The Trouble with Wellbeing

[00:00:00] Rachel: I want to talk to you today about the trouble with wellbeing and why I don’t think we should focus on wellbeing as our

[00:00:06] Rachel: goal.

[00:00:08] 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.

[00:00:36] Rachel: Now, a few years ago I was really stressed and bored in my job. Now that’s a really, really bad combination, but I felt really trapped, I didn’t know what else I could do. I was working as a Portfolio GP, I was also specialising in medical education, but I decided that I wanted to do something a little bit different because I felt that I wasn’t learning and growing in any way at all.

[00:00:57] Rachel: And I distinctly remember being up in the Alps, having a think about what I wanted to do with my life and what the problem was. I was trying to do a bit of a retreat, and I was reading the poem by Mary Oliver called The Summer’s Day. And many of you will have heard of the poem, especially the last line. And that line goes, Tell me, what is it that you plan to do with your one wild and precious life?

[00:01:21] Rachel: And as I read that, I looked around me at the beautiful surroundings in the Alps. I also was looking at the people that I was there on retreat with. Now, a lot of them were people who had moved their businesses to the Alps. And so they were going skiing in the morning or hiking, and they’d work in the afternoon or vice versa. And I was thinking, wow, that’s such an amazing thing to do, but I can’t do that. I have no choice about that. I’m stuck in Cambridge. I’ve got three kids at school. My other half runs a business in Cambridge. What can I do? I can’t choose to move out here. And then I suddenly realised, well, I could move there if I wanted to. I could choose to move there if I wanted to. I could probably get a job in a bar or something. But then I’d be choosing to leave my family and choosing to disrupt them. So that wasn’t what I was going to choose. But it was still a choice.

[00:02:08] Rachel: And I realised that I could choose to live a wild and precious life, even on a Monday morning. And I wondered, was that possible even in the life I was currently living, even in my current work?

[00:02:21] Rachel: You see, all our lives we’ve had this success story that hard work leads to success, leads to happiness, haven’t we? And so when the workload builds up and up and up, we just work harder and harder and harder. But unfortunately, that success story doesn’t work for us anymore, particularly when there is unlimited demand. So the harder you work, the more stuff just comes in. It’s never ending like a hamster on that proverbial wheel.

[00:02:45] Rachel: So working hard isn’t the answer to having a wild and precious life. Nor is having these fantasies about sort of going and living somewhere completely different. Because unfortunately, the thing I’ve realized is you take yourself with you.

[00:02:57] Rachel: But I am convinced that there is a way to have a wild and precious life even in the life You’re in even the job that you’re in right now And part of that is feeling well, is feeling alive, is feeling like I’m physically fit, like I’m mentally fit, like I can cope with stuff and I’m actually enjoying myself.

[00:03:18] Rachel: I think for a lot of people at the moment, the joy has just gone out of life. The joy has gone out of our job. Now, I think that is absolutely disastrous. Firstly, because you spend so much time at work, please, we need to be at least liking what we do, even if we don’t love it. But secondly, we know that there is another success story, and this has been proven time and time again by positive psychology, which is that it’s happiness that leads to productivity, that leads to success, not hard work.

[00:03:48] Rachel: So if we’re in a job where we’re not happy, we’re not feeling well, we’re not at our best and we’re just miserable, well, that is not going to lead to success in any way, shape or form, and it makes us feel miserable. And it certainly won’t mean that we can have our one wild and precious life.

[00:04:03] Rachel: And side note, I like that phrase wild and precious life so much that that’s what I call my organization. I call it Wild Monday after that aspiration of having a wild and precious life, even on a Monday morning, even in the life that we still live.

[00:04:18] Rachel: So then the question is, how do we do that? And many of us think, well, okay, I just need to feel better. And we know that lots and lots of people are leaving their jobs in health and social care and other really high stakes, high stress jobs because of the impact of the job on their wellbeing. And there’s been lots and lots of studies that prove that people are leaving because they don’t like the stress, they don’t like the burnout, obviously, and their jobs impacting their work life balance so much.

[00:04:44] Rachel: So as a consequence, we think, well, okay, if people are leaving because of the impact on their wellbeing and I’m not feeling great, then what I need to do is really, really focus on my wellbeing. If we teach other people how to keep themselves well, then everything’s going to be okay. The problem is it is not. Because the trouble with wellbeing is that it’s not that we don’t know what we need to do to keep ourselves fit and mentally healthy. The problem is we just don’t have the time to do it. And we’re so exhausted and knackered that often wellbeing just feels like another thing on our list of jobs to do.

[00:05:20] Rachel: I remember when I first started going to other organisations apart from healthcare to teach resilience and wellbeing. I started off with a lunchtime group of lawyers. And so it was women in law and they were having this sort of lunchtime networking meeting. And I was talking to them about wellbeing. So I thought, well, I’m a GP. I’ve got a background in education. I’ve trained as a coach. Let’s talk to people about wellbeing. and even though they, they liked what I was saying, I was just feeling that something wasn’t landing right. And I was getting all these sort of looks and I could see people whispering to each other and I stopped and I said that, hang on a sec, I, I can sense here that there’s something slightly wrong in the room here, that, that this isn’t landing, what’s the issue?

[00:05:59] Rachel: And they said, well, Rachel, you’re talking about doing these things to keep ourselves well. We have no time. They said, we are expected to reply to an email from our boss within 30 seconds. I was gobsmacked. I’ve never come across that before. 30 seconds. No wonder their wellbeing was plummeting. Because if you’ve got that much work pressure on you and that much expectation, what are you going to do? You’re just going to focus on the work and you’re not going to prioritize those things you need to do to keep yourself fit and well.

[00:06:27] Rachel: So if you don’t have time, you can’t keep yourself well with the best will in the world. I can’t run a 10k race in 10 minutes. Well, I don’t think I could ever run it anyway, but you get my gist. Wellbeing actually takes time. Things that we need to do to connect with other people, to keep ourselves fit, to actually rest. You can’t do that in two minutes, you really can’t. And that’s actually good news because in my mind the wellbeing factors and we’ve talked about those a lot on other podcasts, but those are the things that actually make life worth living. So if you don’t have time, you are never going to be able to do those things that you know you need to do.

[00:07:04] Rachel: So then the question is, so why don’t we just start teaching people time management, right? Let’s teach everyone time management, then they’ll be fine. And yes, in a way that is right. So we can teach you all about how to manage your time, but then you’ve got the problem because if you’ve got this unlimited demand, And you’ve got a limited amount of time because we all have a limited amount of time, you know, maximum 24 hours in the day, we’re all human, but lots of us don’t have that much time at work because we’re so busy doing this. And then you’ve got this to do as well. So we cannot expand time. We are not Hermione Granger with her time turner.

[00:07:39] Rachel: So if we don’t have time, all the efficiency and productivity teaching in the world is not going to buy us much extra time. It can buy you a little extra time. I know that I can procrastinate. I can focus on the wrong things, but even when I’m focusing on the right stuff, there’s still too much to do. I’ve still got a to do list as long as my arm and it feels like I will never ever get to the bottom of it.

[00:08:03] Rachel: So instead of teaching people how to manage time, which is actually impossible, we can’t manage time because that’s out of our control, we need to start teaching people to limit what they do, to focus on those things that are their top priorities, the really, really important stuff. So powerful prioritization is really, really important here.

[00:08:24] Rachel: Now, I know that a lot of you will be thinking, well, in my work, absolutely everything is important. And yeah, I agree. But I think you’ll find if you were given half an hour to do a whole load of stuff, you would very soon realize what the most important things are. And when we use the prioritization grid, the urgent important matrix, we can soon see that quite a lot of the stuff that seems important to us, isn’t really important to us, it’s just urgent to other people.

[00:08:52] Rachel: So when we’ve identified what we think we need to prioritize, what’s the really really important stuff for us to do, we then need to focus on that and not do everything else. Now that’s a problem isn’t it? I love prioritizing, I love making a list of things that I am going to focus on. But when it really hits the fan is when someone else wants me to do something else and I feel a little bit guilty and suddenly, with the best one in the world, it all goes to pot and I’m no longer focusing on the stuff I decided to focus on, I’m trying to fit in stuff for other people because I feel so bad about saying no.

[00:09:29] Rachel: It’s wonderful to say yes, but with every yes comes a no to something else. And this is what setting boundaries is about. There’s lots of stuff that come at us in healthcare that, not really our job, we shouldn’t be doing it, we’re not paid to do it. There’s lots of stuff that come at us in our job that actually somebody else could do, an administrator could do, but actually we don’t have the, the staff there to do it so we end up doing it ourselves, but it’s not the most important thing for us to do.

[00:09:57] Rachel: So prioritizing powerfully is so, so important because then we will be able to start to get our time back. We’ll start to have a manageable workload in the time we’ve got available. And that manageable workload means that we will also have time outside of our work to do those things that we need for wellbeing.

[00:10:20] Rachel: And it’s not just outside our work, it’s inside our work, like taking lunch breaks, like taking short breaks, like connecting with our colleagues, all of which are vital for wellbeing, but also for our performance. Because we know that team performance improves with the higher amount of informal connections that you have. We know that your own productivity will improve when you are able to take a break and recharge. And we know that your creativity will be far, far higher if your brain has just had a chance to switch off.

[00:10:48] Rachel: So we need to be able to prioritize powerfully, which means we say no to stuff and we set boundaries. So that’s simple, isn’t it? Say no, set boundaries. Of course it’s not, because that is the nub of it. That’s what everyone finds so, so hard to do. Saying no to people, letting people down, dumping on our colleagues, not doing what everyone else expects or requires us to do, that’s really difficult. And it’s really difficult letting ourselves down knowing that I’m never going to get to the bottom of my to do list. That makes me feel like I’m possibly not good enough either.

[00:11:23] Rachel: But we talked about this many, many times on the podcast. It’s not a problem with setting boundaries or prioritization. The problem we have is the mindset needed to hold our boundaries, to hold our no in the face of pushback, in the face of feeling guilty, in the face of feeling not good enough. Particularly with perfectionists, we want to be able to do everything at an incredibly high standard and get to the end of our to do list. Well, we suddenly go to, well, I’m not good enough. And then we feel shame.

[00:11:52] Rachel: Or there’s the fear, fear of what other people are going to think of us. Perhaps we’ll be kicked out of the tribe or would be criticized or get a complaint. All of this stops us from setting boundaries and limits around our work so that we can keep ourselves well, so that we can create a manageable workload, so that we can attend to the wellbeing factors which keep us well.

[00:12:15] Rachel: So you can see if we start with wellbeing, we’re going to lose. If we start with the mindset change, with the way that we think differently about our work, in order to protect our time and energy, we will end up with wellbeing because we’ll have the time and space to do it.

[00:12:33] Rachel: And believe me, you guys know what to do. You know, there’s huge amounts of podcasts out there. Uh, you know, if I gave you 10 minutes to write down a list of all the things that you know you need to do to keep yourself fit and well, you’d soon be able to write me a brilliant, brilliant list.

[00:12:47] Rachel: Now it sounds simple, doesn’t it? But, but it’s really not. And this is where organizations get it totally wrong. They talk about wellbeing to people. They try and teach people wellbeing. And people just say, well, you know what? I haven’t got any time and it’s because of the work that you’re giving me means that I can’t keep myself well. So other people just get so cynical when organizations try and teach them wellbeing. It’s why wellbeing initiatives often fail.

[00:13:09] Rachel: And also with these wellbeing initiatives that put into organizations, they require time, don’t they? They require you to take yourself to a webinar or to a, an event and actually listen. And the organizations don’t give you time or they make you take an annual leave or they make you do it in the evenings. And so you just get more and more resentful about being forced to listen to talks about wellbeing when actually the job is so difficult. And unless you’re working all hours, God sends, you can’t actually do the job. So you get a huge amount of resentment if you start with wellbeing. And if you give people the wrong intervention.

[00:13:44] Rachel: It just keeps people stuck. It just keeps people thinking, well, I’ve tried the wellbeing stuff, but actually things aren’t really getting better. So, so why don’t I feel any better? Because they might’ve tried to fit some exercise into their day, but they failed after a couple of weeks because they’ve just got too much work to do and everyone starts blaming each other.

[00:14:03] Rachel: People say, well, it’s the organization’s fault and the organization says, well, we’ve put on this stuff for you. Why don’t you just keep yourself fitter and healthier? And then you just say, well, look what you’re expecting me to do. How on earth am I expected to do that? And wellbeing just becomes another thing on your to do list, which you feel guilty about. When you get this right, you do get better outcomes with less effort, less resources. You get an empowered team and empowered workforce, and actually all areas of your life improve.

[00:14:29] Rachel: So what should we do about this? Well firstly I want to talk about the organisation. We need to make jobs better. There’s a lovely quote by um, Friedrich Herzberg. He did a lot of work around motivation in the 1960s and a brilliant quote from him that I love is Forget punishment, forget cash, You need to make their jobs more interesting.

[00:14:47] Rachel: Amen to that. And if you just use that quote and change the last word, what would you put in there? Forget punishment, forget cash, you just need to make their jobs more what? Doable? Manageable? Enjoyable? Any of those. So yes, the organization has a massive responsibility to look at the demands they’re placing on people, to look at the resources they have.

[00:15:08] Rachel: Unfortunately, that’s way above my pay grade. I’m talking about the individual and teams, okay, so there are people looking to change the system right now and that is fantastic,. and you know, there’s all sorts of things going on to try and look at this. But while we are working in a complex stressed out healthcare system, while you’re choosing to work there, there are things that you can do yourself to protect your time and energy.

[00:15:32] Rachel: And I do just want to say that if you are someone who has a lot of resilient skills and all these are skills productivity skills, boundary skills, you know mindset skills, but you are working in organization which is really really toxic and the leadership just does not get it and they’re constantly over demanding, not listening, and it’s a really awful culture, then you may need to leave. Because no matter how resilient you are, if you’re put in a culture like that, most people will burn out.

[00:16:00] Rachel: But in today’s difficult world, if you don’t have those skills, no matter how good an organization you’re in, you’re also going to find things tough. So there are lots of things that we can do ourselves.

[00:16:11] Rachel: So this is called the performance pressure curve. And this is something that I find incredibly useful just to describe what’s going on. So you’ve got pressure along the x axis and performance along the y axis. And if you just imagine a line going from 0 and going diagonally upwards, well, that’s what happens to your performance under increasing pressure.

[00:16:30] Rachel: To start off with, we all need a bit of pressure to perform, so your performance will start to go up. But after a while, it will start to plateau. And then, unfortunately, rather than carrying on going up, it will start to go down. And very soon, you’re really heading down the curve, you’re not performing well and you may well be in burnout.

[00:16:49] Rachel: So you’ve got these four different areas. Number one, pressure is not high enough to perform. Yeah, I need a deadline to get anything done. You’ve got area two, pressure is just right to perform. That’s your peak performance zone. Number three is where you’re just starting to slip off the curve. And number four is where you may well be becoming ill. You’re affecting other people with your lack of performance. So we’ve got these four different areas.

[00:17:13] Rachel: Now, the zone that we’re aiming for is right up here, is between two and three in the performance zone. And in fact, you’re probably better to be further to the left so that you’ve got a bit of a buffer, you know, you’re going to be performing really, really well before the pressure gets too much and you start to slip down the curve.

[00:17:31] Rachel: Now we all know why we start to slip down the curve because our brains just can’t cope with too much pressure. We become overwhelmed. We can’t think straight. We stop looking after ourselves, lack of sleep, all that sort of stuff. The performance goes down. And we know that there are things that will shift us along that curve to area three and four. The first one is, well, that’s unlimited demand and demands from the organization. We are not in control of that. That is just stuff that’s going on. There will always be people who need you. There will always be more and more patients who need help, okay? That is unlimited in the NHS.

[00:18:07] Rachel: But there are things that we do ourselves to push us along the curve, to make things worse like getting stuck in the urgency trap. That is just firefighting the really urgent stuff all the time and not focusing on the things that we really need to do because we feel so bad. And we tell ourselves, I should, well, I should do that. I should rescue my team. I should help out there. I can’t possibly say no.

[00:18:33] Rachel: The other thing that pushes us along is over responsibility, feeling responsible for everything and everybody. That’s what happens because we’re good people. We like to help people but we feel everything’s our problem and when no one else does it, we just think we’ve got to do it. And even stuff that is outside our control, that we can’t possibly influence or do anything about, we feel guilty for. We also start to rescue people, particularly if you’re a leader and your team are overwhelmed, you take on their work and do it too. So those four things will push us along the curve, will push us into higher pressure, which means we slip down the curve.

[00:19:08] Rachel: The other thing that does this as well though, is avoiding conflict, avoiding those really difficult conversations that we know we need to have because we’re so frightened of this short term discomfort when that happens. So our short term discomfort and conflict avoidance, even though we know that long term we really need to do it and if we don’t do it, it makes things worse. It causes more pressure. We just have underperforming members of our team and again it pushes us along the curve.

[00:19:36] Rachel: And so the things that we can do ourselves is learn to think differently. Okay. So change some of those mindsets. We can learn to say no to stuff, which will keep us back in our performance zone. And part of that is setting boundaries, which means you cannot be everything to everybody. That is why boundaries are so important. And it’s so important that we just protect this zone. We protect this performance zone here. That’s where we’re going to get a happy and a thriving team.

[00:20:08] Rachel: So we can do that by reducing the external pressure. Well, we’re not in control of that. Organizations have to look at how they do that. But we can reduce the internal pressure and change the way we think about these things.

[00:20:19] Rachel: We also need to absolutely 100 percent protect our time and energy and stay in that performance zone. And there were three main ways that we can do this. And this is what we need to be, learning ourselves and teaching our teams rather than focusing on just wellbeing initiatives that tell you how to do more exercise in a week.

[00:20:40] Rachel: The first one is control. Work out what you’re in control of and what you’re not in control of, because that will limit the amount of pressure because the stuff you can’t control, you’ve just got to leave. And we talk about the zone of power all the time and I’ll pop a zone of power handout in the show notes so you could have a look at how to work out what’s in your control and what’s not. We should only focus on the stuff that’s in our control.

[00:21:01] Rachel: Secondly, there is so much stuff in our control. There’s a lot of stuff we could do about stuff, but we can’t do everything. So we need to decide what we’re going to prioritize. We need to prioritize powerfully and protect that stuff that we have decided to do. That is in our capacity. There’s lots of stuff that’s in our control that we don’t have capacity to do, but whatever’s in our capacity that is in our performance zone, we’re going to stick with that and not feel guilty and bad about everything else is outside our capacity, outside the performance zone, outside the thing that we have decided to do.

[00:21:32] Rachel: That involves not only choosing what we’re going to do, but getting the mindset right to be able to tolerate the discomfort of people maybe being a bit upset when we say no. People maybe feeling that we’re dumping on them. And patients may be not getting 100 percent what they need. Now, I’m not talking about patient safety issues. I’m not talking about saying no when someone might die. If that’s the case, do something different. I’m talking about these other things. There’s other reasons why we don’t set boundaries and it’s mostly not because it would cause patient harm.

[00:22:03] Rachel: But then finally, we need the skills to do all this, right? This is actually a skill, this stuff. Saying no is a skill. We’re humans. We have interactions with other humans. In order to stop rescuing, we need to learn how to take a much more coaching approach to help other people solve their own problems. So being human, having difficult conversations, taking a coaching approach, working out what you’re going to prioritise, working out how to say no and set boundaries, these are all human skills and this is what we need to be teaching and learning both ourselves, that we need to be enabling our teams to do this. And these are the interventions that work in organisations.

[00:22:42] Rachel: And we’ve been doing this for several years with our Shapes Toolkit because we recognise that it does not start with wellbeing, you’ve got to start with choice and control. You’ve got to start with thinking differently and you’ve got to give the people the skills to do this.

[00:22:56] Rachel: And also, you’ve got to aim at your managers and your leaders, so this gets disseminated throughout the organisation, plus the managers and leaders, they’re the people that are burning out the most.

[00:23:07] Rachel: And then the obvious stuff is you’ve got to give people enough time to do it. So if you’re in an organisation, build this into your meetings. Give people protected learning time to do all this stuff. Give them short bite sized stuff. Give them podcasts that they can listen to while they’re walking the dog or on their way home. Use a credible source. Don’t use people that have never worked on the front line, they have no idea what it’s like. And avoid the words resilience and wellbeing because it just doesn’t work.

[00:23:35] Rachel: We particularly enjoy face to face stuff at the moment, the face to face one day events and conferences are really, really wonderful for building those connections. We have FrogFest, we have lots of stuff going on and we also have a conference coming up about all of this called Work Well Live, it’s on the 21st of May in London. So if you’re listening to this episode before that conference then just click on the link in the show notes to book your space. But do join our mailing list, do sign up and find out what other events we’ve got going on because this is a conversation, we haven’t got everything right and it’s not a simple solution. But we really want to change the conversation about wellbeing in the NHS. It is not just about telling people what to do. We actually have to help them change the way they think and give them the skills to do it. But we need a system to teach this. We need a system for people to learn it and get hold of it. And that is where our Shape System comes in. So if you’re interested in any of this, come and let us know. We also cover so much of this on the podcast. So look at previous podcasts that we’ve done on saying no and setting boundaries. Previous podcasts we’ve done on choice and embracing your capacity and embracing your limits.

[00:24:44] Rachel: Let’s get this right. So you need to look at what you can do yourself which involves choosing, which involves setting boundaries and tolerating the consequences of doing that and getting some skills.

[00:24:57] Rachel: And finally, protecting your time, managing your energy and embracing your finite capacity, these are the things, these are the things I think that you need to do to have a one wild and precious life. And the reason it’s so important is not just so that you feel better, I’d love that, but actually it’s so that you get better outcomes.

[00:25:21] Rachel: Because think about the question, who suffers when I’m not thriving? Well, it’s not just me, believe me. It’s my family, it’s my friends, and it’s the people I work with. It’s my clients, it’s the patients, all that, all those people suffer when I’m not thriving. So you thriving, you protecting your time, managing your energy and embracing your capacity is about you having a great impact and influence on other people. This is for that. It’s not just for you. It’s for other people too.

[00:25:50] Rachel: So we’d love you to join us at any of our face to face, beat stress and Thrive, Leapfrog Career drays. or Work Well Live programs. There’s loads of other stuff we’ve got going on. Come and join us and join the conversation. Join the movement of people who want to live a wild and precious life, even on a Monday morning, even in their current job.