How to Choose What Kind of Problem You Want

[00:00:00] Rachel: I’m recording this podcast on the 5th of February and I thought I would share with you something that has been going on for me in January. Now this podcast is not about alcohol, however, I have been doing something called the alcohol experiment. So from new year I decided to do dry January but I didn’t want to spend the whole of January just clenching my fists until I could have another glass of wine or a gin and tonic.

[00:00:24] Rachel: And everything I know about behavior changes, when you stop doing something and tell yourself you can’t have it, that’s when you really want it. And even though I don’t feel I’m addicted to alcohol at all, I still feel that I have a slightly unhealthy relationship with it. So this podcast is not about me trying to tell everyone to give up alcohol at all, but it is about something I found out and I reflected on whilst I was doing the alcohol experiment.

[00:00:48] Rachel: 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 energized 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.

[00:01:17] Rachel: So the alcohol experiment has been set up by Annie Grace. And she is the lady who wrote the Naked Mind book. It’s a totally brilliant book which just helps you examine your beliefs and thoughts around alcohol. And I’ve done an episode on alcohol with Giles Croft in the past so do have a listen to that.

[00:01:33] Rachel: And the difference between the Alcohol Experiment and Dry January is they start to examine every single belief and every single thought you have. And so every day you get a little sort of podcast type video all around a different belief around alcohol. And one of the things she was talking about was cravings. And I found that when I have been going out for dinner, the time when I would really like to have an alcoholic drink is when I’ve just arrived. And Annie Grace was saying in one of these lessons that she found that the cravings around that time were really hard as well.

[00:02:06] Rachel: And when we talk about cravings, we’re not talking about absolute desperation to drink. It’s just this sort of, Oh, it would be a lot easier if I could just have a drink now. You’re often a bit hungry, your blood sugar’s often a bit low, and you’re just thinking, Oh, you know, I could just give in and have it.

[00:02:21] Rachel: But she talks about when you have these cravings, you need to start to think to yourself rather than focusing on the, I wish I could have a drink. I wonder if I’m going to have any fun, it’s going to be difficult to relax. Yeah. Those are problems that you might have for a few minutes. But what kind of problems would you rather have?

[00:02:40] Rachel: Would you rather have a, a few sort of cravings and a few uncomfortable moments as the room sort of warms up and people get to be a bit more sociable, would you rather not sleep very well? Or when she was drinking, as soon as she had a drink, she’d lose her inhibitions, she’d say things she’d regret, and in the morning she’d feel absolutely terrible.

[00:03:00] Rachel: And so this question, what kind of problems do you want to have? She was applying to alcohol and that initial, oh, I wonder if I should have a drink or not because I’m feeling a bit awkward here. She says, do you want the awkwardness of that moment and that slight craving that you can get over, or do you want the crushing regret the next day when you’ve had too many, you haven’t slept well, you’ve ruined the whole weekend and you’re really, really regretting what you said? What kind of problem do you want?

[00:03:26] Rachel: And that got me thinking about some other situations I’d been in recently. One of them was a training session for a safer working program for a training hub. And I’d presented some stuff around how to say no, set boundaries and deal with pushback. And there were some practices that were talking about some of the changes that they had made.

[00:03:44] Rachel: And somebody in the group spoke up and they were really concerned because when they had tried to limit the amount of appointments they gave out, what had happened was that the wait for routine appointments had got even longer. And this person was saying, so we just can’t limit things. This isn’t going to work for us because patients will have to wait. We don’t like telling them that. We get loads of complaints.

[00:04:05] Rachel: And even though there’d been lots of different ways of working presented in different things that they could try, the answer was, no, that will be too difficult. People aren’t going to like it. It’s going to be really awkward.

[00:04:15] Rachel: And of course, we don’t want to inconvenience other people, we don’t want to give people a bad service. But I remember thinking to myself, well, that’s interesting because this person thinks that they’re choosing to avoid these problems at all. As I was running this training, I just thought back to that alcohol experiment talk that I’d heard in the morning about what kind of problems you want to choose? Because this person, by trying to avoid the problem of patients waiting too long, was inadvertently choosing a whole different type of problem. And what was that sort of problem they were choosing? Staff burning out. Staff leaving their practice. People not being able to continue. The practice potentially having to close down because things were so precarious.

[00:04:59] Rachel: So by avoiding that short term hurt, the difficulty of patients complaining, it being a bit inconvenient for people, people moaning and groaning and not really wanting to change, by avoiding that problem, you’ve got an even worse problem down the line. So often we do that, don’t we? We think we’re avoiding the problem, but actually we’re creating a much worse one for ourselves.

[00:05:21] Rachel: Now since the new year, as well as doing the alcohol experiment, I’ve also taken up watching Slow Horses on Apple TV, which is totally brilliant adaptation of the books by Mick Herron, and if you haven’t read the books, I’d really recommend the books, read them first and then watch the series.

[00:05:38] Rachel: In this spy thriller, there’s a lot of times where they’re on an undercover op and someone comes up behind them, pulls a gun on them and forces them to get into a car or get into the boot of the car and get driven off to some house. And then when they get driven off to this house what happens? Well, they’re completely trapped, they get locked in, they get tied up, there’s nothing they can do.

[00:05:59] Rachel: And I remember talking to some self defense expert telling me that the best time to struggle is right at the point where someone’s trying to grab you. Because yeah, the consequences might be that you get injured, yeah, shot or stabbed, but you know what, once you’ve got in the boot of that car, you’ve been transported to that safe house and you’re tied up, you’ve got no chance.

[00:06:21] Rachel: And that’s a bit like these problems. We think that addressing things head on is going to be really awful. We’re often fearful of the immediate consequences. What if I get a complaint? What if things go wrong? What if other people are inconvenienced? What if they don’t like me? What if they think I’m dumping on my colleagues? What if that conversation I’ve got to have is really awkward? What if I upset somebody?

[00:06:41] Rachel: And we don’t realise that if we fail to do it, all we’ve done is we’ve delayed the problem and the problem’s going to be different and it’s going to be worse. It’s going to be a different kind of problem. Because suddenly you’re not just dealing with a bit of a fight you’re dealing with being locked up, being in a room with cable ties around your wrist, blindfolded and not being able to do anything.

[00:07:01] Rachel: You know, the benefits of getting in that car with the gun to your head is you avoid a fight. You avoid potential hurt right then, but the risks are things are much, much worse in the longterm.

[00:07:14] Rachel: And we are constantly ignoring these longterm risks. We’re constantly not facing up to the fact that these longterm harm that is caused by us not choosing what sort of problem we want, well that is the real issue, not the thing that’s in front of us.

[00:07:31] Rachel: So most of us would choose to avoid that awkward conversation for fear of damaging the relationship or upsetting somebody. Most of us would choose to, to go along with what other people want because to say no to them feels a bit confrontational. We risk upsetting them. We risk a complaint. Most of us would choose to try and grab any career opportunity we can, even if we’re overloaded because we think down the line we might not get that again and we’re fear of missing out is, is stronger than actually the joy of having some time and space.

[00:08:03] Rachel: Most of us would choose for ourselves to be inconvenienced, for us to be put out, for us to miss doing that thing for our wellbeing, to disappoint ourselves rather than let somebody else down, or disappoint them, or not give them exactly what they want or what they need.

[00:08:19] Rachel: We might even choose comfort for our children. To give them everything they want, to pay for everything that they need, so that they don’t experience a feeling of discomfort. You know, perhaps if you’ve got a child who’s at university going overdrawn and it feels horrible, you don’t want to let that happen, or you don’t want to let them have to worry about money, but you know what? Long term, what are the consequences going to be? That person will never learn how to budget. That difficult behaviour is going to carry on. Those patients will keep demanding more and more, knowing that there aren’t any boundaries. Everyone else’s morale in your practice or department will go down because somebody’s behaviour has been left unchecked. And eventually our health suffers. We get bad relationships anyway, that’s what we were trying to avoid by avoiding the issue. We get burnt out. Our staff leave. We get resentment and we get frustration.

[00:09:12] Rachel: I don’t know about you, but when I’ve caved in and said yes to somebody when I didn’t really want to do something, it’s been much, much worse for our relationship in the long term because of the frustration and resentment that I’ve got. And me not being the greatest shrinking Violet, I often feel the need to tell them, particularly if it’s close family. I’ll give in to do it and then I’ll moan about it. And then my children will say to me, Mum, if you didn’t want to do it, just don’t do it. But don’t say you’ll do it and then moan about it afterwards.

[00:09:39] Rachel: We might be trying to avoid a GMC referral. So we give in to everything our patients want, but along the line when we’re burnt out and we can’t think straight. Well. We may well be up against the GMC anyway when our judgment lapses.

[00:09:53] Rachel: And we might want to keep the peace amongst our colleagues. And so we avoid that problem of difficult conversation in a meeting. But in the long run, what happens? Well, people stop talking to each other. Everybody stops communicating. It becomes a really horrible place to work.

[00:10:09] Rachel: So how do we choose what kind of problems we want to have? Well firstly, we need to face reality. We need to really think to ourselves, when we’re facing an issue which we’d rather avoid, or when the emotions become a bit difficult, when we start to feel guilty so we just cave in and do what somebody else wants us to do, or we avoid setting boundaries or saying no, we think about, am I really avoiding a problem here? Am I really avoiding difficult consequences?

[00:10:35] Rachel: Because here’s the thing, our actions are inside our control, inside our zone of power. The consequences are often outside our control. And I think I’d rather control my actions, like what I say to somebody, how I raise a difficult issue, than I deal with the unknown consequences outside my control of leaving that issue to fester.

[00:10:56] Rachel: So there’s a couple of realities we have to face up to. Number one is, what is in our control? Yeah, there are some things that just aren’t in our control at all, we can’t do anything about. But so many of us magnify the problem in front of us and diminish the problem down the road.

[00:11:11] Rachel: My colleague, Sarah, says we always overestimate the immediate consequences, the difficulty of having that difficult conversation now, and we always underestimate the consequences of not having that conversation in the long run. So we overestimate the immediate stuff and underestimate the long term stuff.

[00:11:31] Rachel: We need to face reality and rebalance that a little bit. Think, actually, what’s the worst case scenario? What might actually happen? What’s the best case scenario? That it’s just gonna go away? Is that really true? Is that actually gonna happen? If we ignore this, is it really gonna go away? Nine times out of ten, no, it’s not.

[00:11:47] Rachel: So number one, face reality. And you might want to use the zone of power to do that. And we’ll put a link to that in the notes. Secondly, make sure you’re not in the corner when you’re thinking about your options. Because when we’re considering what kind of problem we want to address, what kind of problem we want, and we’re in our stress zones, when we’re in our threat zones, we’re not thinking straight. All the blood is quite literally directed from our prefrontal cortex to our big muscles so that we can run away and fight or fly or freeze or fawn. Sometimes all we want to do is just make things better, particularly when we’re stuck in the corner in that adrenalized zone when our inner chimp is out. It’s a very bad time to decide what kind of problem you want.

[00:12:26] Rachel: Wait until you’re feeling calm. Wait until you’re in your parasympathetic zone where you can listen to your wise self and your intuition to think, what is the right thing to do here? What is the best thing to do here? If I was giving advice to someone else in the same situation, what advice would I give?

[00:12:41] Rachel: So dealing with this like the outside of the moment is really, really important. That’s why in the Alcohol Experiment, they’re saying, decide before you go, decide before you go what problems you want to have. Once you’ve made that decision, that becomes a non negotiable.

[00:12:55] Rachel: And finally, when you’re looking at these different problems, just check the story that you’re telling yourself. Where am I overestimating the impact of this? Where am I telling myself you’ll be a really bad person if you upset that person or leave them waiting or say you can’t do it? Is that actually true?

[00:13:13] Rachel: And actually, if they did think badly of you, so what? What does it actually matter? Start to question some of those deeply internalised thoughts and beliefs that we’ve got. And then you can think to yourself, in my gut, what is it that I know? If I’m honest with myself, what is it about this that I’m just trying to avoid some short term hurt? If I’m really honest with myself, where am I just lacking courage to really address what needs to be addressed?

[00:13:38] Rachel: Now there are of course mistakes that we can make in all of this. Firstly is just not picking our battles properly. Not everything needs to be addressed. Some stuff we can just let go. Not every behaviour needs to be challenged, alright? So some people we know are really prickly, they call everyone out on everything and that can just be a little bit wary and doesn’t particularly help the psychological safety it has to be said because you’re constantly second guessing if you’ve offended them. So don’t be that person who calls everyone out on everything. Just give people some grace and some leeway.

[00:14:07] Rachel: But secondly, don’t be that wet doormat that’s constantly giving people leeway because it doesn’t matter. Because some things really, really do matter. In fact, I was speaking to someone just now and she’s a very senior leader in healthcare and she said that recently she’d said no to her manager. And she’d really dreaded doing it, but her manager stopped and he congratulated her. He said, well done. He said, I’ve never ever heard you say no before. Well done, I congratulate you, she wasn’t expecting that. We overestimate the consequences of doing it, so start to say no and practice saying no.

[00:14:40] Rachel: Say no to little things like, do you want a cup of tea? No thank you. Or, would you like to come to this thing? No thank you, rather than fudging it, or I might, or let me check, or whatever. If you want to say no, say no and practice it.

[00:14:52] Rachel: And the final mistake we make, and I think a lot of us in healthcare make this mistake is thinking people are going to thank you for it.

[00:15:00] Rachel: Last year, I bought myself a robot hoover. I was getting sick of piles of crumbs in my kitchen because for some reason my family sweep up crumbs and then just leave them in a pile next to the broom. That really annoys me because it’s saying either you should do it, or maybe we just leave it for somebody else to do. It’s so selfish. I’m like, if you’re going to sweep the crumbs up, then put them in the dustpan and brush and put them in the bin. But they’re constantly just piles all over the kitchen.

[00:15:25] Rachel: Now, I had given some very robust feedback about these crumbs several times, but nobody was taking any notice of me. So I did a zone of power, thought what is in my control about this? I consulted with some friends who told me they had bought a robot hoover and it had changed their life.

[00:15:38] Rachel: So the next day I purchased Brian, my robot hoover, and I love Brian. He’s the only thing in my house that does what I ask them to do and doesn’t answer back. Anyway, Brian lives in my cupboard and the other day, Brian had been out sweeping the hallway, sweeping the kitchen floor, and um, he makes quite a lot of noise. And suddenly I realised that Brian wasn’t making any noise anymore.

[00:15:59] Rachel: So I went and looked for Brian because he wasn’t back at his base. He’s quite a clever little thing. He’ll pootle around the kitchen, he’ll sweep up. But when he’s full or out of battery, he’ll go back to his base and they’ll suck all the dust out of him and he’ll recharge himself. But it wasn’t his base he wasn’t pootling around and eventually I found him underneath a stool. And he was just sat there and I thought Brian what are you doing there and this electronic voice came out saying robot is out of charge please recharge the robot.

[00:16:28] Rachel: Now I love Brian and I’m very grateful to him for what he does for me. But did I say to him, Oh, Brian, you poor thing, you’re out of charge. Let me take you back. No, I was like, Brian, why have you gone out of charge? That was ridiculous. What’s the point of you if you’re just going to stop and not do your job? You know you need to charge, so I picked him up, put him back on his base and made him charge before he went out again. Brian had malfunctioned.

[00:16:54] Rachel: Now we have sort of the opposite mindset, don’t we? Oh, you’ve been so helpful, you’ve been working so hard that you’ve not been looking after yourself. Well, what a saint you are, you’re always doing stuff for other people. We know that if you make mistakes when you’re burnt out, you’re not going to be given any leniency.

[00:17:11] Rachel: There’s been some very high profile cases of doctors who didn’t have enough support, who’d been working too long, where something had happened and nobody said to them, Oh, well, you know, well done. You’re such a hero because you kept going and we’ll let you off that big mistake you made. No, that doesn’t happen. People do not thank you for the bigger problems because you’ve been a saint and put up with stuff.

[00:17:36] Rachel: No one’s going to say, Oh, you’ve lost all your doctors because you’ve been working so hard. You’re so amazing. No, they’ll say to you, what were you doing? Why wasn’t that managed properly? Why didn’t you address this much, much, much earlier when it was a much smaller problem?

[00:17:51] Rachel: And if you say, well, I didn’t want things to be awkward. I wanted to do stuff for the patients. I wanted to make sure no one was disappointed, well the response might be, there’s a lot more people disappointed now.

[00:18:01] Rachel: Nobody gets any prizes for carrying on, not setting boundaries. Nobody gets any prizes for being selfless when long term the shit hits the fan. They just don’t. People won’t be turning around and thanking you and saying, well thank you so much for sacrificing your health, for sacrificing your relationships.

[00:18:21] Rachel: They won’t. They’ll be blaming you long term, which is far worse than them blaming you short term for upsetting them or it being inconvenient, really. And I can’t emphasize this enough. This is why self care is not selfish. This is why we say put on your own oxygen mask first. It’s not because people really like you, it’s because they need you performing. They need the health service working. They need things to be okay. And if you’re not putting boundaries in, and you’re not saying no to people, and you’re just keeping on going because it’s so awkward there, you don’t want to disappoint people, you will end up disappointing people far more in the long run.

[00:18:57] Rachel: That’s why, um, one of my favourite podcasters, Glennon Doyle, says, if you have the choice about disappointing yourself or disappointing other people, disappoint other people every time. Because if you disappoint yourself, you’re guaranteed to disappoint other people long term.

[00:19:13] Rachel: And this all stems from not choosing what kind of problem we want. So often we choose that, I’d rather have the long term problems then, then actually deal with this short term discomfort I feel, which comes from perfectionism, people pleasing, and fear of the future predicting what might happen if I address this right here and right now.

[00:19:33] Rachel: Now, that got quite heavy, but I do want to summarise by saying, number one, robot hoovers are fricking brilliant. Number two, in this life, we will have suffering. There are always problems, there are always issues, but what is in your control is which issues you want to choose. And lastly, I want to say that these sorts of things, they are a little bit like a muscle. Because when we’re avoiding stuff, what happens is our brain says, Oh, well done, you avoided that, therefore, that was the right thing to do. And you get this sort of feedback loop that avoiding it, not addressing it, that was the right thing to do.

[00:20:05] Rachel: But once you’ve started to address things, once you’ve started to set boundaries, you’ve started to say no, you’ve started to have difficult conversations, you get this other feedback loop where your brain goes, Oh, actually, that wasn’t as bad as I thought. Maybe next time. I can do it a bit better. Next time, I won’t be so upset or worried about it. It’s a skill, it takes practice, and it gets easier.

[00:20:25] Rachel: In fact, I heard about someone who dreaded asking for what they needed so much they spent a year asking for things that they knew people would say no to. I mean, it was ridiculous. He went around asking if he could sunbathe in people’s gardens. He went to Burger King, and not only did he ask for a refill of his Coke, he asked for a refill of his burger, and you know what? Half the time, people actually gave him stuff. That he never thought would happen.

[00:20:47] Rachel: So why don’t you try some little experiments this week? Work out what kind of problems you want to have, start setting boundaries, start saying no, start paying attention to the smaller problems, to those smaller problems of hurt that you can address right now and stop them coming along the line later.