Overwhelm, Underwhelm and Not Giving a £*?@

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Overwhelm, Underwhelm and Not Giving a F*?@

When there’s too much to do.

    Not that I feel like writing today, but you can see that I’ve somehow managed to begin.  I’ve written previously about tricking oneself into action and it seems that Mark Manson, The Subtle Art of Not Giving a F*?@, may agree.  It’s a book I’ve read a few times, what prompted me to flick through his reams of wisdom today I’m not sure; possibly kismet?

‘Don’t just sit there.  Do something.  The answers will follow…Action isn’t just the effect of motivation , it’s also the cause of it.’

    Over time I‘ve realised this, not through reading books about being more productive or books on the paralysis of overthinking, but verified via tried and tested thought experiments. Thinking and acting can occur simultaneously, results are usually variable but surpass the benefits of inertia. 

    Overwhelm is mentioned frequently at work; for frontline staff the reality of demand management can be a stressful experience.  A head full (and handful) of tasks can all feel equally important.  Sometimes I’m much busier in my head than in reality, the art is to notice what’s real and what’s blown up.  I’m reasonably good at getting things done and solving problems only because it’s where I choose to focus my attention.   There are plenty of tasks I’m mediocre at, or quite frankly disinterested in.  I’d like to write fiction and yet my ability to write creatively is directly linked to the time I spend inventing stories — arguably it’s another experiment for another day.

‘Happiness comes from solving problems.  The key word here is ‘solving.’  If you’re avoiding your problems or feel like you don’t have any problems then you’re going to make yourself miserable.  If you feel like you have problems you can’t solve, you will likewise make yourself miserable.  The secret and source is in the solving of problems, not in not having the problems in the first place.’

    Clearly the concept of freewill applies here, we get to choose which problems we want to solve when, even if we don’t believe this, we choose nevertheless.  And how effective we are is determined by how much time and energy we apply to any aspect of work or life.  Much of Manson’s book explores the paradox of being human.   The more we are preoccupied with the overwhelming nature of what is ahead of us, the less inclined we are to set about planning, problem solving, working our way out of our current scenario.    There’s an NLP technique that can help.  Visualise yourself dealing with whatever problem you’re grappling with, the protagonist of your own movie or novel, what would you have them do if you were writing the scene? Play it through using different plot  endings.   When you have the answer that feels right – go do that.

‘Whether you realise it or not you are always choosing what to give a f*?@ about.’

    Choosing badly can become a self-limiting strategy, therefore the ‘do something principle’ can include a number of other associated skills according to Manson;

  • Commitment
  • Saying no
  • Setting boundaries
  • Building trust
  • Making choices 
  • Managing expectations
  • Accepting failure as learning

    My own strategy might involve all of the above, but it most definitely involves making a to-do list.   I get to choose the non-negotiable components of the list for that day, month, year or years.  With consideration these might change, it’s a conscious process and will certainly involve a period of reflection and consultation with those affected.   The key is in the title, TO-DO.  Even a To-Be list involves doing something differently – I might choose to be kinder.  There are people who may disagree with the following quote, believers in the path of least resistance.  And yet, therein lies the paradox of The Subtle Art of Not Giving a F*ck: 

‘To become truly great at something you have to dedicate shit-tons of time and energy to it…Who you are is defined by what you are willing to struggle for.’

                                                                                                  Mark Manson

Manson, Mark (2016)  The Subtle Art of Not Giving a F*ck   A Counterintuitive Approach to Living a Good Life.  Harper Collins.

*All quotes by Mark Manson.

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Finding Your Voice – Writing Your Way Out Of It by DBC Pierre

For Prisoners Everywhere

Which also means Us 

DBC Pierre 2016

    This blog was going to be about writing. To be exact, what DBC Pierre has to say in his book Release the Bats – Writing Your Way Out Of It.  I’ve read the book numerous times, and the more I read, the more I notice how his wisdom can be applied to almost any venture; but something of interest to me is the act of  finding your voice.

‘I started to write.  It wasn’t a lifelong wish.  I didn’t train for it, didn’t know any writers, editors or publishers.  I just had a strong feeling with nowhere to go… Thankfully it’s a knack you can practise over time.’

‘The Gods of writing weren’t waiting for another impeccable tomb from some learned technician, they were waiting for a shout from the rooftops.  For mine and for yours.’

    The issue of finding your voice comes up regularly in management and leadership, as does the art of active listening.  It seems that one’s voice needs to be heard by people willing to listen.  Like the writing of a Booker award winning novel, it’s a grind: an  artful, stoical and delusional journey demanding fortitude.

‘My feeling was that shout and by isolating it, wrestling it, and building it a cage, I was harnessing the only thing I had to give.  I couldn’t compete with theory or craft, the shout was all I had.  But take note if you mean to write: it was enough.’

    I was inspired to write recently, by Dr Matt Morgan, he’d written a patient story, one of many that had meaning for him.  And yet there are so many humbling experiences to honour.  The children who took their last breath because science wasn’t enough, the children that lived because science won, the children that lived against all the odds; the child that woke up on intensive care and ate six Weetabix in the middle of the night, the teenager who refused to enter the MRI unless I held onto his foot talking him through it, the children who legged it into the lifts causing dignified scuffles around the hospital: as a student, the old man who gave me a pound for looking after him, his crumpled face on its return.  Along with the people who shared these experiences with us, all these people live in our hearts.

    There are two requirements of writing according to DBC Pierre:

  • Something to say
  • Patience to write it  

    Pierre began by writing a page in anger and found he liked it, all it needed was a spark  doused with rocket fuel to keep pushing through. How will you find your voice?

 

Release The Bats, Writing Your Way Out of It (2016) DBC Pierre, Faber and Faber.

Vernon God Little (2005) DBC Pierre, Faber and Faber

Be Truthful not Neutral

    Christiane Amanpour CBE is a journalist, CNN Anchor and television host.  I’ve been listening to her being interviewed by  Brian Rose of London Real, she speaks with wisdom, knowledge and purpose.  Her purpose, transparent and invigorating, is that of truth seeker.  

    London Real, is a global media company, educating, inspiring and informing; it’s for people tired of mainstream media and is an ‘unedited look into the world of real people.’  I recommend everyone dip their toe into this eclectic, exemplar pick and mix of personal development.  I’m going to share insights from Christiane Amanpour but I recommend watching the full video at London Real.  Life has taught me that we all hear through our own personal filters, perhaps listen to the interview yourself, with nothing on your mind.

    I’m so invigorated by this interview, the pressure of being neutral under certain conditions can be overwhelming for truth tellers.  A coaching colleague of mine once said, ‘the truth doesn’t lie,’ and whilst this resonates, there are times when it can burn the hell out of a quiet and predictable existence.  Truth telling takes courage, endurance and a predisposition to internal fortitude; a Hero’s Journey beginning  with baby steps to full Marvel status.  I propose Ms Amanpour falls into the latter truth-teller status.  She talks of being courageous, having a vision and the guts to act, she knows that popularity is at stake if your job is to tell the truth — we just have to be gutsy enough.  The interview is an hour long but core qualities of a Marvel graded truth teller looks a little like this it would seem:

  • Be truthful not neutral.
  • Be courageous.
  • Have a vision. 
  • Have the guts to act.
  • Stare down propaganda and false accusations.
  • Take your profession seriously.
  • Bring your experience to the table — knowledge versus opinion.
  • Don’t get depressed, it’s a troubled world.
  • Find your purpose and mission.
  • Be responsible for finding the truth.
  • Find your algorithm during troubles and don’t seek safe spaces.
  • Find views that conflict with yours and debate them.
  • Don’t put yourself in a corner.
  • Believe in the power of truth.

    This interview struck me as one that could have been about professionalism as much as journalism.  In any profession there will be ‘players’ who have their own version of the truth, people reluctant to intervene use variations of the truth to selectively take sides — morally equivocating,  a practice of half-truths.  But we must stare down this behaviour when people attempt to delegitimise us according to Ms Amanpour.  Our biggest challenge,  who to believe in a post truth world?

 

‘Believe in the power of truth.’

                                        Christiane Amanpour CBE

 

 

*Gratitude to Brian Rose and London Real TV

Notes on Stress and T-Rex

     I’ve been listening to Dr Joe Dispenza and Ed Mylett talking, actually I listen to Dr Joe fairly regularly.  It feels good to listen to him, he has the ability to change emotional states.  A neuroscientist claiming to work at the boundary of science and holistic medicine, his work does appear to demonstrate the power of Mind over matter.  He’s getting amazing results it would seem.  Listening this weekend I was struck by what he said about fear AKA survival.  

‘If you’ve living in survival why would you open your heart, it’s just not a time to open your heart.  I mean, if you’re getting chased by T-Rex it’s not a time to meditate, it’s not a time to learn, it’s not a time to connect or communicate, it’s not a time to sit down and go within it’s not a time to be vulnerable, it’s time to run, fight or hide.’

This interests me because I work in high stress environments and many of my clients operate at high levels of baseline stress and pressure. This explains something we all know to be true;  teams perform better in conditions where they feel safe, safe to speak-up, safe to create positive outcomes and safe to make mistakes,  learn and reflect.

    ‘Our senses become heightened when we’re under stress, we become materialistic and narrow our focus on the danger – all your attention moves to your body in preparation for T-Rex’.  

     I was going to write a blog about The Wisdom of Wolves, as I’d been reading the captivating book by Elli H. Raddinger.  There’s a chapter on Leadership, which suggests that ‘for a group to succeed people must work together and be led by confident personalities.  This applies to wolf packs as it does to large human families and dynasties.  The successful ones always place the interests of the community above those of the individual.  This ensures long term survival.’   She says the three principles of success are concentration on the essential, constant communication and shared rituals and strong leadership.’ 

     Raddinger describes a study that shows leaders of the group as suffering the most stress and suggests that leadership involves ‘long-term, high social stress.’   She emphasises the need for the good pack leader to maintain a harmonic and stress free state in the group.  It’s suggested that this is done through setting objectives, boundaries with a clear framework for action, along with enacting rituals.

     It’s a question for all of us, how do we create a safer working environment or community, one that promotes collaboration, creativity, learning, listening and reflection.   It would seem that the answer may be some or all of the following:

  • Stay grounded (don’t be set off balance, whatever’s going on)
  • Set objectives (clear and time scaled)
  • Create boundaries (people need to predict with relative reliability how you will behave)
  • Create an action oriented culture (getting things done reduces overwhelm)
  • Provide for team rituals (I have a regular supply of Freddo’s for one of  my team).
  • Tell the truth – people don’t feel safe around people who bullshit.

     And one of my own transformational aha moments came when I found out that it wasn’t all about me.  Mastery of ones ego takes a lifetime, and is always work in progress.  As Dr Dispenza says beautifully:

‘The perfect definition of creation is when I forget about myself.’

The Call To Adventure 

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    Today, typically, I’m writing at a coffee shop, it’s noisy and full of chattering people, there’s an extra buzz belonging to the bank holiday – who doesn’t relish a four day week?  I’ve been churning over something I want to say;  the noise is distracting, I’m arguing with myself, can I write or not, are the conditions good or bad?  Being human I can find a downpour of excuses not to start regardless of reasons to be begin. I’ve started writing anyway. The Procrastination Monkey hangs his head refusing to make eye contact and is swiftly replaced by Perfectionist Monkey  – now you’ve started you’d better make this good, she grins and squeals with mischievous delight;  I choose not to be distracted by my monkey brain, it’s difficult.   Thoughts are formless, we apply meaning to them – or not; I tell them to shut up, a trick I learned, from Richard Bandler.

    I wonder how many times I tell myself that I can’t do something when  I probably can?   It’s a personal call to adventure, I know this from a man called Steve who lives in Arizona, Steve Hardison – The Ultimate Coach.  Steve has a thing about commitment, it’s serious, he’s serious.  You’d think he invented commitment, not just the word, the act.  I asked him once, ‘How do you know what to commit to?’  His swift and concrete reply, ‘You Choose.’   Oh hell, it’s all on me, no excuses.  There are days I wish it weren’t.

Studying creative writing I stumbled upon Joseph Campbell’s monomyth, The Hero’s Journey, more recently modified by Christopher Vogler (1998). The Writer’s Journey: Mythic Structure For Writers.   It’s an essential read for anyone interested in mythology but also personal transformation.  Workforce advisors  tell me that people can’t change, fundamentally they are who they are, you might be able to change their behaviours but not the person, officially people don’t change.  Therein lies the nugget, the insight the ‘old chestnut.’  

    In organisational terms, change is something that can be externally applied, the same truth applies to individuals, we can change peoples’ behaviour by applying a set of principles or rules of engagement, and we uphold these rules or principles usually through policies and procedures – the primary business as usual management methodology.  Transformation, on the other hand, is a process of change from within, true of organisations and people.   Transformation is not a process of learning but one of realisation.  It has a deeper, more sustainable feel about it.  Our role is merely to provide the conditions necessary to catalyse  this deeper more transformative change either in ourselves, our teams or organisations.  

The transformation journey is a call to adventure.  Many, understandably, refuse the call.  Nevertheless, for those who have the courage to set out on this journey, the path is paved with necessary obstacles, some real others illusionary; this journey can often involve a process of letting go – of something familiar, comfortable or predictable.  It’s a very personal experience, and whilst nobody can make the journey for us there will always be mentors, allies and providence to help you along the way.

    ‘We must be willing to let go of the life we’ve planned so as to have the life that is waiting for us.’

                                                                 Jospeh Campbell

Vogler, Christopher (1998) The Writer’s Journey: Mythic Structure For Writers.

A Compassionate NHS – Notes on Michael Sheen’s Aneurin Bevan Lecture.

     A week has passed since I listened to Michael Sheen’s lecture, it wasn’t a lecture about the history of the NHS, the one I was expecting. 

     With well informed, insightful rigour the artfully woven narrative plunged deeper, and then deeper still, to reveal the truth at the core of our NHS – Compassion.

     We know, we feel, we hear and see, that this is where its source, its soul, meets ours.  The collective consciousness of our single spirit concealed within a multitude of human forms tricks us but only at the level of consciousness, deep down we know the answer.   It feels good to be reminded to tune out of the  background noise of life, organisational red tape (yes, and the politics) — a mere distraction, a distraction from our purpose, our mission, our commitment to ease the suffering of others.

     There was so much to inspire us from this speech that Nye Bevan himself could be provoked to join the debate.  I scribbled notes furiously into my Moleskin Notebook, reserved sizzlers — and here’s what I heard…

  • Compassion and empathy should form the basis of our decision making.
  • Practice compassion, bit like a muscle that needs exercising.
  • We must travel beyond our own personal borders to show empathy. It takes imaginative transgression to look out of the eyes of another.
  • Exercise your imagination, things aren’t permanent.
  • Nothing about the future is fixed — it can be shaped.
  • Choose to put people back at the heart of the NHS, community and life.
  • Go back to the source of the NHS, what was there?  Tredegarise  (new word for Dr Johnson) the model of care. 
  • We humans are all complex, none of us are ordinary regardless of social status.
  • Develop cooperative models. 
  • Everything takes time, commitment and encouragement.
  • Move beyond silent conformity and use your anger to fuel change.

     And most of all I was blown away by what could have easily come out of a book of NHS good management practice, I believe.

“People who don’t feel listened to and don’t feel they can speak their truth, speak their reality, what’s going on for them —  get frustrated and frustrated energy turns in on itself.

     If people are given the platform to speak and to be listened to and that they can see that things come out of that, then that helps.”

     Bravo Mr Sheen!

     Anyone wondering why they work in the NHS today would be inspired by this, and you can find it on line or the Hay Festival website.

The Aneurin Bevan Lecture – Hay Festival (2017) Michael Sheen

 

Thought Experiments

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I love thought experiments, they’re popular with clients, fun and failure free.  ‘Everything is a case study’ according to Ray Dalio in his superlative management book Principles.  This doesn’t apply only to work but life in general,

These experiments ask ‘what if?’  What if  perceptions designed to hold us back weren’t true?  Perhaps a convincing personal illusion that encourages our rear ends to sink deep into our zone of comfort.

Case studies or thought experiments can’t fail, they only test what we believe, testing out what’s possible, a series of curiosities or hypotheses.  What if Grant Cardone is right about the 10X Rule?  What if we could improve our performance in any area of our lives by ten times?  

Brian Tracy (Eat That Frog)  would advise do 5 things everyday to take you closer to your goals and keep going until you get there. He also cautions us about sub-consciously adopting the beliefs of the people around us – don’t be discouraged.

Go ahead, test your hypothesis, there’s no peer review or publication required. Nobody need know.

Mr Henry Marsh: Philosophy, Plumbing and Humility

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Paula Goode

I’m listening to the neurosurgeon, Mr Henry Marsh, talk to a large group of the public, this includes teenagers with an expectation of insights into a life of glamour as a neurosurgeon. Mr Marsh’s leaves us feeling inspired, thoughtful, and most of all sober to the inevitable fact, that with life comes death.

He calls neurosurgery plumbing because he’s no neuroscientist; nevertheless, neurosurgery is a career for educated plumbers with nerves of steel (one must achieve three A graded A Level’s, to be shortlisted for medical school). He describes the stress of emergency life-saving surgery as verging on terror, yet, this doesn’t get in the way of fast plumbing.

An ability to act in spite of fear has been suggested as a hallmark of success. It points to a well documented core leadership trait – courage. Being a doctor isn’t for everyone, but the principle of courage stands, whatever your…

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Mr Henry Marsh: Philosophy, Plumbing and Humility

Status

I’m listening to the neurosurgeon, Mr Henry Marsh, talk to a large group of the public, this includes teenagers with an expectation of insights into a life of glamour as a neurosurgeon. Mr Marsh leaves us feeling inspired, thoughtful, and most of all sober to the inevitable fact, that with life comes death.

He calls neurosurgery plumbing because he’s no neuroscientist; nevertheless, neurosurgery is a career for educated plumbers with nerves of steel (one must achieve three A graded A Level’s, to be shortlisted for medical school). He describes the stress of emergency life-saving surgery as verging on terror, yet, this doesn’t get in the way of fast plumbing.

An ability to act in spite of fear has been suggested as a hallmark of success. It points to a well documented core leadership trait – courage. Being a doctor isn’t for everyone, but the principle of courage stands, whatever your profession or your status therein.

Failure for Mr Marsh was core to the learning process, an uncomfortable truth perhaps. He described over delegation and misplaced trust, yet in essence, the ability to deal with failure was necessary even when the stakes were life or death. Mr Marsh was notably humble and authentic in the presence of his starry-eyed audience.

In a nutshell, the art of being a ‘consultant neurosurgeon’ appeared more about decision making than it did surgical skills; that is, to operate or not to operate? One could be forgiven for thinking Mr Marsh a philosopher not a plumber. But undoubtedly, there were no shortcuts to plumbing or philosophy.

As a true master, he glided effortlessly through two hours of crafted teaching, leaving the attendees with discreet golden insights into the world of transformation. We expected glamour, we received philosophy, plumbing and a humble version Mr Marsh. Encore!

What can we learn from Mr Henry Marsh?

  • In the presence of fear we can still do what’s necessary.
  • We don’t always get it right, this is a part of our growth and learning.
  • As we accept our fallibility, we learn humility, this creates clarity of decision making as we gain experience in our field.
  • We work as part of a team, as a leader we must own our team’s mistakes.
  • If you don’t know the answer tell the truth, we’re not all neuroscientists or…fill in the blank.
  • It takes courage to do what you love – do it anyway.

Books by Henry Marsh:

Marsh H (2014) – Do No Harm.
Marsh H (2017) – Admissions.

Is The NHS a Burning Platform?

 

Did someone mention a burning platform? As operational managers, many burning platforms distract us from planning and effectively running our clinical services on a daily basis. Some would say that putting out fires is the job of an operational manager; this is undoubtedly true. However, in our blindspot there is an uncomfortable truth. Allowing a fire to take hold is also a sign of failure, our failure. This could be due to an act, or omission, on the part of the manager and clinical team. It can often be the result of system failure, as the corporate wheel spins in the opposite direction, preventing managers from managing effectively (pyromania is for another article and will not be debated here).

A burning platform is a description often used in the NHS to describe an impending service catastrophe, one which we may or may not be able to fix (rather than prevent). The best operational managers have developed fire-fighting as a selling point or winning strategy and this has become an essential part of our roles. If we scale this up it would reflect our evolving healthcare ethos, closing the stable door after the horse has bolted (remember Sir Derek Wanless?).

Undoubtedly we have the best emergency care services in the world – another example of our flare for fire fighting. Our A & E services are so efficient (unless an inpatient bed is required) that patients flock to our doors. As victims of our success, the patients keep coming, the majority of whom we treat within four hours.

But there’s a good reason to be talking about burning platforms. Some years ago, I was in conversation with an oil industry health and safety manager, talking about training off-shore workers in light of the Piper Alpha disaster (a North Sea oil rig that caught fire). The fire was responsible for the death of 167 men. Lord Cullan reported inadequate maintenance and safety procedures as responsible and made 100 recommendations.

I learned that as part of the fire safety procedures, personnel were required to move to the designated fire point and wait for instruction. Personnel were advised not to jump off the rig into the sea as this would result in certain death. As the fire worsened, men continued to stand at the designated point waiting for instruction; however they were unaware that the fire marshals had already been killed in the fire. A number of men, in the face of certain death, jumped overboard; others stayed waiting to be told what to do. In this instance, those who jumped had a greater chance of survival because it was the worst oil platform fire in history.

The fire took thirty-six days to be extinguished by wild well controller Red Adair (The Guardian 2103). Red Adair, as you can guess, wasn’t famous for fire-prevention, he was famous for dealing with burning platforms. To be an expert at this, you would need to spend at least 10,000 hours practising, and the same is true for fire prevention.

In light of the above, do we really believe that the NHS is a burning platform? As much as I jump at the chance of putting out fires, fires are a sign of system failure and should not become the norm. But like a turkey fattening itself up for Christmas, it’s a big ask for those of us who have developed a career out of fire-fighting. The first stage is to recognise the number of burning platforms we own. What we allow persists.

I’m uncomfortable thinking that I may contribute to this Red Adair culture. However, to transform we must feel uncomfortable with the status quo. We must feel the heat of the flames licking at our feet in order to shift positions or jump; either that or die complaining. The Kings Fund leadership team teach that we are all part of the solution regardless of the problem and I believe this too. But it’s a scary environment: we’re programmed to respond to fear and as Florence Nightingale once said, ‘How very little can be done under the spirit of fear.’

But the news is good: we don’t work on an oil rig or a burning platform, we work in the NHS. Although somedays it can feel as if we are on fire, we are not. The burning platform is a powerful illusion but we must decide whether we are going to stand around waiting for instructions or whether we feel uncomfortable enough to shift our position. We don’t need to jump into the cold North Sea, we’re on solid ground. Once we can see this, our vision of what is possible will change and we can find new ways to work that take the heat out of our experience.