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As a medical professional, facing high-stress situations every day might make you think you can handle anything. But the truth is, decisiveness isn’t always what you want when things go wrong. Not every crisis is the same. Sometimes, the best course of action is to take a step back and come back to the crisis later.
In this quick dip episode, we uncover why we become terrible in a crisis, even as healthcare professionals. We explore how we typically react to stressful situations and their consequences. Then, we discuss strategies to ensure you’ve left the stress zone before you handle your crisis. It all begins with self-awareness and self-apprehension.
Before anything, it’s crucial to take a pause. If you want to know how to develop good crisis management skills for yourself and others, this episode is for you.
Show links
Episode 157: The Power of Pressing Pause
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Reasons to listen
- Discover why being in our stress zone makes us terrible at dealing with crises.
- Learn the best course of action when you’re backed into the corner.
- Find out how to make your own amygdala hijack rescue pack.
Episode highlights
Dealing with Crises as a Healthcare Professional
Why We Become Terrible in a Crisis
Four Choices When You are Backed into the Corner
The Amygdala’s Job
You are Responsible for Your Reaction to a Crisis
How to Deal with Being Backed into a Corner
Knowing What’s Urgent and What’s Not
Get Out of Your Stress Zone
Investigating the Stories in Your Head
Making Your Own Amygdala Hijack Rescue Pack
Episode transcript
Rachel Morris: This is a You Are Not a Frog Quick Dip, a tiny taster of the kinds of things we talk about on our full podcast episodes, I’ve chosen today’s topic to give you a helpful boost in the time it takes to have a cup of tea, so you can return to whatever else you’re up to feeling energised and inspired. For more tools, tips and insights to help you thrive at work, don’t forget to subscribe to You Are Not a Frog wherever you get your podcasts.
I pride myself on being good in a crisis. And in fact, I’ve talked about this on the podcast before last year, I had to resuscitate somebody in the middle of a ski village in the middle of the Alps. And because I was the only doctor there, it seemed that I responded really well. I responded quickly. I knew what to do. And many of us think that we are great in a crisis.
But I remember a time not so long ago when I was working at the university when I was peer reviewing a teaching session. And I had to give some feedback to a colleague and this colleague, to be honest, was a little bit scary, I was really worried about giving the feedback. Five minutes before I had to sit down with them and tell them what I thought of the session and give some constructive suggestions about how they could improve it, I got a phone call from my bank.
And the bank told me that someone had broken in, essentially, to my account and had tried to steal about 10,000 pounds, had actually stolen my identity. And they’d set up all sorts of loans in my name, they’d set up credit cards in my name and the head very nearly got their hands on some of my money. As you can imagine, I was really stressed. I was really, really triggered. I was in a bit of a crisis.
But because I know that I am good in a crisis and I’m a doctor and this is what we do. I soldiered on. I went to give feedback to this person I had to give feedback to and you can imagine what happened, I was far too direct, I was not empathetic, I was worried. I didn’t give good feedback. And it turned out really, really badly. But I thought I was good at this, so what’s going on? So many of us, because our training to deal with people in emergencies has been so good, we think we can deal with other sorts of emergencies.
Now, resuscitating someone is very much a case of ABC, as we all know. And please, please side note, if you haven’t had any resuscitation training, go and get some. You could well save somebody’s life one of these days. But when we view every crisis the same, and we think we’re fully equipped to deal with everything, that’s when the mistakes happen. That’s when the complaint starts to come. And that’s when we break relationships.
Because the reality is that most of us are terrible in a crisis. We pride ourselves on our decisive actions. But in a lot of the sorts of crises we have to deal with, black and white decisive actions are the last thing that you need. You need to contemplate stuff, you need to think about it, you need to be empathetic, and compassionate. And that just is not possible when you’re in your stress zone.
And you’ve heard me talking about the amygdala many, many times before. When a threat happens when our brains detect a threat, such as a tiger coming towards us or a bus coming towards us or somebody being rude to us, perhaps, our amygdala send us straight into our stress zones into our fight flight or freeze zone.
I call that being stuck in the corner. When you’re backed into the corner, you have four choices. The first is to fight — come out with your boxing gloves on and you get really aggressive and try to prove your point and stand up for yourself. You can flight — you can run away and just avoid it completely. You can freeze — like a rabbit in the headlights where really you’ve already checked out and runoff.
The fourth reaction that I’ve only found about quite recently is to fawn. Fight, flight, freeze or fawn. I noticed myself doing this just the other day when I was on the phone call with somebody and I had mentioned something about somebody else. I realised I hadn’t been as kind as I wanted to have been and I really worried that I’d upset somebody. I found myself fawning. I found myself over praising this person saying how wonderful they were. And actually not being completely true to what I really thought I was fawning because I was so worried about the other person’s reaction.
I remember being in meetings with quite a scary person at the helm. Everyone would be agreeing with everything that this person said and telling them what a wonderful idea it was when I knew that they thought anything but. This was fawning behaviour in action.
Now this threat response, this stress response is actually really, really helpful. Because if there genuinely was a tiger coming towards me, I would need to run away. What happens is our amygdala reacts very, very fast. It’s part of our limbic system, and it reacts five times faster than our rational thinking brain. So this is an unconscious reaction that we have, which is just as well really, because you don’t want to be stopping and thinking, ‘Oh, is that tiger coming towards me? Isn’t it? Should I run away? Have I got the right shoes on?’
No, you just want to get into action as fast as possible. So this protective threat response causes us to be safe. Our amygdala’s job is to keep us alive. But it’s not to keep us happy. So in an ideal world, we’d have a chance to see the threat, appraise it, and then respond in a rational human manner. But in the real world in which we live, the way that we’ve evolved, has been to always expect the worst, to expect that threat around the corner so that we are prepared and we are already running before we find out actually, it’s not a tiger. It’s a completely harmless animal.
Now, Dr.Steve Peters calls this immediate reaction that we have, our ‘inner chimp’. He says we can’t stop our chimps from coming out, which for me, was actually a really, really helpful thing. Because I had thought I was a really bad person. I’ve been really beating myself up by the fact that seems to get annoyed or upset, or anxious really, really quickly. As soon as I realised that this was an unconscious reaction, due to conditioning from years and years of responding to various things, and it was just my brain keeping me safe, and I wasn’t really very in control of it, I just felt a lot better.
The problem is, and as Professor Peters points out, that once your chimp is out, you are responsible for what happens. So you can’t maybe stop yourself from having this stress reaction. But you have to manage yourself when the chimp comes out. That is exactly what I had failed to do when I was giving feedback to one of my colleagues. My chimp was already out because of the thing that had happened with the bank. I was also going into a very tense, difficult situation where I had all sorts of stories going on in my head about who am I to be giving feedback? And what if they react badly, and what if I do something wrong, that I was well and truly backed into the corner.
Now the problem with being backed into the corner, being in our stress zone, being in our sympathetic nervous system zone is that our cognitive function declines. We literally have less blood and less glucose flowing to our brains, because it’s been diverted to our muscles. So our executive functioning goes down, our working memory goes down.
So just remember, the time that you were in any sorts of oral exams, where you suddenly feel that you can’t speak, you can’t remember your own name. That’s because your brain is not working the same. When we feel threatened, our performance deteriorates massively.
The other thing that happens is because our brain has been activated, it’s very difficult to sort of perceive very small signals. It’s very difficult to pick up on stuff or to be empathetic to other people, or notice what’s going on over there. Because actually, our brains are programmed to just focus on the immediate crisis in front of us. We also tend to generalise more. So we tend to lump everything into one category, because that’s a shortcut for our brains. And we make accidental connections.
So if somebody fails to smile at you, you automatically assume you’ve done yet another thing wrong, and maybe you get into more of a tizzy yourself. They might just be lost in thought of course, thinking about the conversation that they just had. We become very, very defensive about things, we err on the side of caution. We’re not honest and truthful with people. We become much more easily triggered by other stuff as well.
So being backed into the corner is not a good place to be, particularly if you’re having to deal with a type of crisis that you probably have to deal with on a daily basis. Difficulties between team members, supporting teenagers, having to make really complex decisions about competing priorities. All this sort of stuff cannot be dealt with while you’re backed into the corner while your brain isn’t working properly and you’re making all sorts of assumptions, and you’re feeling defensive.
I’m sure that all of you can think of times at work where you were just not the person you wanted to be, where you behaved in ways you look back and think, why on earth did I behave like that? What on earth happened? And it was probably because you were in your stress zone. It’s really interesting, because whenever I do training on how to say no, and why we need to say no, and why we need to prioritise and manage our workload, people always come back to me and say, ‘Yes, but what if I get a complaint?’
And the ironic thing is that actually, you’re much more likely to get a complaint if you don’t say no. Because if you can say no, in a calm and rational manner, for a good reason, you may get a complaint but it can be dealt with and it can be explained. If you fail to say no, you become overwhelmed, you become defensive, you become grumpy, you’re gonna get a much worse complaint. And it might actually stand up because you’ll lose your judgments. You’ll be led down a path that you just don’t want to go down.
So trying to deal with difficult stuff while we are in crisis mode, in stress mode, is a really, really bad idea and can lead to all sorts of bad things happening like fractured relationships, like severe mistakes, like being really rude to someone and causing a whole extra heap of pain. But if we wait until we are out of the corner, in our right rational thinking mind, then we become much, much more collaborative, we find we’re able to solve problems and connect ideas. We have inspiration, we can be empathetic.
I have noticed recently that my best ideas, my most creative ideas, come while I’m in the shower, when I’m not thinking about stressful things while my brain is switched off, and I am just relaxed. We know from the broaden and build theory that if you are experiencing positive emotions, then you are much, much more able to think outside of the box and to solve these complex problems. We see more options around us and we just perform better.
The mistake that we make, as doctors and as other professionals, dealing a lot with high stress situations, and high stakes situations is that we feel we need to act quickly. We think that being good in a crisis means being very decisive. The reality is that actually, the only thing that is truly urgent is CPR. Most other stuff can wait. In fact, CPR is a really good example of when we do need that very decisive, black and white linear thinking that we get when we’re in our stress zone, because you literally have to follow a linear thing.
You don’t want to be debating, ‘Oh, should I do A before B, B before A, what do I do about this?’ You want to just know what you’re doing, and get on with it. The mistake I make is that when other sorts of crises come up, like, so I get a really difficult email, or there’s a problem with something at work or a problem with one of the children. I go into my stress zone and I feel that I’ve got to act straight away. I have this overwhelming urge to send an email to get on the phone to sort it out. I’ve actually learned that when I feel an overwhelming urge to sort something out or speak to someone urgently, probably that is the very time I should be stepping back and pressing pause.
So how do we deal with this? How do we make sure we are not dealing with crises in our stress zone so we are dealing with crises when we are not hijacked by our amygdala? Well, firstly, you need to be able to recognise when you’re in the corner, when you’re in that stress zone. That can be quite hard to do, particularly if we’re in that quite a lot that can just almost feel like the normal zone. But I’m sure you can all recall sitting having a coffee and being quite relaxed. And then maybe a friend comes in and joins you and they’re very, very agitated and you can just tell that they’re in their stress zone, but they haven’t noticed it.
Other people can often tell, so phoning a friend is a good idea or having somebody that you know really well that can just say ‘Hang on, Rachel, you seem a bit agitated now’ and can just get you to press pause. Just think about your early warning signs. A friend of mine says that she knows when she’s been triggered because she’s walking along the street and everybody is in her way.
So what do you do? Do you come out fighting like a rhino? Or do you go really spiky like a hedgehog; do you withdraw? Do you find stuff clamming up in meetings? That’s a really good indication that you are in the corner. Or maybe you find yourself getting really aggressive and arguing about stuff or raising your voice or becoming tearful, notice what happens to you. When that happens, work out what you’re going to do.
First thing — and we’ve talked about this before on the quick dip episodes — is to press that pause button, is to take that break, unless someone has literally collapsed in front of you, you have at least a few seconds to do that, even if it is just to take three grounded breaths, three deep breaths to try and get yourself from the sympathetic side into the parasympathetic zone.
Even better, if you can take a longer pause if you can leave something overnight, or for at least a few hours and go and check out the episodes on how to press pause. Now Jill Bolte Taylor, the neuroanatomist who had a left brain stroke has written extensively about your left amygdala, your right amygdala. She also says that when you’re triggered when you think of thoughts that produces an emotion, that trigger of neurotransmitters that causes that feeling only takes 90 seconds to settle down. Unless of course, you keep rethinking that thought.
So even if you can just pause for a minute and a half, to let your physiology calm down, that will be helpful. If you can distract yourself in any way, even better, so you’re not just ruminating on things. I know that some people just do star jumps or go and play something on their phone or look out the window or make themselves a cup of tea. Anything will help.
But when you do start to feel that feeling. Don’t repress it. Obviously we don’t want you to go throwing things and punching things but going off and punching a pillow in private, it’s a great way of feeling your anger. If you squash down emotions, they will pop up somewhere else. So feel that feeling and try and name it. We all can name a feeling of anger, sadness, fear or happiness. But if you’re feeling afraid, what is that fear? Is it that you are anxious? Are you worried? Are you upset if you can get much more granular about your emotions, you’ll start to understand yourself more.
The other day, I was just about to start a three and a half hour online course that I was presenting all around how to say no and deal with pushback. Just before the call started, my other half said, ‘Oh, by the way, we’ve got a builder coming in to fix the litter box, it’s gonna be a little bit of banging.’ And they hadn’t told me and the front door was right next to my office. And I reacted really badly. I said, ‘No, that is not happening. Why didn’t you tell me before?’ And I was pretty stroppy. I was pretty short.
Off I go, did the course. And even through the course, I’d been feeling pretty self righteous about it. As the time went on, I started to think, you know what, I didn’t react that well there, I realised the benefit of hindsight and time, I was a little bit short, a little bit grumpy. And so just getting some time and perspective is really, really helpful on things. And then I had to go up and apologise afterwards, I said I’m really sorry.
And luckily, my other half understands all about the chimp. And he said, ‘Was that you just reacting a bit there, Rachel?’ I said,’ Yeah, you know what, it was. And I didn’t mean to.’ So it’s really helpful just to get some time and space between what has happened and your reaction. And that time and space helps you then investigate what’s going on. It helps you ask yourself, what stories are going on in my head and we talk about stories all the time. We’re going to do some more quick tip episodes on some of these toxic stories we tell ourselves that put us straight in the corner.
But if you can start to investigate — are they actually true? Is that true? Is that rational? And again, phoning a friend, journaling, leaving a voice note, all those things just to start to get those stories out of your head in black and white onto some paper or something like that is really helpful, because you’ll start to read it and think, ‘Oh, my goodness, did I actually really believe that thought?’ You will then be able to choose what your response is going to be.
The other thing that I wanted to mention was, when you are feeling those feelings when you are recognising what your reactions are in the stories are: don’t beat yourself up about that. Don’t tell yourself how stupid you are, or how rubbish it is for you to be reacting and responding like that. Have some self compassion. Speak to yourself in the way he would speak to your best friend. So nurture yourself and Tara Bragg talks about rain. When you are in a bit of a sticky situation of recognising what’s going on, acknowledging it and going, ‘Of course, you’re feeling like that. Who wouldn’t?’
Then investigate. Why am I feeling like that? And then nurturing yourself. What do I need now? What do I need? Because here’s the thing, nobody is good in every crisis. Sure, there are some crises we are trained to be better in and practice really can be very helpful. We have all these things that we know we should do in crises and emergencies. But can I encourage you to get your own amygdala hijack rescue pack?
Firstly, write down your early signs. What are they? For me I know it’s when I feel this overwhelming urge that I have to act incredibly quickly. When that happens, I know that I probably have to do exactly the opposite. Step away from that email, step away from the conversation, step away from the phone or the text message, then write down how would you hit pause. What can you do to physically get yourself some time and space? Thirdly, how would you investigate what’s going on with you? Write it down, leave yourself a voice note, phone a friend? And then finally, write down something nice that you can do to distract yourself and just to nurture yourself a little bit so that when the time comes to deal with the crisis, you are in the right state of mind, you are in positive emotion, rational thinking so that you can use your prefrontal cortex and all that lovely stuff in your brain about how a good human being will respond in this situation that you’ve built up over the years and you know, this stuff.
And then upskill yourself. If there are situations where you know you were responding badly, like for example, you know how to performance manage, or give someone feedback regularly and you really dread it, get some training and how to do it. If you’re being triggered into the corner when you have to speak in public, for example, then get some training, practice, upskill yourself. All these things are skills that you can learn.
But of course, there will be crises that hit you out of nowhere out of the blue. And for those — you have to be really careful. Don’t presume that just because you’ve mastered that over there, you’re going to master this over here. You need to make sure that you take the time, trust your instincts — but trust your instinct from a place of love, a place of safety, when you’re not in the corner, and reacting through fear.
If you want to find out a few more strategies about what to do particularly around saying no, which puts many, many of us in the corner then do download our handout all about how to say no. Check out some of the other podcast episodes we’ve got about how to have difficult conversations, how to have better meetings, how to deal with all these difficult things. And in the next Quick Dip podcast, I’m going to talk about the different things that actually trigger us into the corner and how can we avoid them.