Are You OK?

Dr. Rachel Morris: How are you? How are you really? And when was the last time you paused long enough to check? Since the pandemic rather than getting better things, if anything, seem to be getting harder. And most of us have just jumped back into our old life with less resources to deal with the overwhelming workloads.

This week our guest on You Are Not a Frog is James Spice — coach and human development expert who thinks that we are all far from okay. And why should we be considering what’s happened and what is happening in the world? We discuss why we’re all struggling so much, and just what we can do to make things better for ourselves.

This episode is a really important one for anyone who’s been struggling on and perhaps ignoring that still small voice telling them that they’re not okay. So listen to this episode if you want to know the unhelpful strategies that we are using currently to cope with not being okay, the very simple tool you can use to work out what’s going on, and the rule of three to help you work out when it is, in fact, okay not to be okay and when it isn’t okay not to be okay.

Welcome to You Are Not a Frog, the podcast for doctors and other busy professionals in high stress, high stakes jobs. I’m Dr. Rachel Morris, a former GP now working as a coach, trainer, and speaker.

Like frogs in a pan of slowly boiling water, many of us don’t notice how bad the stress and exhaustion have become until it’s too late. But you are not a frog. Burning out or getting out are not your only options. In this podcast, I’ll be talking to friends, colleagues, and experts, and inviting you to make a deliberate choice about how you will live and work so that you can beat stress and work happier.

If you are a training manager or clinical lead, and your teams are under pressure and may be even feeling overwhelmed, we’d love to share our Shapes Toolkit training with you. Our practical tools are designed by a team of doctors and practitioners who know what it’s like to work in a stretched and overwhelmed system with topics like how to take control of your time and workload, deal with conflicts and managing stress. From team away days and half-day sessions to shorter workshops and webinars online or face-to-face, we’d love to find out how we can help your team work calmer and happier. We work with primary care training hubs, ICS wellbeing teams, new-to-practice GP fellowships, hospital trusts, and lots of other healthcare providers with staff on the frontline. To find out more, drop us an email or request a brochure at the link below.

James Spice: Hi, I’m James Spice. I’m a human development consultant coach and a facilitator. I’ve been working with individuals and groups around the area of self-awareness, around the area of effectiveness, around the areas of culture inside teams and organizations for over 20 years.

Rachel: Great. It is wonderful to have you with us, James.

Thank you so much for coming on the podcast. And we had a chat a while back now that there were some things you said that really got my attention, particularly this idea that actually, we are not that okay, right now that you’ve noticed that something happened last year and we are in this weird new normal, but, but most people actually aren’t okay. What do you mean by that?

James: Well, I think we see it all around us. If we look at the biggest parts of where the world is at at the moment, massive uncertainty, a lack of leadership. People doing things in a way that really, I think, against the very heart values that most of us hold. It’s really in contradiction to it.

I think I’d almost sort of play it back and say, well, how can anyone be okay when the world around us is such a mess where there’s still so much uncertainty? And then what do we do about it is really my area of focus of working with people and with groups, is taking the time to get to the bottom of where are we really at, and then what do we do to work and hopefully create a different future.

Rachel: And that’s the reason I got you on the podcast. I think this, what do we do about it and what can we do for ourselves that’s in our control is such an important question. What have you noticed in people’s behavior, especially that that is a bit of an indication and a bit of a clue that we’re not really that okay?

James: Hmm. Well, I think it comes through in a couple of ways. Most obviously, I think the first is avoidance. It’s like we really have stopped allowing ourselves to have an opinion that is different. It’s very difficult, isn’t it? Because at the moment it feels like society is sort of saying, well, this is the way we are going, and if you don’t like it, beware of saying anything, or you’re gonna get cut off at the legs.

I think that that’s what’s causing such dissonance because we’ve got the sort of idea that, ‘ Well, if I can’t say anything, but I disagree, I have to passively pretend that I’m okay with what’s going on and then almost by default, I’m then complicit.’ So I look around at the world and go, it’s totally not what I would like in my heart of hearts, it doesn’t represent who I am, but I can’t say anything about it. So that I think is the first point of inflection that I really notice, is there’s a lot of people that have gone quiet around things that actually are really important to them.

Rachel: Can you give any examples? Any particular, are you talking about values here where people can’t speak up with their core values because whatever they say is it’s just gonna be taken wrongly or?

James: Yeah. It’s like, where does our truth have space and where does it not have space? We look at some of the social media things, you know, the big topics that are being pushed out. I don’t know that everyone is in agreeance, but I don’t know if they know how to say, ‘Hold on, I disagree.’ So then the behavior is then, so then I avoid it and I just pretend like it isn’t happening. And so then a lot of big decisions end up getting made and roads being rolled out that I disagree with, but I don’t say.

So it’s a dangerous place because then how do I feel a sense of connectedness in a community if I can’t have a voice?

Rachel: So there’s that thing about maybe some people feeling that they can’t express their values and having to go along with stuff. I think probably in the health service we, we are seeing that we’re having to do some stuff and just go along with stuff and there’s some very difficult decisions to be made there.

The other thing you said just now before we started the podcast is we were just chatting about Christmas and you said, actually most people just after the year we’ve had, actually didn’t want to do much over Christmas. Didn’t really want to be particularly sociable, just wanted some downtime. And that got me thinking, well, you know, the year we just had, most of us were out of lockdown after Covid and, and I think we expected everything to go back to normal.

There’s this maybe a feeling of, ‘Well, why are we still feeling pretty awful?’ I mean, there is, there is the workload, and particularly in healthcare, things have not got better. They have continued to get worse. So the workload aside, is there something else going on as well?

James: Obviously with healthcare, you were at the absolute forefront of the pandemic.

But on the other side of this is that the entire world has been through an existential crisis. I think it’s hard to look at it as anything else. We all shut down. Everything we thought we knew, all of our futures, all of our goals, everything was stopped immediately. So how can you come back out of that and realistically think that we’re gonna go back to what was?

It’s a very dangerous thing, isn’t it, the new normal? Without saying or asking yourself the question, what does this new normal look like for the me that is now? Our values have shifted, our purposes have shifted. You look at the Great Resignation. There’s so many terms being coined in pop psychology stuff about what’s happening in the world.

I see it really as a great disengagement. And my existential crisis means I’ve asked these massive questions. Who am I? What is important to me? What do I really want out of the world? Yet, as we discussed, we’re living in a world in a time that’s saying, you’re not allowed to say what it is that you want, which just compounded again.

So if we don’t take the time very deliberately to start to unpack, what am I trying- who am I trying to be? And how does that come to life in a really authentic way? We’re running the risk of running into somebody else’s normal. And somebody else’s normal is performance based. It’s, you know, again, so it’s just the pressure: we’ve got to get back. We need to decrease waiting times. We need to do all of this stuff, which is just more of doing and less of human being.

So we are just disconnecting. My fear is as we’re disconnecting more and more. So as you said, I saw it everywhere and I felt it myself. And this is someone who does this work on a regular basis. I got to Christmas and I was just flat. I just needed time to not think, not be, and certainly not do.

Rachel: And do you think that part of the doing, I guess, is the demand of the job and, and other people saying, ‘Yy64ou’ve got to do this, you’ve got to do this, you’ve got to do this!’ But I wonder if some of that doing is coming internally as well, because it’s actually easier for us to just keep performing and judge ourselves on performance than it is to take the time to stop and think, ‘Who am I? What is important?’

James: Exactly. It’s such a big question. I did it with a group this morning virtually. I’ve been doing it with groups all last year. I ask three questions at the start of any session with people. The first is, ‘How am I?’ and you watch people like, just, ‘What? I’ve forgotten how to ask. I’m afraid to actually pick beneath the surface.’

The second question is, ‘Who am I?’ Who am I to myself? And that’s when we’re talking purpose, values. You know, what’s really important to me as my own human being. It’s my own identity. And then I go, ‘How do I appear to others?’ That’s the third layer of question because I think it’s important to distinguish between what is my intention from myself, and then what is the impression that I leave with other people.

So just those three questions. I wish that groups of people with all different levels of businesses, organizations, all different industries and all different cultures all around the world, just literally get stuck and chew over those three things.

And if surely, being a human being, the starting point is how am I, and the second one is, who am I? And then I can go into the world with courage. Then I can go out with compassion and love. I can be authentic. I can know what I want. So we are slightly stuck. And I agree with you, Rachel. You’re hitting the nail on the head. It’s so much easier to just keep doing to somebody else’s version of what they think is best for me. And we wonder why burnout levels were suicide. All of these, because we are disconnecting. So around the world, it’s everywhere, it’s every society, it’s every culture.

Rachel: And that’s so true. I think also for doctors who are, and other people in healthcare.

When you say playing to someone else’s or working to someone else’s version of who you should be, often yes, it is someone else’s version, but it’s also this internalised version of who we think we ought to be, or who we expected we would be having gone into this particular profession.

It’s interesting, that first question — I was talking to a chap recently. He said he’d, he’d been at a conference with entrepreneurs and startup founders and someone had started with that question, you know: ‘I just want to ask you guys, “How are you?”’ And then he stopped and he said, ‘And I want you to think about that. I’m now going to ask you a second question. How are you really?’ And he said half the room burst into tears. And it was mainly men.

James: Yep. The evidence is in, it’s everywhere.

Rachel: It’s everywhere.

James: We’re not okay.

Rachel: I know.

James: We are not okay. But again, it’s then not to get so dramatic about it. I think the first point for all of us is just to own it. It’s okay. There’s nothing wrong with not being okay.

It’s very difficult. I think culturally, most of us who have grown up in environments and it’s a different narrative depending often by gender. So boys are told don’t express your emotions and keep them in. Or women are probably told that you can have them, but you’re not allowed to necessarily express them in any environment.

But to some level, we’re taught from a very young age that your feelings are something you hold on to. And so it’s actually almost quite liberating just for people to say it’s alright to not be okay. It’s okay to say it. Because anything we try and do on the other side, any actions we take to create this new normal, unless they’ve come from a place of authentically, ‘I’m not okay and what do I need to do to be okay?’

Okay, so then otherwise, it’s a reaction, isn’t it? It’s just like it’s a reaction without really being honest. I think that authenticity, if we really want to be authentic, we’ve got to be open to asking ourselves, ‘How am I? And then how am I really?’ And not to judge it too quickly, just be with it.

Rachel: I think it’s that being with it that is so hard. I think many healthcare professionals know. I am certainly someone who gets interactions, so soon as I can answer, ‘How am I?’ or “I’m not okay’, what do I got to do to make myself okay, and I’m not happy to sit often with that, ‘Oh, I’m feeling quite sad, and that’s okay.’

I guess it’s like anxiety as well. I think, or I have observed — and I’ve heard lots of people saying this — that being anxious is actually okay. Like there’s quite a lot of ‘fair-enough’ anxiety. I’m anxious about my exams coming up. Yeah, fair enough! Be anxious about your exam. That’s the interaction.

But what I’ve noticed, and a lot of my children, for example, are very anxious if they’re anxious. I’ve got anxiety. I’m really worried. What I’ve got to do is get rid of my anxiety rather than learn just to sit with my anxiety and cope with it. Now, am I completely off the mark here or is that something that is important to be able to do?

James: Not at all. You’ve hit the nail to me completely on the head. So something that I often talk about is the rule of thirds. In life a third of the time, we should be really happy, really engaged, really effective. A third of the time, we should be fine and it’s okay. And a third of the time we should be anxious, uncertain, a bit lost.

Because that’s really what being a human being is all about. We often aim for some form of perfection that is completely unrealistic. Again, I know a lot has written and spoken about social media and you know, the interpretation of, you know, look at my world, look how happy I am. Look how fabulous my life always is.’

And, and for kids especially, it’s a very, very dangerous game. Aspiring to something that is always perfect, of course is a fool’s gold.

Rachel: So that’s interesting, isn’t it? Because yes. If you asked anyone what they want for their kids, what they want for themselves and their lives, it’s like, ‘I wanna be happy, I want my kids to be happy.’

But you can’t actually have happy unless you have a bit of sadness, unless you have, you know, a bit of anxiety. Unless you’ve got, like you said, that full spectrum of emotions. You can’t have love without loss and grief when it goes and things like that. So when we are not okay. And we try and distract ourselves out of it, is that just sort of actually feeding into this vicious cycle, which will actually make us more anxious and sad because we’re not ha, we’re not letting those emotions run through us?

James: Yeah, so we’re not having the full human experience, or allowing ourselves to, and then the other is: “What expectation are we setting up?’

You spoke about the medical professions. Why do people start off? What is the expectation of young doctors going into the field? You know, nurses, what are their expectations around what that career really looks like? Now, I can’t imagine they are told at a young age, ‘Oh, by the way, it will be the most stressful, challenging, you’re gonna be put under this pressure, that pressure, the other pressure, the expectations of the entire country are gonna be on you. We’re gonna have a pandemic which is going to put you at the cold face of a really, really…’ That’s not how it is pitched. And so the expectation of what this journey’s really going to look like is false from the start. So when we deviate from that, perhaps we feel guilty.

It’s like, ‘Oh, I’m not supposed to feel like this. You know, my grandmother told me there’s no higher calling.’ Or some of the narratives that might be in and around it. So for young people going into the workplace, I don’t know that they are well prepared.

If we look at the statistics, there are, and even in my client base, you’re finding people in their twenties having nervous breakdowns. So something’s going wrong in this system. And I believe a big part of it is about just allowing people to not be okay, to sometimes be all right, and to sometimes, you know, this rule of thirds, and sometimes be ecstatic and great and fully engaged. And that’s a much more realistic representation of what life is like, about what workplaces are like.

Rachel: So you’re saying it’s okay not to be okay. And this is very interesting to me because we have this at a bit of a catchphrase, ‘it’s okay not to be okay.’ But I guess we generally use that in the communities that I run. In terms of it’s okay to be unwell and it’s okay to be maybe depressed or be very stressed or be burned out and get help. So it’s giving people permission to get help, but this is a slightly different ‘it’s okay not to be okay.’

It’s like it’s almost normal to have those difficult and different emotions, and that’s okay. And in fact, it’s almost needed. But then the question is, I guess what, what do you do with it from there? Is that right?

James: So what do I do? First is just to acknowledge, ‘I’m not okay.’ And then, ‘how do I deal with it?’

You know, this is where I think a lot of people certainly in the work that I do, I like to try and bring a sense of, well, who are you and what do you actually need? What motivates you? And so we start getting into some of the personality preferences.

So if I have more of an introverted personality, okay, then how I would deal with, ‘I’m not okay, what do I need to do?’ is very different to if I’m an extroverted personality, just by one example of preference. So if I’m introverted I would, I need to spend a bit of time with myself. Some walks in the forest, take some lists. What are the actual feelings? Do some journaling, you know, and actually unpack personally for yourself where you’re at. What does this mean? And then some of these questions of who do I want to be? What’s my vision for myself? Then you can start to take it out to the world.

So that would be the kind of process I would recommend for someone who, if you know that you are more introverted, that’s the kind of functional process I would advise going through. Now for the very extroverted or more to the extroverted tendencies, what we need to do is to talk about it. Actually admit it and actually say when someone says, ‘Oh, how are you?’ Rather than, ‘Yes, I’m fine, everything’s great.’ It’s often a, the extroverted version of, ‘Actually, no, I’m not okay. And I’m really struggling a little bit and I’d love to talk to you about it.’

Again, talking to probably a very similar thing, which is what’s going on, what’s the actual feeling that I am experiencing at the moment? What does it mean? How would I like to be? And then maybe what’s my way, but to really more do it more of an engaged way.

Rachel: And as you were saying that, I was thinking that this is where I think there probably is quite a gender divide. I’m gonna be quite siloed and bucketed here, but I know that I will, when I, with my friends who I meet up with ev every week after a particular circuit training class, we will go and they’ll be probably someone who isn’t okay, and they will say, I’m not okay, or they won’t, they won’t necessarily say that, but they’ll say, this is what’s going on with us.

It’s obvious that they’re upset about it. They’ll talk about it, they’ll say how they feel. We’ll all talk and by the end, people are feeling a lot better, generally, and that’s so therapeutic and it’s so helpful.

Now contrast that with my other half, who does a circuit training class with his boys and goes to the pub afterwards. And sometimes people do say, ‘I’m not okay’ and discuss it. And that’s starting to happen more and it’s brilliant. But by and large, a lot of his friends don’t. They’ll just, just a lot of banter, a lot of, they have a nice time together, but I can say to him, ‘How was so-and-so tonight? Because I know there’s this going on.’ And he’ll be like, ‘Oh, they didn’t even mention it.’ Is that a male-female thing? I don’t know. It’s very difficult to say this is male, that’s, that’s female. But I do observe. I think that maybe it’s one of the issues.

James: It’s much more so. Look, it is much more so, but again, this is down to the culture. This is how we’re brought up. This is very much a nurture piece, not a nature piece. so I think our relationship to our emotions, again, is really how we make decisions. So some people are more feeling, more heart, more gut, more instinctive, more about what the impact on me or the collective community will be.

Other people are a little bit more logical, a bit more thinking, practical, rational. So again, we’ve got this, this difference by preference of personality. But then what we’re talking to now and what you’re talking about is very much how we are brought up.

A little boy falls over and what do you do? You tell him to pull up his socks and big boys don’t cry. Off you go. In all of my work, I commonly find that men are much just less able to even identify what an emotion they are having, let alone that they’re having it. So we’ve sort of almost had it, to coin a phrase, beaten out of us that we’re even allowed to acknowledge what it is.

So we’ve lost a language of emotion. So that’s not a- that is absolutely correct. And often I find that with men, they don’t have the language for the emotion. So typically what do they do? They go to fix. They go to do.

Rachel: Before they’ve even identified what it, what it is that needs fixing.

James: Yeah, exactly. But again, I mean if you look at it in most relationships between men and women. Women will say, oh, ‘I’ve got this problem’ just wanting to discuss it. And a man will say, ‘Great. I can do this. I can do this. You can do that. You can do the other. And then let’s play that one out.’

Rachel: Yeah, the old, ‘men are from Mars, women are from Venus’ thing, right? We’ve all read that book. We’ve all read the book

James: We’ve read the book, we live and we live the, you know, we live those.

Rachel: Yeah. And I think also I have observed, I think there are some, there are lots of women, maybe particularly female doctors, that then take that approach as well because that’s how we’ve been trained. We’ve been trained to fix people’s problems. So when we are feeling a bit iffy, we just try to fix it. We don’t, we maybe don’t go right down thinking actually, ‘How am I, what emotions is it that I’m experiencing?’ I mean, how do you teach people to recognize what those emotions are?

James: The biggest thing at this point is time. It’s time to be. So I’m not surprised in the medical profession, because you have to go to fix. The metrics of how your performance is managed, you know, and again, this knocking on the back of the head, waiting time, waiting time, waiting time. You’ve just gotta get through it.

I’m sure that that is a challenge for a lot of young doctors and nurses. I see a human being in need and what I’d like to do is to spend the time with them to help them fully, and not being able to, I’m sure that’s a source of big frustration. It is very much the time to be with it.

Rachel: Yeah. Constantly. Everything comes back to time. You know, in all the resilience training we do everything about wellbeing. It’s time, isn’t it? Because you can’t look after yourself unless you have the time to do it. You can’t have conversations unless you have the time. And this time to set aside just to think how am I? What emotions am I experiencing now? Just, well, I was about to say, just doesn’t exist, but I’m gonna contradict myself because actually it does exist, but we are using that time for other things. Maybe social media, distracting ourselves, watching telly, doing other stuff. Right?

James: Exactly. So I think again, it’s down to this thing of the acknowledging that I’m not okay. And one of the key criteria to finding ‘okay’ again, is to take the time with myself, to actually pose the question, ‘How am I?’

You know, the most powerful developmental tool is this.

Rachel: James is holding up a pen for everyone who’s listening.

James: And it’s got four colours. It’s the old four colour one.

Rachel: Oh, so you can colour code. Love it.

James: Just take the time. Blank piece of paper. Just write it out. I call it brain vomiting, you know, just blah. Just purge. Because how you are, you fully know — you’ve just blocked off. So open it up and just let it flow, get to the bottom of it. And even just that process can be hugely cathartic. I mean, the studies show one of the most powerful psychological interventions in individuals and teams is to write about your values for 10 minutes.

Rachel: Wow.

James: It’s got the longest lasting impact and the most powerful impact on people’s sense of well being. When was the last time you wrote about your values? Do you even know what they are? It’s not to you, because I know you would work in this, but to your listeners, you know, can we all agree that values are crucial in how we show up as a human being? I think most of us would say yes to that, but then I go, so what are they?

Rachel: Yeah. I mean, I must say in medicine, most of us haven’t done any work around our values. I mean, I have because recently we’ve been doing. Looking at, you know, the podcasts and our training and what are our values? And that’s been really, really helpful. But I think people find it hard even to know, what is a value? What is a value?

I guess, for me, the easiest way to know a value is when it’s been knocked, like if you get angry, right? Because there’s some value of yours that you’ve had, like someone’s not being honest with you, or someone’s done something that doesn’t seem fair or something like that, or somebody’s not being compassionate or kind to somebody.

James: They’re the triggers. That’s often how we notice what our values are when they’re under threat. So they’re being under threat and it will bring often out of character response to it. And I think maybe that we’ve got to be careful of the bumper stickers, you know, say, oh well, integrity, honesty, and sort of out come the four or five things that we aspire to. And often I’ll say to people, so ‘Well, if that’s your starting point, how does that manifest in your life?’ Because values to me are things that are actually actions.

There’s actually something that is going to be coming to life, there’ll be some kind of impression left, when I am in that place of value. It’s not a static thing. And I think it has a very personal interpretation. Really good organisations with their five value sets above the door, and they are not necessarily always obvious in the behaviour of people because values drive our behaviour.

Rachel: I mean, I’m sitting here looking out over Addenbrookes Hospital, and I know that their values are to be kind, to be safe and to be excellent, which is a brilliant aspiration. The problem is,

James: Sounds wonderful.

Rachel: Sounds wonderful, doesn’t it? But at the moment, you’ve got ambulances queuing out the door, because of the, because of all the backlogs through all sorts of reasons. And so there are people working, where they can’t provide the excellent care they want to and they can’t be as kind as they’d want to. And that’s really, really difficult.

But I digress. I mean, I think one of the things, the bugbears I have, is when companies say yes, our values, integrity and honesty, it’s like, no, no, no, that’s just being a decent human being. That should be like that should go and be taken for granted. So what else? What else have you got that isn’t just actually someone that I would ever do business with? Right?

James: Yeah. I’m being a good human being, that’s a great place to unpack.

Rachel: What’s that look like? Right?

James: What’s my version of being a good human being look like? Because then we actually start to get into a little bit of meatiness and we get away from these sort of bumper sticker words. We go to what really matters. Because the other thing is, I think, one of the personal development tools that I use measures behavioural preferences.

I spoke a bit to it earlier with introvert-extrovert thinking and feeling, decision-making. And last year, for the first time, I’ve been using the tool for about 12 years now. And people are so consistent that when they get remeasured, they’ll stay in the same preference space over and over and over and over again. Last year 79% of remeasures, i.e. people doing it for a second time or more, had moved position completely.

Rachel: No.

James: So I don’t believe people really understand. So it’s easy to say, yes, we’ve been in an existential crisis. Now, what do we do? Rather than we’ve been through an existential crisis? What is the impact on me? What is the impact on you? And then how do we build a normal that is healthy and relevant to where we’re actually at, at the moment.

Rachel: So you’re saying that we’ve actually completely changed as people through these last few years.

James: I think that it would be very difficult to find many people that have stayed the same way they were prior to everything that we’ve been through to the present. Would be very, very- it would be more extraordinary than the norm. And that is a huge shift to what was happening prior to it. People typically weren’t changing.

Rachel:

That’s interesting. So I wonder whether one of the issues then is what we’re doing is judging our behaviour on our old values and who we used to be? And what used to be going on? Is it Myers-Briggs, you’re talking about there?

James: No, I use Insights Discovery. But again, all of them, all of those tools come from your own preferences.

Rachel: Yeah, that’s fascinating to me, because and here we’ve got a dilemma, right. One of my theories that I’m just sort of working up this year, is that a lot of the stress that’s happening for doctors in particular, is due to their own innate perfectionism and people pleasing, because they can no longer practise in that perfect way that they would expect because of all the demands on them.

And when they can’t be excellent, when they can’t help people all the time in the way that they want to, that bangs against their values. That causes a lot of shame, because you’re not living up to your own values and consequently, causes even more stress. So here we’ve got this dilemma if that we really know who we are, who am I? And those are our values, but we can’t practise in a way that meets our values. It causes even more of a problem. So does that mean we need to change our values? What do we do with that, then?

James: When our values are unmet, what happens? Does the system change to meet our new value set? Or do we need to change something in order to bring our value set to life, or to meet the needs of my values?

Rachel: So perhaps the values stay the same, but our needs in relation to those values needs to change, because it says your values are to always be able to help people and I know some people are looking at the Enneagram type thing that number two is really driven by helping, aren’t they?

But what happens when you’re in a system where literally, you cannot help in the way that you want to, and if you do, you will burn out almost instantly. Your needs relating to that helping have to then change, don’t they? You can still keep the helping value.

James: Exactly. So it’s more about their expectation of myself. So what am I expecting of myself within a system that is where it is? The system inherently doesn’t change.

Rachel: This question, ‘How am I?’ to actually take the time to sit with it and probably writing it down is one of the best ways you can think of it actually. ‘How am I really? Sometimes, I found with some of my coaching clients, even just keeping a mood diary or whatever what I’m doing and how I’m feeling can be quite revealing when you find there’s lots and lots of you know, miserable faces down there and stuff like that.

James: Draw a picture. See what comes out. Play a musical instrument, what’s often expressed through music can be expressed through body as well. Do I run in order to just run myself, to break my body because I’m trying to sate some unfathomable need? Or am I running for the joy of running? So again, maybe I think there’s some other areas outside of just writing that it will come up.

Rachel: Yeah. Am I hitting the whine the minute I get home from work just to cope with the day? Yeah, bingeing on Netflix, eating too much? Yeah.

James: Absolutely. Am I shouting at my kids more than telling them that I love them? And I think this comes back, I used the word earlier about my intention. So what am I really trying to be on a daily basis? Who am I really trying to be? What’s my starting point? What’s really in my heart? Because, you know, I’ve worked with hundreds of thousands of people all over the world for many, many, many years. And I’ve yet to meet the person that said to me, James, I go out of my way every day just to piss that one person.

Rachel: Oh, I think I know a couple like that.

James: We all do, many of them. But that’s the impression that’s being given that is very, that is not the starting point of anybody that I have met. So there’s a disparity. So if I’ve got a good idea about how am I, my values, what’s really important to me, I can start to set intention and live with it. And when I’m outside of it, I can clean it up. I can go ‘Rachel, sorry, yesterday, I said to you over there, what I really meant was this.’

So yeah, so it’s this being able to start to build the practice of someone who lives with intention. And when I’ve got that, I start to create this elusive, quote, unquote, new normal, because that actually, I am at the heart, and I’m in control of the experience I have as a human being.

Rachel: Yeah. And I love that because we talk a lot about setting boundaries and saying no, and stuff like that. And one of the ways that we teach is for people just to know what they’re choosing the actions, that they’re choosing the behaviour that they’re choosing, because we don’t like letting people down. We don’t like limiting the amount of help we can give. We don’t like taking time off when we know everyone else is really knackered, but we know we have to for our family. And I love the fact that you’re saying what we do is we work out our values first and what our needs are in relation to those values. Then we’re working out how we’re going to choose to behave.

And I think this is what a lot of us get so wrong, but we don’t, we don’t get that this is how I’m going to choose to behave bits. Which is fine when it’s ‘I’m going to choose to be happy and nice to everyone all the time.’ That’s well, I would say that’s not that easy. It’s ‘How am I going to choose to behave in ways that are difficult to behave like that but I know that serve my intention.’ Isn’t it right?

James: Yeah, yeah. So because we’ve got, we need to have the courage to be our true selves, yet live in community to have the love and respect and compassion for others. It’s very much a duality. If we go all love, we make it all about other people, often we’ll descend into fear. Some kind of, you know, hiding our truth. And if we make it all about ourselves, and this is what I need, this is what I need, it can often fall into ego and arrogance.

So it’s very much having the courage to know who I am, and take a stand for it and what I need, but in relation to what the world around me needs, the people around me and what did they need?

Rachel: Yeah, a few minutes ago, we’re talking about how people have changed. So about the fact that you’ve noticed that a lot of people have changed. How do you think people have changed? What have you been noticing? Are there any themes that have shifted for people?

James: Yeah, I think for a lot of people that have been shoved, being told not to leave home. There was a massive, I think, change of priority around what does my world at home look like? Certainly for a lot of fathers in relation to their children. You know, dad was typically off away, saw them on the weekend, and was probably tired and pressured under there and maybe not that fun.

A lot of men are really deeply connected with being a father and that resonated very strongly for them. So it’s an interesting one around the hybrid things like, I don’t want to give up actually, being able to drop my kids off at school, pick them up at school, which wasn’t something that I was used to before. So I think that the elements of family and relationship piece for men is very, very strong.

I think some of the other changes are, ‘What is important to me?’ I think we’ve broken a lot of the illusions of before. So we were living off a lot of lives, having careers that were sort of based upon illusions of past. And then again, this is back down to actually acknowledging it. So what does being a doctor look like from here forward for me, understanding the realities of where the profession is at? What does that look forward to?

I think maybe what I’m talking about is what I hope people are going to be doing with this, which is to take as a chance to reframe, and to re-own what their future looks like forward in their careers and their relationships. And perhaps that penny hasn’t consistently, on a big enough scale, really dropped.

Rachel: It’s interesting, I think what has dropped is that people’s values have changed, and what’s important to them has changed. Because when everything’s stripped back and you’re in lockdown, then it really doesn’t matter what sort of car is sitting on your driveway, does it? It really, really doesn’t, it doesn’t matter if you’re wearing the most amazing new shoes, because no one’s gonna see them.

It is all about relationships and health, and who you love and purpose. So people’s values have shifted, what I don’t think has shifted is their behaviour. They know that the values have shifted, but they’re being asked to behave in exactly the same way. Like you said. So what?

James: Yeah, so the community ask, you know, it says like, so we had community ripped away, and which had all sorts of implications for, for many of us in various different ways. And then so then the system itself, the ask isn’t being changed?

So are businesses really engaging with people to say, how do we create a way of work that suits us now? Suits you and us now? It’s very much I think, I feel like the way forward is very much more in partnership. Again, it’s back to how do we take the time to have these conversations?

Rachel: And businesses are really struggling? You know, obviously healthcare, a lot of it is back to frontline work, but still, I think meetings and things you know, consultant teams that have never met face to face since the pandemic.

It’s just easier to get together online and other businesses are really struggling with the virtual hybrid working because we know that teams work better when they’re face to face, but how do you mandate that for people and it’s a real struggle.

So what should people do? How do people work out how to change their behaviour so it suits their values more without causing massive problems. To other people in the system in which they work?

James: Yeah, again, I think it to me, it’s about, how do I exist in community is probably the real conversation. So I think one of the things shifted is with lockdown. And that period of time is that I, my needs became more prevalent than the system that I exist within. And so if my needs have changed, how do I then bring them back into community? As I said before, I think it’s very much a co-creation. So we need to have a conversation of what has shifted? And what does that mean for how we are working together?

Because we still have business objectives. We still have strategies, we still have, you know, from the NHS aside, obviously, we’ve got key deliverables. So how do we meet that, but in a way that doesn’t break us as individuals, so it doesn’t disconnect us?

Rachel: So, James, I’m just looking at the time. We’re nearly out of time, but have you got any tips as to how people can start to do some of this? What practical things can people do if they’ve sort of managed to give themselves a few minutes to ask themselves, ‘How am I?’ and they think, ‘Well actually no, I’m not that okay at the moment,’ what can people do next?

James: I spoke earlier to the power of the pen. It really is such a powerful thing to write out where am I actually at. Just take note, because it just gives it voice. And once it’s out, it can flow.

So just start to take track of where I might act. I like people to remember the rule of thirds. So again, if we’re journaling, if we’re just doing that reflection of a sitting in the car, where was I today? Because if there’s an imbalance in that, if I’m spending all of my time, either all ecstatic, ecstatic or not great, not great, all fine, fine, fine. Where do we make space for the others? So I think to be quite aware of the differing needs.

And then I think the last thing is to, if I’m able to start articulating where I’m really at, who do I communicate that with? What are the communities whereby my sense of well being is really important. So is it in my family unit? Is it in my professional environment? Is it in my recreation, or my social environments? And how do I start to bring a more authentic understanding of myself to those those environments so I can be supported.

Because we’re human beings. We exist in community and in relationship with each other.

Rachel: And that’s where I think maybe people are having issues that they don’t have that supportive environment. And I always try and encourage people to find it. Because if your team at work is awful, and one of the causes of most of your stress, then find another community support group, a couple of peers go for coffee, create your own where you can have a community.

I think we should be proactive enough about doing that. And GPs are constantly sort of saying, I don’t have anybody to talk to, my practice seems not any good. But there’s loads of GPS in the area, why don’t you find a few friendly GPS and meet up or get online, find a group? There’s so much stuff out there. But again, I know, I know, it’s time. I know, it’s time.

James: Always time. But again, the thing about time, is, if we don’t take the time, what is the consequence. So we fast forward all of this, and we don’t take this time to build healthy communities, to do the proper self-reflection of where am I at, really, don’t get the support when we need it. The impact is we are going to further disconnect, we’re going to find less of a voice because the system has has taken what it’s taken. So how do we start to regain our footing? It’s out of balance, so if we don’t do something about it, I fear ongoingly for the health and well being of people.

Rachel: Yeah. And I think one thing people are aware of is their own health and well being and the one good, good thing that’s come out of the pandemic is that it has gotten to the forefront of people’s minds. And actually, the well being of the workforce is really, really, really important. What people struggle with is what on earth to do about it. And it is something that only that person can do themselves and it’s in the choices that you make.

So it’s prioritising that time to do that self-reflection. And when a therapist, find a group of friends, find a coach, join a coaching program. There’s lots of stuff out there but people don’t often know where to go to do it. And there’s a podcast. I mean, gosh, there’s so much stuff isn’t there?

James: So much information. I mean on LinkedIn there’s just these reams and reams. Every, every social media outlet sites to how do we start using social media for the benefits that it could bring us rather than watching cat videos?

Rachel: Well, I quite like cat videos.

James: Yeah, I’m more of a dog person, but no, no judgments. But yeah, I mean, starting to get just more deliberate and taking ourselves more seriously because we matter.

Rachel: I think that’s the message that doctors really need to know. You know, you matter as a person. You’re not just the human doing. It’s the human being. Because if you just keep with the doing that will burn out unless the being comes first. Right?

James: Yeah, absolutely. And we need you, doctor. We need you so bad. We support you, you know. That’s, that’s a message for those of us outside of the system is deep appreciation. But please take the time to be.

Rachel: And I personally want my doctor to be happy content, thriving, knowing what they’re about. Having done some self reflection, can be a much better doctor, then if they are one crisis away from not coping, completely miserable, and not taking any time for self reflection or to do any of the work it is and it is work actually, isn’t it? It’s not straightforward and simple. It’s work.

James: If it was super straightforward and simple, we would all be well-adjusted and fulfilled. It as always amazes me how many people have got gym memberships that they don’t use for their body. But if whenever I’ve tried to do open courses, or take me on for just a little bit of money, people won’t invest in themselves. And I go, we understand the mind body spirit relationship better than ever. So let’s invest equally in those three.

Rachel: Yeah. Brilliant. Thank you, James. So if I was asking you for three top tips, what would they be?

James: Get a pen, start being authentic and write down how do I feel and what is important to me. It’s a starting point. Two, find a community, a healthy community whereby you can actually start sharing a little bit of where you’re at, hearing ideas, supporting each other, a healthy community. And three, remember, you’re whole, complete and perfect. Okay, you deserve it. So do it for you.

Rachel: Wonderful, thank you so much. James, if people wanted to find out more about you and your work, where can they contact you?

James: So I’m on LinkedIn under James Spice. So feel free to reach out. I have a website, www.jamesspice.com. Probably LinkedIn is the best way to do it. Drop me an email. I’m always available to have a conversation. I’m deeply passionate about humans being the best beings they can be. So please reach out if there’s any questions you’ve got.

Rachel: Brilliant. Thank you so much. And we’d love to have you back at some time to explore this a bit more. Will you come back?

James: Rachel, you call, I will be there.

Rachel: Thank you so much. Wonderful to see you have a good rest of day.

James: Thank you. Bye bye.

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