to understand what your measures are? What does success look like keeping people safe, but also the unintended consequences? These undetected consequences is isolation, lack of caring, people feeling scared, the mental health and the emotional health of these people.
There’s lots of other things I won’t even go into, but we have to understand the full picture, that 360. Develop a system, a model where we can mitigate, some of the times you can’t change the badness. Sometimes it’s just is. Yet, most times it’s not. We can create systems, which allows connectivity for us to address some of those other things. There was a study some years ago that if I remember right, it was that isolation and loneliness more dangerous to anyone, to someone than smoking fifteen cigarettes a day. That’s what the study can’t found. I believe it.
This was part of my journey, when my bride had to leave me in the hospital the first time when I was admitted and again that sense of loneliness and despair. Even though they were wonderful caring people around me, nurses and so forth, in my own head, I was alone and it was devastating. I even talked about it was more devastating than the issue with my hat. We need to open our eyes and look at the intended and the unintended consequences of all these types of decisions. Those that impact the health and wellbeing, not physical, but mental, emotional and spiritual of people we need to be addressing.
In regards to the isolation, there’s so much research. One of the behaviors that I will often talk about is around creating belongingness. We know how much research there is. We are pack animals. We need each other. Thousands of years ago, we couldn’t have survived without each other. If we were voter outside of the group, that was a death sentence. I would argue that now it’s still a death sentence. It looks different now when we’re pushed outside of a group or we’re isolated because of the environment that we’re in right now is a concern for me that I see with this pandemic, the isolation that has been pushed on many. You’re wearing a 22 shirt from the military talking about how many people commit suicide every day.
Twenty-two veterans per day in America are committing suicide. That’s one of the reasons because a lot of my book is generated as based around my work with veterans. I’m not a veteran. I try to highlight often as much as I can the challenges spectrums were facing and be it, my work within the VAs and so forth, but also to let people know that, 22 veterans per day are committing suicide. I believe although I haven’t seen the intense study to support it, that number is increasing during the pandemic, not only for veterans, but for others as well.
If you are a veteran, if you’re in crisis or if you know a veteran and you know they’re in crisis or potentially, there’s a suicide prevention hotline, a Veterans Crisis Hotline, it’s 1-800-273-8255. The pandemic is escalating. These challenges that people are facing. We need to find additional ways that we can support, care and love for people during the pandemic and beyond. The Telehealth has done a lot of good things on this and yet it’s not the same. A lot of the studies because the pandemic has been going on for X number of months now is that Telehealth is missing some key very basic aspects of healthcare, such as blood pressure checks.Healthcare is all about caring and loving, not hitting the numbers. Click To Tweet
We’re missing out on that part and we’re missing out on the human connectivity. We’re missing out at that opportunity to develop that relationship and that trust to have the appropriate touch. When you put a hand on a shoulder, on a hand to connect at a human, bringing humanity into healthcare, keeping humanity in healthcare, we’re missing out on that. I see a lot of people talking about technology as this panacea. Technology is a tool. It’s a tool to help us, care, love and connect better. It’s not the solution in of itself. We need to keep that in mind. Too often, we think the easy button is technology. Like we’re talking about with some of these other things, there’s a lot of unintended consequences as we go down that technology path. We need to be aware and have our eyes open as we’re making these decisions.
There are a couple of things. One, going back to the conversation we had around HCAHPS and some interesting research that I will often reference where they looked at healthcare organizations and their HCAHPS scores and what they did was they transpose these, that’s the word I want to use here, with engagement scores of the institution. What they found was that the lower the engagement was within the institution, those HCAHPS scores were in line with those. There was a pretty significant gap in terms of, if your HCAHPS scores were high, then chances are, you had an organization that the employees were more engaged versus less engaged. That brings an important question to you, Tom, is that you mentioned about the majority of this might be system related, but there’s a people component. As I look at it, didn’t the people create the systems? If we have disengaged individuals, isn’t that what we need to start?
It’s a phenomenal point and you’re absolutely right. The system is made up of people. When Deming talks about system related versus individual or person related, he’s talking about processes and operations, which are created by people. Yet, we go to the place of, “I’m going to blame that nurse for being mean.” No, we create the system that led to her or his burnout that led to them being disengaged, that led to them being tired and not being able to go to the bathroom for the last twelve hours. Now they missed something. They forgot a pill. We have to fix, as I’ve said, both ends.
We have to fix the system that allows that nurse to be engaged again, that safe container. They feel whole and healthy so that they can now deliver the caring that we all need to have delivered within the health care system. It’s definitely both ends. The system is made up of people, people make broken systems, they also make good systems and we need to be aware of all of it. I’d go to the place of fixing where the fixes need to be made. Is it people? Is it system? Also go to the places of them, again, going back to your point of celebrating.
When we have that nurse, that doctor, that respiratory therapist, that transport aide that I talk about in the book and so forth, that they’re doing something well and they are living love, living caring. We want to celebrate that. We want to honor that. We want to show that, number one, it’s the right thing to do. Number two, when we start to recognize that these are the behaviors that we’re expecting, that we’re going to hold people accountable for when they’re not, but also celebrate when they are, that also changes culture. It leads to that culture change, which to your point, leads to system change as well.
I would agree with that especially around celebrating when things are going well. If you have an organization, where the only time I hear from you, Tom, is when I’m not doing something right. I’m now on a good path, I’m doing the right thing, you never seem to come around and tell me, “Patrick, thanks for making the change or this is exactly what I was hoping that I’d see from you.” That then says to me, “You noticed my effort and I want to continue this because this feels a lot better than the Tom that shows up with the stick potentially or wants to point out what I’m not doing right. I like this.” We don’t do enough of that, the celebrating. Everybody’s different. Not everybody needs the same type of recognition. That’s the important thing here though is if you’re leading somebody, it’s your responsibility to understand what is it that motivates that person in terms of how they want to be recognized. It’s not a one size fits all.
That gets back into a relationship. You need to have relationships with these people. They’re not cogs. They’re not widgets. I hear that from doctors and nurses all the time, that “I feel like a cog of a machine”. I feel like the patients are widgets. We’ve created this factory and production mentality, we hear all the time. “Did you achieve your production goals?” This is healthcare. This is life and death. This is so much beyond. Regina Herzlinger wrote a wonderful book. It’s Consumer-Driven Health Care. She’s out of Harvard that takes the analogy of the French fry at McDonald’s and poses it and puts it into healthcare. I’m like, “I get the logic. However, we’re talking about human beings here. We’re talking about life and death. We’re talking about emotions.”
I love my French fries. If they’re good, my emotions change in a positive way. Don’t get me wrong. However, in all seriousness, we’re talking about people that are on the edge of losing their careers, life, family, and losing all they own. It’s far more than a French fry. We need to truly get to that place of focusing on relationship, understanding and creating the systems that allow people to be on it the way they want to be on it. To ensure that the organization is all about the caring, loving and delivering of great evidence-based health care, not production, not hitting HCAHPS numbers, not these other pieces. It’s about the outcome of a kid and loved on this person. I was going to say got better, but sometimes as we know, people are on the dying journey as well. We also want them to be on it throughout that journey. We want to be there with them for that piece of it. It’s far beyond just the metrics and the numbers.
We’re not going to solve the administrative side of this, but what would be interesting for me to hear is if you’re in the system, what would you recommend for them? I’m somebody that’s part of the system. “How can I make this better for myself? What things can I do to help advocate for the change from the receiving end of this?”
I’m going to answer this differently. My aunt read my book and she said, “Tommy, what the book did for me is it brought more awareness to me that I want to be grateful for all those people that work in the healthcare system for when they are caring about me when they are taking care of me. I don’t think I was doing that in the past. I want to make sure that I’m doing that.” As you and I were talking about Patrick celebrate, yes, we want to celebrate within the system. Should we rely on patients and families to celebrate the people in the healthcare system?
No. However, if I’m a patient and a family member, and I can go to that place of gratitude for somebody who cared about me, it makes a huge difference. I hear from nurses and others all the time that when that patient or that family said, “You were there and you held my mom’s hand until she passed. That means a lot to us. I’ll never forget.” That changes lives. That instills that caring in that person to want to continue to do that. That’s a big piece is that lens in that place of gratitude as a patient. Another piece is, understand that you’re not going to understand. Find the experts. I was lucky. I was married to a nurse who was an expert. My bride, she was going through crises as well, emotional crisis and everything else. We were going through this together.
You need to be able to identify other experts, patient navigators, family members, who know the system, whatever it might be and lean into them as well. Make sure that you’re truly aware as you’re making decisions. This expert influence is incredibly helpful on what those decisions should be and could be and what the ramifications are. I had an unnecessary invasive procedure because here I am, again, health care leader married to a nurse, I didn’t know the odds. I was scared. My doctor said, “This is the right thing to do because I said it.”
I was at that place at that point with, “I’m going to do it because my doctor told me I should do it.” You still have to advocate for yourself. If you can’t emotionally or otherwise have that expert, that trusted person that you can lean on, that can say, “Here’s what it means. Here’s what the risks of going through with that. Here’s what the benefits are of going through with that. Now let’s figure out what’s best for you,” and so that’s key as well.
You bring up such an important point there in terms of advocating for yourself, having people that understand the system on some level to be able to bounce things off of. I’ve heard of even people, especially if they’re dealing with life-threatening illnesses, is having somebody go to their appointments with them. If I’m sitting there and listening to the doctor, I’m listening for different things than the patient might be listening to. I might be so wrapped up in concern of this, that I’m not picking up the other pieces. Having somebody else there is important.
That’s how you can manifest or that’s how you can put into action. Those experts bring them with you or consult with them before and after, because it’s helped with them before you make any specific decisions, especially life jeopardizing decisions. Several years into my career, I should’ve known that. When you’re in the midst of it, you’re not in that place emotionally and otherwise, at least I wasn’t. We would have benefited from somebody like that. Someone who sat in that room that was dispassionate, that loved me and cared about me, but was dispassionate it’s about the facts and about the evidence.
Along those lines, was there ever any thought for you of, “I’m going to get a second opinion?”
We went through a number of different doctors. It was the 7th or 8th opinion, for lack of a better term, that saved my life. It was going down that path of being open to. I was tired. I was beat up. My career was over. I may die. My family is going to be left destitute. My wife was a nurse so that is an exaggeration, but still how I felt from an ego, a humor perspective, I was letting everybody down. I was done. I was pretty much given up at that point. This has been going on for a long, long time. This amazing nurse that I had worked with, she got down on a knee in front of me at one point while I was sitting in a chair and she held my hands and she said, “Tommy, this is a detour. We’re going to get you through this.”The cheapest and easiest way to start change is to love and be kind to one another. Click To Tweet
She wasn’t doing it because she was financially incentivized to do it. She was sharing her heart with me because she cared. She loved. Not just me, but she’d loved people. That was the person that she is to this day. It was her who connected me with that next provider probably 7th or 8th that showed me a different way to practice medicine, care, to take healthcare, and create healthcare. It was that, in that container that my wife, myself in that position and others became part of that led me to being able to work again, write a book and tell a story and hopefully help others.
One of the things that I think of, if you’re saying you got to number seven, that there was something inside of you, that’s saying this isn’t right. You were listening to that on some level, bringing in other people, “The expert is saying this, but it doesn’t feel right.” I wonder how many people don’t do that because they’re afraid. They don’t think they’re going to be listened to whatever that might be. They don’t have that opportunity to find what’s going to work for them.
Some of those physicians were recommended by my cardiologist. Some of them were, “Let’s look at it through a different way.” My cardiologist is very good. “Let’s look at it through different lens. Let’s connect to these other specialists that can figure out. Is there anything else that’s driving this, is there any other opportunity?” On top of that, it was also that probably stubbornness in me that said, “No, I’m not going to grow up with my family or my team.” Even with all that I’m even saying, “I wasn’t going to give up.” I gave up. There was a point in time where I said, “I can’t do this anymore.” I remember I was in the bathroom and I’m on the ground. I’m in tears saying, “I can’t go on.”
Thank God for my bride, at that point, that helped me get past that and the rest of the journey. As we said, cry a number of times as a healthcare leader married to a clinician and my sister’s a nurse as well. To throw out my family, I can’t imagine folks that speak a different language. I can imagine it more because I talk and I hear these stories, but it was so hard for us from all different perspectives. We owe it to all people throughout the country, the world to have access, to have the right information, to have someone who cares and support stuff, to have that expert opinion, to have the mechanisms, the systems in place where people are engaged. Creating betterments and creating opportunities for people to get better or to go down that dying journey in a peaceful way, we owe it to them.
The system is that broken. Not that I knew at all by any means, although I thought I did, if we couldn’t manage it, I can’t imagine people again, as I described the elderly and others trying to manage it. It’s impossible. We created such complexity that it’s leading to more and more harm. When you think about the harm we do in healthcare, when you think about the lives lost to the pandemic, lives lost to diabetes and heart disease and so forth, medical errors is way up there on that list too because we’ve created a broken system that leads to harm and we need to do much better.
I’m going to put you on the spot here, Tom, you’ve got one copy of this book that you can give out. Who would it go to?
Part of me wants to answer it with, “I want that patient, that person to read this book so they are well positioned to understand. That’s part of where I would be coming from,” but if I had to go, it’s one answer. I would want the Dr. Fauci of the world, the folks that are out there at the highest level, to brilliance and doing lots and lots of good things to also read it from another perspective. It’s those people that can drive policy change and can drive many of the other changes that we need here. I would answer it that way.
I should have given you two books because there are two different ways it can go. I can see both of those being so important. There are so many good professionals out there, practitioners that are caught up in the system that there’s an opportunity missed in terms of a patient feeling as though this person is interested in what’s going on with me, as opposed to, “I’m number 23 out of 30 that are going to come through this other day.”
I have a chapter in the book called The Heart Attack. I remember I was going to a visit for one of my appointments and my name isn’t necessarily easy to say. I said who I was. The person at the front desk, a very nice person. She’d gone through it. She couldn’t find my name. She finally found it. She goes, “You’re one of the heart attacks.” That’s what I became. I became my diagnosis. I was no longer Tom or Tommy or Mr. Dahlborg or any of that. I was a heart attack. It’s not an operation, unfortunately. How often do we hear, “I have three diabetics I need to see before the end of the day or whatever it might be?” We need to change that. We need to bring that humanity back into the equation. We have long ways to go. There are incredible people that I highlight in the book as well, doing amazing things, everyone from the front lines through the entire system, to CEOs of healthcare organizations, doing it the right way. We need the fan their flames as well so they don’t burn out.
Tom, this has been a pleasure as always having this conversation with you. It’s such an important topic right now as this pandemic goes on. It seems like even fewer resources to do a larger body of work in terms of helping people. Thank you for your commitment to that through this book.
I appreciate that, Patrick. The last point you made, there are lots of systems to be changed and we can love now. It doesn’t cost any money. If we can connect, if we can love, we can care and we can start that and every one of us could do so. It’s the cheapest, easiest way to start the change is to start to love and be kind to one another.
I would completely agree. Wishing you all the best in that.
Thank you, Patrick, for having me on again. You have a phenomenal show and a phenomenal platform and what you do with cables, changes organizations and positions, people to make a difference and kudos to you.
Thank you for that.
- Michigan Center for Clinical Systems Improvement
- From Heart To Head & Back Again: … a Journey Through the Healthcare System
- Consumer-Driven Health Care
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Depression has its way of convincing you that there is no way out of the darkness you are in. Tracey Maxfield was able to overcome that, escaping the rabbit hole of depression and, now, helping others do the same. She joins Patrick Veroneau to share with us her journey of coming out of that in this honest, raw, and hopeful episode. Bringing her book, Escaping the Rabbit Hole: My Journey Through Depression, Tracey talks about what it was like experiencing an acute depressive episode, how she battled through it, and recognized that there is hope. She shows others that there will always be a way out, even when it feels like all hope is gone. This conversation is particularly for those who have struggled and are struggling with difficult moments in their lives. Allow Tracey to remind you that tomorrow could be better. Join her as she shares the kind of mindset we need to have, as well as how we can impart that to our children as they grow up and face the realities of the world.
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Getting Out Of The Rabbit Hole Of Depression With Tracey Maxfield
My guest is Tracey Maxfield. She’s a retired nurse and a powerhouse. She’s an author of the book, Escaping the Rabbit Hole. She’s also the host of the very successful podcast called Engaged, Educate, Empower. In our conversation in this episode, she talks about her own experience battling depression and going down her own rabbit hole. The value here is trying to help people recognize that there are hope and ways to either help themselves or identify and help somebody else that going through a very difficult time. Certainly, we are in our environment right now where many people have struggled with going down on a rabbit hole. I hope you enjoy this episode. There’s so much value here.
Tracey, thank you for taking the time to be on the show. I appreciate it. We’re living in some unique times. We would both agree and we had this conversation about some crazy things that are going on. Your background certainly is well-suited in terms of you’ve had a wildly successful podcast as well as a blog. You had a book that you’ve written in regards to Escaping the Rabbit Hole that talks about your own journey. I’d like to have you tell your story in terms of what was it like to end up to where you are now and how did you get there? As we talked about before, how do we help people dealing with so much on their plate right now in these times?
Let’s take a step back and I’ll tell you a little bit about my story. I’m a nurse and retired with 37 years of experience. Back in 2011, when I started a new position, it was more of a supervisory team leader role but that was the first time I encountered a bully, and the bully was my superior. After about 4.5 years of constantly being harassed, threatened and intimidated, it wears you down. It culminated on August 20th, 2015 with a meeting that I had with her including union reps present. It was the icing on the cake per se. She basically came in with fully-loaded guns and fired at me. Personal, professional insults, lies and threats. It was horrible but what happened was I ended up falling down the rabbit hole.
I had a nervous breakdown or an acute depressive episode. My life changed. I can say I’m coming up to my anniversary of falling down the rabbit hole. My life since that day has never ever been the same. Certainly, it’s now better than it was, but in order to get to where I am now, I had to go through an awful lot, as you can appreciate. With depression, it’s not just the emotional cognitive. It’s the physical, suicide ideation and suicide attempts. It’s the feeling that you’re never ever going to be the person you were before and don’t even think that you can ever regain a possibility of life. It was through a lot of hard work, which comprised of journaling, expressing gratitude, sessions with my psychologist, medication and adopting a daily routine of a holistic approach to try and look after myself. All the time, as I started to get a little better, I started a blog. It was upon my psychologist’s recommendation to write a blog because most of my friends were healthcare professionals.
We’re talking social workers, doctors and nurses. When I would explain to them what I was going through, they couldn’t understand it, “You don’t look depressed. You seem fine. You’re functioning fine.” I was getting so frustrated that he recommended, “Start a blog. Tell them what it’s like living them with depression and give them an idea of what your life is like.” As soon as I started that, immediately, the conversations were, “We’re sorry. We never realized it was like that. This should be in a book.” Every single time I made a post, it was the same thing, “This should be a book.” After about six months, I was fortunate to be in touch with someone on LinkedIn who had previously written and published books.As human beings, we are our own worst enemies because we are so self-critical. Click To Tweet
I contacted her and said, “Do you want to take a look at this blog? Everyone’s going, ‘This should be a book. What do you think? Please be honest.’” A couple of hours later, she contacted me and said, “I have an editor for you in Toronto. Your book needs to be written.” Writing the blog, even though it was very painful because I was very raw and honest, it was also very cathartic. That definitely helped with the healing process and me coming to understand and coming to terms with what I was going through. The reason that I wanted to get the book out was because every day, I felt like I was the only one in the world going through this and no one would understand. That’s not true because the more people I met, the more I realized there were so many similarities. Even though each person’s journey with depression or any mental illness is different, there are certain things that we do have in common, perhaps the best way to say it.
I wanted someone who was reading the book to know, “You’re not alone.” Even if you think you are, you’re absolutely not alone. Over time, you will get better. In 2015, I never thought I would be sitting here talking to you. There was no hope and light. There was nothing. After the book was released, I began going to talk to people. I started a YouTube video. I did a weekly blog post about different types of mental illness, especially as they pertain to children and teenagers. I talked about bullying. I went on radios, podcasts and TV. My platform initially was to talk about my book in depression but I moved in the direction of speaking out for children and teenagers after I was invited to go to a middle school and talk to them.
I ended up having 63 teenagers, ages 11 to 15 come and confide in me about what they were going through regarding bullying, suicide, mental illness and self-harm. I was heartbroken and overwhelmed. Those were the two words. Overwhelmed that there were so many of them. I thought this is a problem with the school. It was only after I did some research that I realized it’s a global problem. This is something that’s happening everywhere. It was at that point upon a doctor friends’ recommendation who said, “This is your purpose. This is what you should be doing. It’s educating, going out there, advocating and supporting kids that are going through it.” That’s basically what I’ve done. Now I have a podcast, Engage, Educate, Empower. That’s how we connected because you were my guest on the podcast. It’s trying to get people to understand. I’m a firm believer of the more you know, the more empowered you are and the better able you are, not only to take control of your life, but to help others and try and move in a more positive direction.
I would guess that as this blog went out to, what it provided people was permission to be able to say, “I’m feeling that too. I’m going through that.” You felt a release from it but I’m sure they did too of saying, “It’s not just me.”
What surprised me was the number of messages I received from people that said, “I swear, you were standing over me as you were writing that.” It’s those feelings of helplessness, worthlessness, exhaustion and berating yourself. Dr. Daniel Amen is a very famous psychiatrist. He talks about ANTs in the brain, Automatic Negative Thoughts. I wrote a chapter about them because, as human beings, we are our own worst enemies. We are so self-critical. When you have a mental illness especially when you have depression, you allow those negative thoughts to percolate and 1 becomes 10, 20, and 100, and you knock yourself down constantly. It’s very hard to pull yourself out of that. That was also part of the message of the book of strategies of what you can do to take that next step forward and to keep going.
I mentioned at the beginning. I found that gratitude helped me enormously and that was being more mindful and accepting now and not, “Will I be healed tomorrow, next week or next month?” As bad as everything that I felt was going on with me, there was still beauty and wonderful things in the world. It was a habit of taking that time to acknowledge that there are wonderful things present. Lots of it was imagery from nature. It was those things that gave me some joy and peace. It gives you that little bit of motivation that even in the midst of all the darkness, tears, no it’s not, and everything that’s going on, you can stop for a moment and see two puppies playing, laugh and smile. You know that it’s possible. There’s something that you feel. To me, that was like the little ember that was getting brighter that you can feel peace and joy, you just got to keep working at it.
It’s interesting that you say it that way because I oftentimes think of it as a dance between expectation and gratitude. You need to expect that things are going to work out but also be grateful for where you are for the things that you do have. That’s how I see it as you were able to balance those things that you don’t beat yourself up. If you didn’t get, “I want to get to this level, but if I’m not there, I’m at least going to be grateful for this part of the journey right now knowing that I still expect to get there.”
One of the things I write about is it’s okay not to be okay all time. Here we are and it’s been years since the rabbit hole. Whilst I am so much better, unfortunately, with depression and I have the genetic form of depression, I still have good days, bad days and very bad days. In fact, when we were initially supposed to connect for the show, when you said to me how you do and I said, “I’m not doing well.” It was one of those weeks where it was very overwhelming.
When they used to happen, I get very scared because I used to say to people, “I’m dangling my feet in the rabbit hole or I’m circling in the rabbit hole.” It was that fear of, “I can’t go back down there.” Finally, I started saying to myself, “You were there and you got out so give yourself a break.” It’s not fair. Now is not a good day. You’re feeling very overwhelmed and hopeless but you know that tomorrow could be better and keep going forward. Once I gave myself permission to say, “It’s not such a good day now.” It takes the pressure off.
I heard somebody say once around mindfulness and challenges, they said to shake hands with your challenge as a way that you take the power away from it when you embrace it for that reason.Shake hands with your challenges as a way to take power away from them. Click To Tweet
Certainly, right now things are not good globally. I know especially the United States is having multiple challenges that they’re dealing with more so than other countries. Lots of people are feeling this confusion, this sense of being overwhelmed and stuck. It’s the uncertainty. With uncertainty and confusion comes fear because we all like to be or think we’re holding control. There are certain things in your life that you can control, especially your thought process, actions, the way you respond, the way you talk to people and body language. There are other things that are totally out of our control. This is why we’re seeing so many people that are reacting in a less than positive way to what’s going on. They have allowed their ANTs, Automatic Negative Thoughts, in the brain to take over to such a degree that sometimes they’re not able to think as clearly as they would have before.
We’re both on social media and I am seeing so much hatred, negativity and fear from people that have surprised me. It’s because they have allowed themselves to get caught up in this. Definitely, it’s like they’re in some vortex and they’re not quite sure how they’re going to get out and what life is going to be like when they do. They’re standing up for what they feel is right, but they’re standing up for things that haven’t even happened yet. They’re caught up in many of the conspiracy theories. They’re caught up in the, “This is what’s going to happen. You will have to do this and this,” and human nature says, “That’s not going to happen. You’re not infringing on my rights.” It allowed them to become a little bit emotional and carried away. They’re already preparing for what will happen when we don’t know what will happen if that makes sense.
Tracey, along those lines, it brings up an important topic around kids dealing with this. I haven’t seen the latest numbers but we already knew that suicide rates were trending higher in that age group under 24. You may know better than I am in terms of where those numbers are now, but I haven’t seen the exact other than to know that they’re not getting better through this whole thing. How many kids are now isolated and struggling because of this, but also having parents that need help understanding how you help kids deal with this if I’m the parent and I’m not dealing with this myself?
One of one good thing that has come out of all of this is there have been many resources that have come onto the internet from reputable organizations like the American Mental Health, the Canadian Mental Health and the World Health Organization that are providing resources and tools that parents and even children can use to make some sense of what is going on. We’re at the time where most governments are trying to get people back to a sentence of normalcy because we know the school year is about to restart again. That’s creating more fear and angst than ever before because of the unknown trajectory of this COVID-19. As parents, guardians, foster parent or even adult, any adult that’s involved with a child or teenager.
The most important thing that we have to remember is kids pick up so easily what you were thinking and feeling. If you’re anxious, panic-stricken and angry, they’re going to pick that up and that will then shape their behavior. That isn’t what we’re wanting to do. As parents, it’s now more than ever, is the time to try and remain very calm and positive. It’s time to get back to the basics of what is important, not only in an adult’s life but what is important in kids’ lives. That is the very small infrastructure that community network, who are the important people in that. It’s all working together as a team to reinforce support, love and confidence that we will be there with you. We don’t quite understand what’s going on just yet but don’t worry, we’re going to help you.
We will have a conference together or talk about, “If you go to school, you’re wearing a mask and your friend won’t, how is that going to make you feel? What will you do?” Try and get them to understand and get them to talk about their feelings. The most important thing, especially with kids, because by the age of fourteen, 50% of all mental illnesses will start showing signs and symptoms. By 24, it’s 75%. Kids are vulnerable. Teenagers are vulnerable period. Now, we bring into this equation COVID-19 or we add into this equation, Black Lives Matter, the racism, protests and everything that’s going on. We have kids that are very fearful, so as parents, we need to get informed.
We need to educate ourselves, first and foremost, to be there as a support to guide our kids. I know it’s very unfortunate because not everyone has that family network or connection. As parents, more than ever, you need to have this opportunity to start making personal connections with your child or your teenager to know what’s going on in their lives, what their fears are, what are their hopes once life gets back to normal, what would they like to do? What are they missing doing right now? How can you help them try and make the next best option? There is no easy answer but it’s okay. We don’t have the ideal solution in front of us but let’s brainstorm together. What could make it better? Kids and teenagers can come back with some very outside of the box thinking that helps inform adults way more than they would ever like to admit.
Through that, it would seem to me that if I want my kids to be more open and willing to have these kinds of discussions, it’s about vulnerability which I need to demonstrate that myself first. To be able to tell our kids, “I don’t have all the answers. I’m scared right now. I don’t know what’s going to be next.” There’s a balance there because it provides an opportunity for them to say, “It is okay to talk about this stuff. I don’t have to walk around like I’m okay. Put on a front when that’s what’s going on.” I watched my parents. They put on a front all the time. I know they’re stressed out but they act like it’s nobody’s business.
This is what we’re seeing. What this situation has done is people have shown us their vulnerability. Sometimes, for the best outcome, you have to embrace your vulnerability and give yourself permission to be vulnerable because you can move forward. Some people are ashamed or embarrassed by it that they then try to conceal it with anger, blame or negativity. In an ideal world, it is beyond honest. We are all hoping that you can go back to school. Are you good with that? Are you looking forward to going back to school? No. What scares you?
It opened those doors one after the other and it is saying, “I must be honest. I’m a little worried about you going back to school too but let’s work together.” Especially teenagers, as much as they don’t want to have the adults in their life telling them what to do, they would much prefer to work together and allow them to make decisions that you would agree with because they’re more likely to follow that plan instead of you imposing a plan on them that they have no say. It’s back and forth. The bottom line always is that you have got to keep reassuring them how much you love them, support them and you’re going to be there for them. Together as a family unit, you will get through this. More than anything, this is what adults need to hear. It is, “We’re in this together. We’re not alone. We’re going to do this. If this way doesn’t work, then we’ll look at that out of the way. We’ll figure it out.”
That was all kids want to know, “We’re going to figure this out,” but when you turn around, I’m going to be right there with you. It’s just reinforcing that over and over again and having those discussions. When I say discussions, I don’t mean you should be talking about it every hour, every minute of every day because it’s too much. It scares you, it overwhelms you, and you want to shut out the world. When you do talk about it, talk about it. If there’s a negative, counteract with a positive, “Mom, did you see the news? A hundred thousand people were diagnosed.” “I know. Isn’t that sad? Did you know that no one is dying right now? The medical treatment is improving. Look at all these people that have survived. That’s good.”We have to remember that kids pick up so easily what you are thinking and feeling, which will then shape their behavior. Click To Tweet
It’s always trying to find the positives that come out a bit and reinforcing, “We’re doing our part. We’re social distancing, washing hands and helping to be part of this solution.” That gives them that more confidence and a little bit of peace that we’re okay. It’s moving forward and trying to connect. There was a news reporter. The research has said that when COVID is over, they anticipate that mental illness amongst children, teenagers and adults around the world is going to be the highest numbers they have ever seen.
They anticipate at least a ten-year acute mental illness response because even when all of this is over, we don’t suddenly walk up the door and life was back to normal. Many people have dealt with many issues. We know that child abuse has significantly increased since lockdown. Not so much lockdown but social isolation of not going to school, online bullying, sexual predators and human trafficking. I couldn’t believe the numbers are three times higher than they were because having kids at home has provided a portal for them to weave their way into the kids’ lives and start taking them. It’s scary even though you’re in your home as parents, as adults, role models in that child’s life, you should not be given them free rein to go on any site to occupy their time. More than ever, you need to be talking about cybersecurity and working together., what sites are appropriate and what is not. Reinforcing all those danger signals with them because it has increased.
That’s where I think that as a parent, we play a significant role in how our kids are going to be able to address these things by how we show up. Unfortunately, that’s not available to all kids in all homes, but to me as a parent, that’s a huge responsibility to monitor how I respond because it’s being observed.
I always say, “Be responsive, not reactive.” As a parent, sometimes you have to literally bite your tongue and take that time out of mentally counting ten in your head before you will open your mouth to say something because we know whatever comes out of the mouth, your child is going to grab and hold of that. They are going to hear that. Even if you come back later and say, “I didn’t mean that.” They know at the moment you did especially if your eyes are open and right in the body language. I know that there are so many children and teenagers out there that do not have that stable family unit. That’s why it’s always important that as adults, as people in the neighborhood, in the community, you should always be looking out for the kids in that community to be their guiding force, their role model, a person that they can turn to if they’re struggling or something is not right.
You need to be aware of what’s going on. If you know that there’s a particular family that is not doing well, it’s not a case of mind your own business. It’s a case of, I’ll text, phone or stop by, maintain social distance and say, “I’m going to the store. Do you need anything? How’s everything going? Is everything okay? I picked up a few video games. Do you want to borrow them?” It’s keeping eyes on in a situation because we know what goes on behind closed doors for many kids and women in domestic abuse relationships. With children, they are still being abused. They are witnessing that.
We need to move past the intrusive nosy neighbor and be the concerned adult that’s looking out for the best interests of a family during this time, “I’m just checking if you’re okay. Do you want me to pick up something? Do you need a ride to an appointment? Is this something I can do?” If they say, “No, everything’s fine.” You’ve made that initial step, that’s why when you’re talking to your children as well, you may have a good family unit but ask about their friends because their friends don’t. It’s that link them to, “How are your friends?” More than ever, if we’re going to come through this, we’ve got to start standing together. We can stand together against political unrest and when we want to go on bash the police. Why aren’t we standing together as communities to support one another because that’s how the community grows?
I would circle around to a couple of very solid strategies that you had in the beginning that helped to do that. One is journaling but also looking at it from a standpoint of, “What am I grateful for?” There’s a contagion to that that we create. If we focus on the gratitude piece, there are a lot of things that are wrong right now but I believe that there are many opportunities that come from this. Also, there are more good things than bad things. If we practice that, as you said around gratitude, it puts us in that place that we become more problem solvers too, as opposed to getting sucked into, “This sucks.”
The challenge is as adults, we have to make it become a positive habit because it will reflect on the children and the teens. They will pick up on that and they believe that negativity is normal. When your teenagers say, “It’s not fair. Life sucks. I can’t see my friends. I can’t do this. I can’t do that.” You can miss them but you understand, “I hear what you’re saying but why don’t you try this or what was nice about now? What was good about now?” The more you retrain them into thinking that, you better able them to manage anxiety and stress when it happens and not beat themselves up. I’ll share a very quick funny story. When I was at that school and I’d been given 30-minute talks to the teenagers, at the end of the day, there was this thirteen-year-old boy and he hadn’t been engaged at all.
I knew there was something wrong with him. He was all in a black hoodie, very withdrawn. He came and he’s very embarrassed, he asked me, “Could I talk to you?” I said, “Yes, of course, you could.” He fell into my arms, sobbing his heart out. He said to me, “I’ve been in the rabbit hole for seven years. When will I escape?” He had depression since he was six. I sat with him in a private area and started talking to him. Everything was very dark and black. I said, “Mom.” He goes, “Mom is good.” I said, “That is something to be grateful for. That’s your gratitude is that you have a mother who loves you and will do anything for you.”
He said yes. Twenty minutes in I said, “Tell me, I know life sucks right now but what is it that you’re grateful for?” He is like, “Nothing.” I said, “When you go home, are you going to have an ice cream or something? That can be gratitude because that’s something that you love and you enjoy.” He’s like, “I got nothing. It’s just dark. It’s black.” I thought, “How am I going to get a thirteen-year-old boy to understand gratitude?” I’m giving him examples and he’s like, “I know I get it.” I said, “I can tell you one thing right now that you could write down that you’re grateful for.” He goes, “You can.” I said, “You’re sitting here with this hot woman who’s got her arms around you, telling you that you’re awesome. That’s gratitude.” He laughed and I said, “See, gratitude is little things. It’s going home, watching your favorite show on TV, playing a video game, and get to the biggest school. It’s going outside and feeling the sun on your face.” He looked at me and he said, “I get it.” He was very calm. I said, “Are you okay now?” He goes, “I’m okay.”Sometimes for the best outcome, you have to embrace your vulnerability. Click To Tweet
He wandered off. About an hour later as I was packing up to leave, he passes by the library, I saw him, I smiled and he was jumping up and down, waving his hands going, “I get it.” If the kids can figure out the tool, if you can give them guidance to what may help them, they will run with it and they will adapt it for themselves but it gives them that sense of control back in their life and that little bit of purpose. It’s always a good exercise to do every day with kids, even when they’re very young. What made you happy, what makes you smile or what was good about now? You get them starting to feel about positives in their life. That will always work when the not so nice things happen.
That was the last piece of it. It’s about routine at that point is what you’ve created.
Routine is safe but you can bring things into your life, into your daily routine that are mindful. It’s appreciating the moment, the little things. More so now than ever with the way our life has had to restructure with COVID, we have to get back to mindfulness and stop looking at, “Will it be gone in December? What is Christmas going to look like? What does my birthday next March going to look like?” “No, let’s do now.” Let’s try and make now the best it can be given the circumstances. If it wasn’t, then let’s give it a go again tomorrow. If you start showing up and doing that as a family, it will filter down to the kids and they will start doing it automatically.
Tracey, if people wanted to get a hold of you, read your book, listen to your podcast, what’s the best way to reach out to you?
The easiest way is to go to my website, www.TraceyMaxfield.com. Everything is on there, my blog, appearances, podcasts, resources and the book. It’s one-stop shopping.
Thank you so much for your time.
Thank you. It’s been wonderful.
I think the things that you’ve mentioned here about gratitude, journaling and making it a routine are such a strong recommendation for people to help them to deal with us. I hope people will take hold of that. Wishing you all the best.
Same to you and your family.
About Tracey Maxfield
Tracey Maxfield is a retired nurse with over 36 years’ experience in gerontology, mental health, and dementia care. She is a regular guest on well-known author and radio host Peter Rosenberger’s show Hope For the Caregiver on Sirius radio. Tracey has written multiple articles on dementia care, medical research and mental illness/bullying in teenagers. She is the Purple Angel Dementia Ambassador for the Okanagan. B.C. and NAASCA Ambassador for B.C., Canada
Tracey experienced her first episode of clinical depression in her twenties and lived with chronic depression ever since. However, nothing prepared her for the acute depressive episode she experienced in 2015. After enduring years of intense workplace stress, harassment and bullying, she plummeted into an abyss of darkness, hopelessness and despair the likes of which she had never experienced before.
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The line that distinguishes depression and burnout from each other is somewhat unclear. But what is certain is that to mitigate these, a significant change in the working environment is needed. This is what Dr. Lisa Rotenstein sought to answer in her study with Dr. Constance Guille, with the aim to create a healthier working environment for healthcare professionals. She joins Patrick Veroneau to dissect her research findings, explaining how understanding the overlapping factors of depression and burnout can help leaders analyze and improve their workplace culture. Dr. Rotenstein also emphasizes how this can transcend into other industries and professions, especially today when most companies are in remote setup and team building is challenged.
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Addressing Depression And Burnout Within The Medical Field With Dr. Lisa Rotenstein
I spent a great deal of my time working with both teams and individuals in the healthcare field. My guest certainly provides a great deal of value, not only for the healthcare field as that’s her background, but I think overall, in terms of there are pieces here that other professions individuals will be able to benefit from as well. My guest is Dr. Lisa Rotenstein. She’s the Assistant Medical Director of Population Health and Faculty Development and Wellbeing at Brigham and Women’s Hospital. She has her undergraduate degree and MBA from Harvard University, and her medical degree from Harvard Medical School. She’s also a faculty member at Harvard Medical School.
Our conversation is going to focus on burnout and depression in the healthcare field, and the work that she’s been involved in. Specifically, we’re going to talk about a research paper that she co-authored with Dr. Constance Guille from the Medical University of South Carolina. Although we’re going to talk about burnout and its relation to depression in healthcare, I do believe this transcends into other professions and areas, the link between the two. In the environment that we’re in where many people are under pressure and stress, that this is a timely article that will provide some resources and some understanding on how you can address this if it’s yourself or if you know somebody else that’s going through this. Let’s get into it.
Dr. Rotenstein, I want to thank you again for taking the time to be on the show. Speaking specifically about a study that you had published in the Journal of General Internal Medicine and title of it was Substantial Overlap Between Factors Predicting Symptoms of Depression and Burnout Among Medical Interns. Although I’m sure it deals with medical interns, I’m sure you would see this in many other places in the environment that we’re in. I was hoping you could talk about the study and what prompted you to design this study in the first place.
Thank you for having me on the show. I have been studying burnout and depression for some time. I became interested in the topic from a business background. I was in MBA training at that time, coming from a medical background. In the medical world, I saw my colleagues, trainees and physicians struggling with burnout with symptoms of depression. At the same time, in my business training, I was learning about how you affect the employee experience of care, how you tailor the workplace to their needs and their motivations. It was a very different lens than we often apply in medicine. I have been studying this over time, including studies in JAMA, showing wide variation in how burnout has been defined. A study showing that more than a quarter of medical students have depressive symptoms. This then led to the study. We were asking ourselves how much of an overlap is there between burnout and depression.We are much more reliant on technology at this point to help us get our work done. Click To Tweet
When we talk about these issues casually, we often talk about depression, having to do with personal factors, things going on in a person’s personal life, as well as their innate skills. We talk about burnout is having to do more with workplace factors. Yet, it’s not very clear from the literature that these are distinct entities. We wanted to answer this question to understand how much overlap there could be between the causes and the solutions. That’s how we landed on the question and I’m happy to go onto the results as well.
It was interesting because one of the pieces that I had read, in terms of the definition of burnout, that there were over 142 different definitions for burnout.
This was the 2018 JAMA study in which we looked across the literature. Our original question was, “What is the prevalence of burnout among physicians?” We found that we could not answer that question because there was so much variation in how burnout was defined. Even amongst studies, you use the Maslach Burnout Inventory, which is the most common instrument for measuring burnout, there were 47 distinct definitions of burnout so it’s hard to compare apples-to-apples. Similarly, it’s hard to then do studies suggesting that you’ve had an impact or that an intervention that works in one place can work in another place because you don’t understand whether you measure the same thing. That was a key takeaway in terms of our limitations.
The other important point is having to do with limitations and studying burnout is that we don’t have the same limitations for studying depressive symptoms. There are standardized instruments for studying depressive symptoms, and these have been validated against clinical interviews which are the gold standard for diagnosing depression. When you think about comparing these two concepts of depression and burnout, there are a lot of differences, even though there might be similarities in how you assess them.
When you talk about the results of this study, what did you find?
We found substantial overlap in the factors that predicted depressive symptoms and symptoms of burnout. We looked among medical interns. What was nice is that we were able to look at them over time. We were also able to ask them questions about personal factors for example, a history of depression, their early family environment, marital status, whether they had children. We also ask them about their workplace experience, including their overall workload satisfaction and their learning environment satisfaction. We found a substantial overlap between the factors associated with depressive symptoms and the factors associated with two of the sub-scales of burnout, emotional exhaustion and depersonalization.
These factors explained a similar percentage of the variation in both depression and burnout symptoms. It told us that these concepts are probably not so different and importantly, some of their contributors or their predictors are similar. What is the takeaway of that? It’s a helpful takeaway in that people are looking to alter work environments to facilitate wellbeing. You don’t have to think about the intervention separately. If you can improve the working environment, if the people you’re catering towards their trainees, if you improve the learning environment, that tells you that you can impact both on depressive symptoms and burnout.
When you talk about the two different components, one is emotional exhaustion, which seems straightforward. When you talk about depersonalization, what exactly does that mean?
Depersonalization has to do with the way you approach your work. The particular subscale of burnout that we used has been created specifically for those people who work with other people. It’s a scale called The Human Services Subscale. The way it applies to medicine and many other jobs that have to do with service, it has to do with how you approach your work and how you feel about your work. Do you have cynicism when you think about the service you provide or the population you’re interacting with? Have you removed yourself from that work emotionally? Do you have decreased empathy towards the people you work with and those you serve?
It’s almost a disengagement.Stop assuming that everybody's reality is the same as yours. Ask people about their realities and try to understand them. Click To Tweet
When we think about this from the standpoint of measuring depression seems to be much cleaner. The research is much more solid in terms of how you do that. From the standpoint of how we can address this, what are some of the things that you would recommend?
I’ll comment on the first point you made and then get to some of the solutions. I agree, based on what we know from the literature and on validation studies that it is cleaner to measure depression or depressive symptoms, and yet that’s not trivial in our society. I think we should make that point upfront. Unfortunately, in many arenas, there is still a stigma. In medicine, there might be licensing ramifications. This is a point of ongoing discussion, even though we now know more about the overlap, and we know that it is more accurate to measure depressive symptoms. The jury is still out on exactly what we should be measuring just because it’s much more than a data question. It’s a question about how society reacts to the results.
In terms of how we address this, I can speak about medicine but I think that the implications carry across to other fields as well. We have learned through studies in the medical field that interventions that impact the workplace are much more likely to affect symptoms of burnout and those that target the individual. What I mean by that is when you think about individual-focused interventions, those might include meditation or resilience training. When you think about interventions that affect the workplace, you might instead think about giving people their time back.
If people provided some service like teaching within medicine, giving them their time back to that and recognizing it. Thinking about schedule modifications that might facilitate better work-life balance, easing people’s interactions with the electronic medical record, and providing them extra support in the workplace. For example, leveraging other members of the team to help provide care. We know that those types of interventions are more effective, and those are what we should be targeting.
I have a lot of work that I do on the healthcare side, working more with nursing groups and smaller groups but things that you talk about are relevant to what they do as well in terms of scheduling a lack of resources that they might have and how that plays into this level of burnout and anxiety that they experience.
These are interventions that are not as simple and they’re harder to enact but they’re incredibly important. The other piece of it is that there has been work showing that if you are going to introduce people to wellness curricula or experiences that you think might decrease their stress or increase their resiliency, you should try not to make those use their outside time. If you’re going to provide yoga sessions, it might not be the best solution for those at 6:00 PM to be tapped onto the end of the workday. It should be integrated in a way that further facilitates work-life balance.
Rather than throw one more thing on top of a day that’s already completely cramped. I’m guessing with the situation that we’re in with the pandemic, this is somewhat timely for you in terms of this article or for those that are experiencing this.
The pandemic has brought up many additional issues and also highlighted issues that were present before but made us more aware of them. The big question now around is, what does work-life balance mean in an era where many people are working from home? How do you define the boundaries there? We are much more reliant on technology at this point to help us get our work done. How do you achieve balance with technology when people are spending many hours a day on Zoom?
Some of the issues that have been highlighted that were certainly present before are the differential impact or prevalence of burnout amongst female physicians and minority physicians. This applies across other fields as well. We know from previous work that female physicians have higher rates of burnout than their male counterparts. We know from previous work that minority health profession students have a lower quality of life and a decreased sense of personal accomplishment. These are important things to bear in mind, especially in light of the pandemic and a new way of working to think about how we ensure that the workplace caters to all people and helps all people thrive.
From the work that I’m involved in, there certainly seems to be a much stronger drive for change.
The curiosity has to be on a few fronts. It has to be asking, not assuming that everybody’s reality is the same as yours, and asking people what their realities are and trying to understand that. Many people have newfound responsibilities of educating within the home and how that affects your workplace. How does that affect your interactions with your peers and then the boundaries you have on your time? Many people have newfound family responsibilities or newfound family stresses. Having a curiosity to figure out what is going on within your workplace and then being creative about supporting that. To your point, we have made strides over time in trying to find solutions to burnout, particularly in the medical world, but some of these we have to rethink.
We know that scribes can be used to help physicians with their documentation burden. What does it mean to use scribes in an era of remote work? We’ll have to figure that out. We know interventions that promote team-based care. The doctors are working as part of close teams with nurses and social workers, and can alleviate burnout and results in better patient care. What does that mean when teams are remote, distributed, and how do we re remake systems to work effectively in this time of change?
There’s such an important piece to understanding our unconscious biases in these situations that we make judgments on people in situations and their experience without understanding what it’s like to be them and to have gone through these things. From a leadership perspective, I see it in healthcare and other industries that I work in. Those in roles where people are reporting to them if they don’t truly take the time to appreciate all of the additional things that have gone on in people’s lives because of this, they will miss an opportunity to engage people. It will increase this lack of trust within organizations and individuals because people are dealing with a lot of different things. Grief has been underappreciated.Successful leaders are those who adapt to the times in a way that is sustainable for the people they lead. Click To Tweet
We’re not done with the change as the key part of it. Change will continue to happen in the ways we work. It will continue to change in the next few months. Gaining that trust through what you’re saying by asking people about their realities are through flexibility and find solutions for new work will be key for helping people buy into the continued changes that will happen over the next months and years.
You wonder on some levels if some of the things that we’ve gone through. These almost seem like dress rehearsals for real change to happen. How do people deal with this?
In healthcare, we have seen changes that would have otherwise taken 5 to 10 years to happen. Telemedicine has exploded, sprouted, and many of the hesitations we had about it, we had to figure them out. It’s a real-time opportunity. The leaders that will be successful are those who adapt to the times in a way that is sustainable for the people they lead as well.
Outside of healthcare, where I see it as well as remote work, people working virtually where many organizations were very resistant to that of, “We can’t do this.” That has been debunked that people can’t work remotely. It’s going to be very difficult for people to try and put that genie back in the bottle.
Speaking of burnout in teams though, how do you keep a pulse on your team in a remote working environment? That has to do with getting things done but also keeping up morale, understanding what people are worried about and how they are viewing the workplace. That is the next frontier. There was a sense early on in this that we’ll do this for a few months and we’ll go back to the old way of working. Many of us realize that it won’t be quite so simple. That will be the next frontier is how do you recreate the great things about previous workplaces in a new way of working when all of us are remote.
That’s something that I hear quite often, especially around this idea of culture, “How do you maintain culture?” I’ve experienced many organizations that will be happy to see the culture that they had to go away if it can because it wasn’t a healthy culture to begin with. I do think there’s an opportunity to rebuild here. From the standpoint of behaviors, especially from what you’re talking about from interventions, it needs to be supported at the very top for this to take hold and individually, “How do I inspire and empower a team?” It will require much more individual touchpoints with people.
What have you heard about building and sustaining culture in this remote work environment?
Everybody is trying to grapple with that. In my humble opinion, culture for one is about behaviors. It doesn’t matter what you say your culture is. It’s how people behave that will determine what that is. From a leadership perspective, if I’m leading a group, it’s going to require much more effort for me shorter doses of having individual connections with people, contact on a more regular basis, and knowing my team that some people need more attention than others remotely. We are doing an assessment. It’s a remote work assessment that allows individuals to answer questions on how they work remotely, a team from a distance dealing with deadlines remotely working under stress. What it allows individuals to look at is, “What are my strengths if I’ve got to work virtually and what are some of the challenges that I’m going to run into?” This can be shared as a team with a manager. It allows people in this new environment to say, “How do we understand what our strengths and weaknesses are going to be here, and how can we play to those?” That’s going to be valuable.
The challenge will be that managers will have to take the time to figure that out. Coming back to where we started, that overlap between burnout and depression in large organizations. For example, within training programs, it’s often hard to get the pulse of such a large group of people. Leaders will have to find ways to do that effectively. If people are going to recognize the changes, they’re making the working environment, learning environment, and keep workers healthy over the long haul, but the long haul of this pandemic, which we’re seeing and continues to rear its head in different ways.It doesn't matter what you say your culture is. How people behave will determine what that is. Click To Tweet
There’s so much data out there at least in regards to belongingness. We are pack animals, and that we need connection. For those leaders who may not have understood this before, the distance creates more of a drive for people needing to feel connected. There’s a sense of purpose to what I’m doing and to the organization that I’m with. Those that are able to identify this and navigate it will be the ones that will be successful in creating a different-looking team.
One of the things we know about medicine that is true in medicine and is true likely in other industries that both drive burnout and then contribute to disparities is that feeling of appreciation and access to networks of power. We know that female physicians are promoted more slowly and less often than their male peers. We know that there are barriers to minority physicians gaining positions of leadership or positions associated with higher prestigious pay. We knew in the previous way of working what some of the barriers were, even though we have not surmounted them. I do think this new way of working presents even more challenges to closing that gap. How do you create the structures that allow you to thoughtfully connect with a variety of members of your team and create connections that allow you to sponsor them and promote them in a way that is equitable? There are perhaps opportunities there now that many of our interactions are over Zoom, which is a more equitable platform. There are a lot to think about there as well in terms of who is reaching out to who and what do some of those more informal connections look like in a time of remote work?
Two behaviors come to mind when I hear that, and it’s work that we’re involved in. One is around congruence, this alignment of what our values are, and do we practice those? The other is around clear expectations. Oftentimes, what we’ve seen within organizations is that there is a disconnect between understanding what is clearly expected either to get to the next level. They’re not clearly defined. If they are clearly defined, they’re not held accountable. Those two things can be a real challenge within organizations.
There’s also a piece of who gets opportunities and who learns about opportunities through what it means. That will be redefined in our time of remote working potentially in good ways but also in unfortunate ways. We all have to be thoughtful about that as another facet of this pandemic and how it affects the careers of a diverse workforce.
I would agree completely with that. I had this conversation around organizational values. Oftentimes, when people hear that, they roll their eyes thinking, “The values.” Why? It’s because people don’t feel as they’ve had any sense of creation of those values is part of this process. If we want to start having real equity, it’s time to pull out those values and hold people accountable to those. “Here’s what we say as an organization that we stand.” That’s the organization’s compass to be able to make decisions to say, “Is this behavior now in line with what we state as our values?”
What actions do you have to take in a time of remote working to make sure that you ultimately act in congruence with your values? That takes a little bit more planning than it would have in a time of in-person work.
Values are something that needs to resurface as something that is real and not just something that was nice to put together on our website or in our employee handbook, but they mean something.
There’s great opportunity for that in the setting of the pandemic. We have changed the ways we work, and we have had to think long and hard about what we care about and the implications on our society. It’s a real opportunity to re-examine values for organizations from healthcare to every organization imaginable.
Without question, I do think that this is a period of time where people have been pushed in ways that they said something needs to change here like, “I’m not going to do this.” The biggest concern that I would say is that you will have more people quit and stay, than quit and leave their organizations if things don’t change. As we finish up here, based on your research, if the reader might be in the healthcare field and they are dealing with this, what would you recommend to them?
The biggest takeaway is to think about your work environment. There are undoubtedly many personal factors that play into both burnout and depressive symptoms. We know that the work environment affects burnout. We know that changes in the work environment can improve burnout and the work environment has changed. To have a healthy workforce, we have to be willing to re-examine. We have to examine what are people’s new ways of working. What does the new workplace look like? To make changes in a time of constant change, that’s hard but it’s necessary. We know that the costs of burnout are real. In healthcare alone, we know that burnout is associated with worse patient outcomes with decreased quality of care with increased turnover of employees. This is an issue with real economic and health consequences. It’s one to take extremely seriously.Distance creates more of a drive for people needing to feel connected. Click To Tweet
There are many different levels of implication here that I think are important to look at, whether it’s the hospital’s financial health and the patient’s health, there are impacts all along the way here. I appreciate you taking the time to speak about the research that you have done. It’s important for us to understand how we address this. Thank you for that.
Thank you for taking the time. I would be happy to talk to the readers about these issues. The best way would be by email, Lisa.Rotenstein@Gmail.com.
Thank you for your time. Good luck with all that you’re doing. Thank you for putting this together to be able to help those that need this.
About Dr. Lisa Rotenstein
Asst Medical Director, Population Health and Faculty Wellbeing, Brigham and Women’s Hospital
Without us realizing it, there is a part in us that works against our very own success. In this episode, Patrick Veroneau explores that by diving deeper into the reptilian part of your brain, the amygdala. He talks about how it can inhibit your success and impact your goal-setting, relationship building, and unconscious biases. Learn how you can take care of yourself and remove the blocks to your success by getting to know your brain more. Tune into this discussion to find out.
Listen to the podcast here:
How Our Amygdala Can Inhibit Our Success In 2021
In this episode, I want to talk about the amygdala specifically how the amygdala can work against us as it relates to building relationships, setting goals, and our own personal health. Let’s get into it. We’re still in the first month of 2021. I thought it’d be interesting to take a little look at this part of our brain called the amygdala and how it impacts our ability to, first, set goals. Two, how might it play into relationships or biases? Lastly, how overactivation of our amygdala as it relates to threat responses can impact our health? All things that are important as we come into 2021.
We’ll start off with goals. Many people start the year with the best of intentions of setting goals. The problem is that, oftentimes, this part of our brain, the amygdala, which is a reptilian part of our brain is all about perceived threats. It doesn’t know the difference between a real threat and a perceived threat. It responds the same way. When we’re setting goals, there may be an opportunity where we’ve set a lofty goal and our brain is looking at this and saying, “This is risky.” This person wants to change careers, wants to start a business, whatever it might be, the brain says, “You don’t do that. That’s too risky. Play it safe. Do what you’re doing now.”
That is that part of our brain that is trying to protect us. Oftentimes, if we’re not strong enough in terms of the goals we have set, those specific, emotional, and time-bound goals will talk us out of whatever that goal might be. We’ll dumb it down. We’ll do something else. Again, it’s our brain trying to protect ourselves. As soon as we change, the brain is like, “Good thing I helped them through that. We risked. We avoided the catastrophe. They were going to start a business. That would have been terrible for us. We did our job.”
Next, we can look at the standpoint of relationships. There was an interesting article in the mind episode of Scientific American. The title of the article was What Neuroimaging Can Tell Us about Our Unconscious Biases. What was interesting about this article is it talked about how our amygdala can create unconscious biases. What it does is it looks for familiarity. When it senses that it is unfamiliar with something around it, it immediately perceives this potentially as a threat. This can happen in regards to how we interact with other people, especially people we don’t know that we’re looking for similarities. The amygdala part of our brain is looking at this individual, saying, “Is this a threat or not a threat?” Especially in the environment that we’re in right now. We hear so much around diversity, equity, and inclusion. Our amygdala, and certainly the research in this article would suggest that it plays into our self-protection in a way that creates biases.
The only way that we can prevent that is first to recognize the power that our amygdala has. Once we do that, it allows us to slow things down. I’ll use this as an opportunity to talk about smoke detectors in our house. I think there’s a strong similarity here. If we can think about a smoke detector in our house and food burning on the stove, as long as there’s not a fire but the food burned, but nothing else is burning. The smoke detector still goes off. What do we do? We go over and wave something in front of it so that the smoke detector goes off or we have to unplug it. I don’t think anybody reading would say that they would run out into the street as soon as they heard the smoke detector go off knowing that it was just burnt food on the stove. You wouldn’t do that. Our amygdala doesn’t know the difference.
Every time there is a threat, somebody says something to us that may seem offensive, threatening, or we start to question ourselves on certain things, the amygdala part of our brain is in protection mode or self-preservation mode. It’s trying to do what it can to protect us. It’s either going to fight, flight, or freeze. It’s not until we take a step back and say, “This is not a real emergency. This is just burnt food on the stove. I don’t need to call the fire department. We’re going to be all set.” We need to be able to do that in our minds to slow things down and take a moment to say, “Is this a threat? Is this something that I can’t do or is it my mind trying to protect me from the risk of failing?” It’s not a real threat. I need to be able to take a step back and look at this more objectively to pause. That’s the biggest thing here. That’s why we talk a lot about things around mindfulness and emotional intelligence. We’re developing those areas so that we’re able to slow things down and not react as much as we’re able to take in everything that’s going on and then respond.
The last part that is important as it relates to our health is that we know that the more we activate the amygdala, the fight, flight, or freeze part of our brain, we also activate what’s called the HPA axis. What that does is it releases cortisol in our system. When we release cortisol in our system, what it does is takes blood away from many of our organs and puts them into our extremities so that we’re ready to take action. It draws it out of our brains as well. If you think we don’t make decisions as well when we’re under stress or where that fight, flight, or fright is activated, because we’re like, “Let’s get out of here.”
This was an analogy that I was once told. Imagine a hunter back in primitive times. If they were to see a saber-toothed tiger and have an infection simultaneously, what would happen is the blood in the area working on the immune system and taking care of that bacteria left that area and went to our extremities. It said, “If we don’t make it past this tiger, we don’t even have to be concerned about the bacteria because you won’t be around to recover from it anyway. Let’s take care of the thing that’s in front of us first and that’s this tiger. After that, we’ll come back and work on our immune system again.”
If you think about that and if we think that our immune system or our amygdala works the same way as it did when it was with the saber-toothed tiger, then what’s happening is that we’re over-activating the system all the time. It’s too much of the time in a fight, flight, or freeze mode by the environment around us. If we don’t control that, then that’s less time than it has to build up our own immune system. That’s why in the environment that we’re in right now, where more people are worried about catching a virus, their anxiety around catching the virus could be working against them in harming their own immune system. They’re not allowing it to have the adequate resources that it needs to do its job when it’s under a stressful situation.Recognize the power that your amygdala has. Once you do that, it allows you to slow things down. Click To Tweet
We can see here where our amygdala and a smoke detector are very similar when it comes to perceiving threats. It’s our job to take a moment, step back, and say, “This isn’t a real emergency,” and to recalculate how we’re going to respond going forward. It’s not until we do that, that we’re able to truly make sure that we adequately address our goals, our relationships, and our own personal health. I hope you found this short episode helpful in regards to thinking about your amygdala in a different way in terms of how it may be working against you. Once you do that, you’ll be in a better position to, as always, rise above your best. Peace.
Get your goals in check and be ready for 2021. In this episode, Patrick Veroneau talks about what you need to avoid that can derail your success when setting your goals for 2021. Get a deeper understanding of this twist to Patrick’s model, SET, and understand what are the three ingredients for success as he explores each of them. Patrick also dives into the reptilian part of your brain and how this can make or break your success. Tune in and set yourself up for success in 2021.
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What Can Derail Your Success In 2021 And How To Avoid It
In this episode, I want to talk about what we need to avoid when setting our goals for 2021. This is a twist on an episode that I do every year around goal setting. There’s a specific model that I use called SET, which is an acronym for Specific, Emotional, and Time-bound. Those are the three ingredients that I have found to be the most important and vital in regards to being able to achieve our goals. For those that may be used to organizations that they work with using SMART goals, this is an offshoot of that. I am very familiar with SMART goals, and quite honestly, I found them to be more cumbersome at times than beneficial. What I did was tried to whittle that down into the components that are most important.
I came up with these three. One being specific, which is the S, the E is the emotional, and the T is the time-bound. The S and the T are familiar to SMART. With any of the goals that we’re going to set for 2021, we need to make sure that they’re specific. What do we want to achieve? Setting a financial number might be something that I do. It might be that I want to reach many individuals. I want X number of people to go through the programs that I offer. I want to be able to work with a certain number of new accounts, whatever that might be. What’s important is to be specific on it because once I have that piece, it allows me to back into it after I’ve figured out what my time-bound is.When you make decisions based on fear, you don't make the best decisions. Click To Tweet
In terms of goals, I could set out my yearly goals, but also I can back into it and say, “If this is what I want to accomplish by the end of the year, then this is what I need to do.” These are the milestones that I need to hit between now and the first quarter, or between now and the end of the month of January 2021. Whatever that might be. I need to back into this thing as much as I can so that I can figure out what my trajectory is. That’s specific and time-bound. The emotional part is something that you don’t see in the SMART goal. To me, it’s the most important part. That’s the why. Why do I want this goal? Why do I want to have 200 more people go through my program in 2021? Why do I want to work with ten new companies? Whatever those numbers are, what’s the reason? I can come and ask myself that question five times.
It might be, why do I want to work with 200 new customers? Because I know that the program I put in place has the ability to change not only in people’s lives in their work setting, but also in their personal lives as well. Why is that important to you? After experiencing and seeing what people experienced in 2020, I know how important that is for people to be able to navigate that situation so that they have a healthy home and work life. Why is that important? Because I’ve seen the damage that’s been done. I want to be able to do my part to contribute make a difference there. Why is that important? Because I feel like I’ve been given a gift in terms of an ability to identify different behaviors that will help people live better lives and rise above their best. I want that to be my legacy.
Now, I’ve gone from a legacy. I’m creating something for a legacy that came from I want to have 200 people go through my program. The why behind that is so much stronger when it’s now about a legacy that I’m trying to create based on what I put together. We can do that for anything. I could do that for losing weight. If you think about it, I could say, “I want to lose 10 pounds.” It’s specific, “I want to lose it by January 1, 2020.” There’s a timestamp to it too. I need to do it by that time. Now I can back into it. When we get to the emotional part, I could say, “Why do you want to lose 10 pounds?” Because my youngest son is getting ready to play a sport in the spring that I used to coach, and I want to be able to coach again. I don’t feel as though I’m active enough.
Why is it important for you to coach your son? Because he’s going to be going to high school, and this is the last opportunity I’ll have to coach him and spend more time with him. Why is it important to spend more time with him? Because once he’s in high school, our time together will continue to drift apart. I want to build those roots now or continue to foster that growth now in our relationship. Why is that important to me? Because I know that once he’s out of high school and after eighteen, that if you look statistically, as sad as this sounds, I probably spent 90% of the time that I will share with him on average is what they say. That motivates me even more.
Why is that important to you? As an adult, I want to have a relationship with him that continues to flourish and that we build a legacy. I’ve gone from 10 pounds to a legacy, so that when I walk in the house and there are Oreos and an orange sitting on the table. I might be more tempted to stick with the orange than I am to be tempted by the Oreos because I look at this and say, “This is a legacy. This is what I want.” That’s the goal-setting part. If you noticed in the title of this, I said, “Here’s the part you need to control.”
I’m going to go in a different direction here and talk about our brains. Specifically, I want to talk about the reptilian part of our brain, the amygdala, which is responsible for the fight, flight or freeze. The reason I am bringing this up in 2021 and I haven’t in the past is because if there’s one thing that I have seen in 2020 is so much decision-making that’s been based out of fear. When we make decisions based out of fear, we don’t make the best decisions. Our brain is naturally wired to try and protect us. That amygdala part sets up either fight, flight or freeze. I want us to think about our brain in this way when we think about the amygdala. Think about it like a smoke detector in your house. If there was food that was burning on the stove and the smoke detector went off, what would you normally do? You’d simply go over, you’d wave something in front of the smoke detector, or maybe you’d have to take the battery out to get it to stop.
I don’t think there’s anybody reading this that would say when there was burnt food on the stove, unless there was an actual fire, that they’d ran out of the house and called 911 because the smoke detector went off. You knew it wasn’t a real emergency. You did what needed to be done to stop the smoke detector, then you went to cooking a new meal. Our brain is wired in a similar way in terms of its setting off an alarm. When it feels a threat, and this threat looks different, it could be somebody says something to us that maybe we take as an offense. That’s a threat. Maybe we say we’re going to do something. We’re going to set a goal. We’re going to do something that’s above and beyond what we’ve ever done before. Maybe I’m going to take on a new job or I’m going to start my own business.
Your brain or that smoke detector is going off saying, “We got an emergency coming up here. We need to protect this individual.” It’s trying to protect ourselves from a perceived threat that’s going to come up. We have the ability like when it’s burnt food on the table to take a step back and say, “I understand what my brain is doing. It’s making me doubt my ability to do this. It’s trying to protect me, but I don’t need this right now. This is not life-threatening. This is not a real fire. My brain is perceiving it is, but I have the ability to override this.” We need to be able to do that. This is such a powerful system in our brain.
I’ll give you a quick example of that. In our old house, when we had first moved in, the whole house is hardwired with smoke detectors. One night, one of them went off. It was malfunctioning. I was convinced that I could see smoke banking up along the ceiling. I had to get my wife out of bed to say, “Do you see anything there?” I was even fooling myself to think there is smoke there. She had to say, “No. There’s nothing there. Everything is fine.” I say that because we will try and override ourselves, or other people wanting to protect us will be that smoke detector. They will tell us, “Don’t take the risk. You’ve got such a good thing going on right now. Why would you ever take a chance or risk what you have right now? Be happy with where you are.” That’s that same smoke detector. For us to succeed in 2021, we need to get a better handle on the reptilian part of our brain so that we start making decisions on opportunities and not out of fear. The best way that I have found to do that is to strengthen your level of faith because when you strengthen your level of faith, you starve your fears.When you strengthen your level of faith, you starve your fears. Click To Tweet
It’s the best vaccine I know that prevents people from getting overtaken by fear and limiting their abilities. I hope you have found this helpful. I hope that 2021 treats you incredibly well. I know that you have the potential to make that happen. We all do when we set our goals, and they’re specific, emotional, time-bound. Also, we control that one thing in our brain that has the ability to derail us. That’s our amygdala, that smoke detector that wants to protect us but doesn’t recognize that these aren’t real threats. I wish you all the best in 2021. I can’t wait to share many more episodes with you and help you and myself to rise above our best.
It’s the new year, and that means it’s time for us to set new goals and achieve bigger dreams. But what if you take a spin on this yearly tradition, and instead of making it just your year, you make it for others too? In this episode, Patrick Veroneau talks about how to help others set and achieve their goals in 2021. He goes deep into the two models that can guide you to be effective at supporting other people and influence them to follow through. Join in on this brief yet insightful conversation to make 2021 the best year yet.
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How To Help Others Set And Achieve Their Goals In 2021
In this episode, as we’re coming into 2021, and I know so many people are looking forward to 2021, and we always talk about goals. Setting goals, what are we going to do in 2021? Personally, I’d take a spin on this from the standpoint of what do we do to help other people in terms of setting their goals. Maybe it’s people that report to us. What are the things that we can do to help them in terms of setting their goals? There were two things that I wanted to talk about. Two different models. One is called the GROW model, and the other is a Coaching model called SCARF. I’m going to talk about an article that was published back in 2008. It’s an article that I love.
It’s a model that I love because it is based on how do you build trust. It was written by a gentleman named David Rock. What I’d like to do is first let’s talk about the GROW model what’s involved in that in terms of helping somebody to set goals, maybe it’s organizationally, it’s personal development that we’re trying to help them with, but how do we do that? What are the steps that we can take for that to happen? After we look at that model, what are the ingredients, or behaviors that I may need to demonstrate, or the other person that’s achieving this goal or set up for this goal may need to feel if they’re going to be fully motivated? Let’s get into it.
The GROOW Model
As I mentioned, the GROW model is an acronym for a coaching model around goal setting. First, in the GROW model, the G stands for Goal, and there’s a worksheet that you’ll be able to download for this, that allows you to go through these steps. As part of our goal, what do we want to accomplish? Secondly, how will I know when it’s achieved? From there, we’re going to move on to Reality. That’s the R in the GROW model. The first question we can ask is, “What’s happening now in terms of the goal so that we understand where are we?” Secondly, “How far away am I from the goal?” This is about getting a pulse on where we are and the process on this and the goal is realistic as well.
The next is the O and it’s one of two O’s in this GROW model. The first one is Obstacles. “What’s standing in my way. Is it me or other people? Is it a lack of skills, knowledge, expertise, physical environment?” Whatever that is. I will stress in this model that what standing in my way, as perceptions other people are not standing in my way unless I allow them to. It’s my perception of that like lack of skills, knowledge, expertise. Those are all perceptions and possibly their resources. I don’t have enough time or money that we may look at as obstacles. I will tell you that if we look at this in terms of resources, we will always be lacking in something. We need to focus more on resourcefulness because we all have equal access to resourcefulness. Nobody has any more than anybody else. Some use it better, but nobody has more.
That’s not the same with resources. My bank account could be bigger than somebody else’s and much smaller than somebody else’s, that’s a fact. Resourcefulness is not something that one of us gets more or less of unless we choose it for ourselves. The other O in this model is Options. “What options do I have to resolve the issues or obstacles? What am I going to do about this?” This is resourcefulness. There is a question that I love by a gentleman named Michael Bungay Stanier. He wrote a book called The Coaching Habit. It’s a great book. I would highly recommend reading it, but for this show, what I want to talk about is we’re talking about options is a question that he has termed the AWE question and it stands for, And What Else. To me, that’s resourcefulness, when we have the AWE question because the lazy answer is oftentimes the first thing that we think about.
If we take that and then say, “What else could we do?” We answer that and we say, “What else could we do?” What we find is that where we thought we were limited in terms of the options that we had available to us. When we practice this AWE question or challenge ourselves with the AWE question, we find that we’ve got a lot more options that are available to us in terms of solutions. Lastly, in this GROW model, we look at the W, which is the Will. “Which option will I commit to?” This provides an opportunity for the individual or myself to say, “What am I going to do now? What are my choices, or what is my choice that I’m going to move forward on this?” When we can follow this GROW model and help others, it helps them to refine where they want to go.
Now in the work that I do I use what is called SET goals, which are Specific, Emotional, and Time-bound, but what they’re doing is very much in line with what this GROW model is talking about. There is so much research that is out there in terms of providing us with the evidence that shows that we’re capable of making change. You may be thinking that GROW model seems basic or easy to follow in terms of helping other people to set their goals. I would agree. The challenge, if we’re going to be effective at helping other people to set their goals or our behaviors, how we approach them, especially if they’re people that maybe work for us or people that were incentivized in some way by their achieving their goals or improving or developing where they are.We all have equal access to resourcefulness. Nobody has any more than anybody else. Some use it better, but nobody has more. Click To Tweet
The SCARF Model
This could happen at home too if we think about it. My approach to my kids, if I am motivated or want to see them improve, helping them SET goals that can do that. My behaviors are going to be important in terms of how do I support them on that. That leads me to the second part of what we’re going to talk about. This model is called SCARF, and it’s an acronym again. The title of it is SCARF: A Brain-Based Model for Collaborating with and Influencing Others. It was written by David Rock. He’s the CEO of Results Coaching Systems international out of Sydney, Australia. This is an older article. It’s 2008, but I will tell you, this model is one that I don’t use directly as it’s outlined here, but each of the pieces I use in my work and has seen the benefit of this.
The whole idea behind the SCARF model, and I’m going to read a few sections directly from his research paper. He talks about social neuroscience, exploring biological foundations and the way humans relate to each other and themselves. It talks about a diverse set of topics, which include the theory of mind, the self mindfulness, emotional regulation, attitudes, stereotyping, empathy, social pain, status, fairness, collaboration, connectedness, persuasion, morality, compassion, deception, trust, and goal pursuit, that’s a lot. What then goes on to say, “From this diversity, two themes are emerging from social neuroscience. Firstly, that much of our motivation driving social behavior is governed by an overarching organizing principle of minimizing threat and maximizing reward. Secondly, that several domains of social experience draw upon the same brain networks to maximize reward and minimize threat as the brain networks used for primary survival needs. In other words, social needs are treated in much the same way as the brain treats the need for food and water.”
When we talk about the SCARF model, it involves five domains of human social experience, Status, Certainty, Autonomy, Relatedness, and Fairness. What happens is that in these five domains, they activate either a primary reward or a threat. Now, I talked about the importance of our behaviors. We’ve SET goals or help people identify how to set an effective goal through that framework. If we’re going to support people and influence them to follow through on this, then these five domains. The first domain that we talk about is around status and it is about relative importance, pecking order, and seniority. Humans hold a representation of status in relation to others, one in conversations. This affects us in many different ways.
When we feel there is either a perception or a real reduction in our status, it has a negative impact on our ability to perform. In ways that we might see this in terms of goal setting or somebody’s status is if we are micromanaging somebody or we’re questioning the way that they’re going to do something continually in a way that’s negative. We know that what this does is it has a negative impact on their ability to feel they’re going to be able to do this. I can’t tell you how many times I remember hearing organizations that I would work with that you would hear, “You’re the entrepreneur of your territory, treat it like it’s your own business.” That when people tried to do things that might be outside of what was standard practice, they were always questioned on it or told that idea wouldn’t work.
What you do is you diminish somebody’s ability to be able to make a change because I’m questioning. “I want you to run this as your own business, but I don’t believe that you can.” When relating this to the cables model that I talk about quite often in my work, there are two behaviors here that can help to activate status. One is around appreciation. It’s recognizing people for their contributions, that elevate status, but as well, we talk about belongingness creating a sense of inclusion. When people feel they’re part of the group, we also create status. From there, we create psychological safety. When we look at the power of these things, we know that when people feel as though they have psychological safety, their openness to maybe challenging directions in a positive way increases.
That generally benefits both the individual and the organization when that happens. Next, we move on to certainty. Our brains look for patterns or recognition. We don’t like uncertainty as much as people will say, “I love surprises.” We love surprises that work in our favor. We don’t like surprises that I don’t think anybody would say that if they went out to their vehicle and it wouldn’t start that they like that surprise doesn’t work in their favor, we need certainty. In relating it back to cables, we can talk about this in terms of specifics, which is the last behavior in cables. That is around creating clear expectations. What do we need? What’s expected of us?
The better we are in terms of helping other people recognize or understand clear expectations. It might be how I support you, or what you need to make sure that you do in terms of achieving this goal. The clearer that we can be in that, the better we’re going to be in terms of satisfying that need for certainty. Next in the SCARF model is Autonomy. When I see the word autonomy, I immediately think of work that was done by Dan Pink in his book Drive around what motivates individuals. There were three things that he speaks about in his research that he has identified as the three main characteristics or things that are needed. If we’re going to motivate people, one is the purpose, challenge, or the ability to be developed. The third is autonomy. It’s interesting that here. Autonomy is the perception of exerting control over one’s environment. A sense of having choices.
Now we can do this in terms of helping other people to feel that they have options, how are they going to achieve, what they want to achieve and how can they do it? I’ll go back again to what I said before of organizations that will say, “It’s your business run this territory it’s your own business.” Every time somebody tries to do something that is outside of what is normally done. I am not talking about things that are unethical or go against company policy. What you do is limit that ability for the person to feel they have real autonomy in terms of what’s going on. One of the easiest ways for us to help in terms of creating autonomy or the sense that an individual feels they have the autonomy, is to ask them their opinions on things, how they think they can do something.
It’s a goal that we’re going to hit. This is a milestone. “How do you think that you can reach that effectively?” When we do that, we allow people to feel, “I’m in control of this.” It also has the benefit of being able to hold people accountable. When they’ve said that they’re going to do something, it’s easier for me to go back and say, “You mentioned to me that you were going to do this. This was the date you were going to have it by in terms of how you thought you could successfully do this, what happened?” That’s going to be a much more productive conversation than maybe somebody that I told them, “This is what you’re going to do and how it’s going to be done.” They could have resisted from the beginning thinking, “This is not the way that I want to do it, or I would do it if I had the opportunity.” Maybe their way is better. Oftentimes it probably is, if they’re closer to what the issues are.
Lastly, we talk about Relatedness and it in some way, goes back to belongingness. Deciding whether we’re part of the in, or the out-group, when we don’t feel we are part of the in-group that we have a connection there, then what we do is we become disengaged. I will often talk in terms of teams and what makes the most successful teams. There are three vital themes that tend to come up with in teams are that they support, challenge, and celebrate each other. In relatedness, this idea of inclusion hits on the support that we need to be there for each other. From a behavior standpoint, when we talk about cable, it’s about belongingness that we create belongingness, that we’re in this together.
If I’m trying to help somebody as they set their goals, then I need to make sure that they recognize that I’m invested in this with them, that I will support them on this. When I do that, I know that their ability to follow through and get things done is going to be much greater. Lastly, in this SCARF model, we talk about Fairness and it is an interesting one. If I look toward cables, it’s about congruence. “Do I walk the talk? Is what I say and I do the same?” If individuals feel they’re being held to separate standards from other people on the team, then they’re going to lack fairness. If you lack fairness, you’re going to see either disengagement or engagement in ways that are unproductive through disruptive behaviors or maybe other types of more serious aggression.
You’re certainly going to experience a negative effect when there’s a lack of fairness. From a cable standpoint, we’re right into congruence, “Is what I say and what I do the same thing. Am I consistent in terms of how I treat other people on the team?” When we’re not, there’s going to be a sense that there’s a lack of fairness. One person gets treated better than another one person gets held to different standards than another. They get away with stuff that another person doesn’t get away with. One person is held to higher standards which seems unfair when we don’t have fairness, we don’t have trust. When we don’t have trust, it’s very hard to influence people to follow in a direction that we’re asking them to go.When people feel as though they have psychological safety, their openness to challenging directions increases in a positive way. Click To Tweet
As you can see here in this model SCARF, Status is about relative importance to others. Certainty concerns, being able to predict the future. Autonomy provides a sense of control over events. Relatedness is a sense of safety with others of a friend rather than a foe inclusion and Fairness is a perception that there are as David Rock suggests their exchanges between people. When we’re able to activate all five of these domains, which is through our behaviors, then we activate a primary reward rather than a threat with individuals. People don’t feel threatened by us when we’re behaving these ways, they connect with us more. We build more trust and we’re able to challenge each other more to reach where we’re going to go. We support, challenge, and celebrate all three of those things that take place when we demonstrate the five domains of SCARF.
I hope you found this helpful as we come into 2021, you might be thinking, “This is the perfect opportunity for me to try and help this individual,” set the goals and then support them. This approach between GROW and SCARF allows us to do all three of these support, challenge, and celebrate for all the success that we’ll see in 2021. I hope you found this helpful. We have so much opportunity here in terms of helping one another to rise above our best. I look forward to sharing many more episodes through 2021 on how we can become better. Peace.
- The Coaching Habit
- SCARF: A Brain-Based Model for Collaborating with and Influencing Others
- Results Coaching Systems