“At work and in life, in the final analysis, we all want the same things; we want to be happy with who we are and what we are doing in this world.”
– Dr. Frank Gabrin
When we lose it at work
It was insane at work this week. So busy and the patients were so sick! One night when I arrived, we were working a couple of nurses short and the staff was complaining about everything and anything. You know the standard greeting- Turn around and call off while you still can! It’s bad. it’s really bad. I smiled, put my things down, logged onto the computer system and wow! They weren’t kidding! It looked awful!
I grabbed a few charts and got busy trying to put a dent in the workload that lay ahead of us. Soon however, I started sounding just like my staff. I began to complain and added my voice to the choir singing about the negativity in our environment. They just keep coming! Look how they are backing up in the waiting room. We have no rooms to put them in. Another squad, really? And then the police showed up with a belligerent, loud, aggressive and threatening patient. Our modern day equivalent of the saber tooted tiger. This patient was high as a kite on drugs and my crackerjack staff bent the rules, the very rules that are designed to support us when the department is stressed and overburdened and I “lost it!” I lost my temper! I was ticked off and livid! I was so mad I scared myself!
Why do we lose it?
Why does this happen to any of us? Why do any of us lose it? Most of the time it is because we are not getting our way, things are not going our way or, we are not getting what we want. I was acting like a two year old having a temper tantrum. This was not the me that I want to be. Worse yet, I’d just written a book (Back from Burnout) about creating happiness and satisfaction for ourselves and others at work and in life. Clearly, I was not following my own advice. I was not walking my talk.
So what exactly happened to me that night? I was emotionally highjacked! But how did I LET THIS HAPPEN? It’s because I was being careless with myself. I was not paying attention to my own thoughts. Instead I was on autopilot and not mindful. It was because I was not being consciously aware of what was going on inside me that as a result, I allowed myself to default (on my self-responsibility—) and let my human physiology, my animal like neuroanatomy and neurochemistry, run the show. Because of this I reacted automatically rather than having made the conscious choice to formulate a conscious, thinking and caring response.
Our uniquely human hardwiring
To understand why this happens to us, we can take a look at our uniquely human hard wiring and and overlying operating systems. There are basic “physiologic programs” running just under our conscious awareness which are built into our human physiology. These are necessary because our physical five-sense system brings our brain way too much information for our brains to process and interpret without them.
As nothing is more important to any organism than its own survival, it makes sense that all of this sensory information comes directly and indirectly into one of the oldest and ancient primordial parts of the brain: the amygdala, a tiny piece of our brain, about the size of an almond. The primary function of the amygdala is to sort through all of that sensory information coming into the brain, looking for anything in our immediate environment that might harm us. It is a danger detector and it functions much like the robot on the old TV series lost in space: Danger! Danger, Will Robinson!
The amygdala is part of the limbic system, which is considered to be our reactive and feeling brain. While our cerebral cortex, the prefrontal and frontal lobes, are often referred to as our thinking brain, in contrast, our limbic system is responsible for the emotional experience of our lives. Good and bad.
This tiny and ancient piece of our neuroanatomy is in constant and close communication with our five senses and our internal organs, including our adrenal glands. It’s responsible for the dry mouth, rapid heart rate and tense muscles in our freeze-fight-or-flee responses to danger. This system is also physically responsible for our physiologic, autopilot, emotional reactions in our interpersonal encounters with others.
In our modern high tech world, this internal automatic system of ours is responsible for our feeling stressed. This is why I lost my temper. This is why we all loose our composure. While necessary in situations of actual physical danger, this ancient piece of our present day neuroanatomical physiology does not always operate in our best interests, especially when our challenges and choices are more complex than fighting, fleeing or freezing in reaction to the danger of a saber-toothed tiger that just entered the department with the police.
At work, when the volume and the acuity of patients are high, we are short staffed and the challenges seem to be getting steeper and more cumbersome, we can start to physically feel the stress of our environment because of the biochemicals that flood our system as a result of our amygdala and limbic system’s interpretation of the environment as dangerous. When we are so hyper-stimulated by our environment, we often start to feel like we are losing control.
Under conditions like these, our limbic system is hyper active-ated and we can find it oh so difficult to “keep it together.” This process is automatic, physiologic, biological and mammalian. Modern-day stressors activate the system, and cortisol, adrenalin and other chatecholamines are generated. When the amount of stress reaches a critical point, even the smallest challenge can trigger an automatic reaction, an amygdala reaction, a knee-jerk reaction, where instead of caring for those around us, we react like a jerk.
This automatic, physiologic process, running just under our conscious awareness, is human and none of us are immune to it. Social scientists in the past decade have named this process emotional hijacking. The reality is that we are constantly being hijacked by our own physiology. A piece of our brain that is about the size and shape of an almond is working against us and our efforts to be better, do better and feel better. The high catecholamine states generated by our amygdala actually diminish function of the higher cortex, where the power of our free will and “con-science” resides.
This is precisely why I consistently need to remember and use the R.E.F.L.E.C.T. format I developed so I can wake myself up, stay conscious, stay in control, and engage my free will so that I do not allow my automatic physiology to take me over: Remember why I came here and what I want. Earn my satisfaction, Formulate my plan and free myself from agenda, Look to see if I am the cause of something better or the effect of another’s bad mood or situation, Evaluate my success- am I creating satisfaction? If not, Circle Back to the beginning and apply the steps again. Take Care of myself.
Practicing our seven-step framework is not, let me repeat, IS NOT a natural or automatic thing; it takes real effort. Having a knee-jerk reaction, losing our temper or engaging in any of the negative behaviors that go along with it—complaining, avoiding others, judging others, feeling entitled, gossiping, manipulating—ALL OF THAT is automatic. Falling into one of those reactions requires no conscious effort and does not really engage our power to choose, to exercise our free will.
In our day to day, we are not in a position to control our environment or the amount of stress it will induce in us. The only control we do have, if we are looking for happiness, satisfaction or fulfillment in our jobs and lives, is the ability to control our own thoughts and behaviors.
The reason heroic effort is required to put our R.E.F.L.E.C.T. framework into practice is that it pushes us against and beyond our nature, our automatic operating system and hard wiring; our physiology. Executing the framework successfully requires us to use our free will by using the thoughts in our mind, using our conscious awareness to change the chemistry in our frontal and prefrontal cortex.
The downfall of complaining
The opening for my emotional hijacking the other night happened when I allowed myself to complain. If we want to live the high life that I talk about in the book, Back from Burnout, we can never indulge in our natural desire to complain. Complaining is automatic, and requires no conscious effort on our part. Complaining, however, has to be against our personal set of rules if we want to do better, live better and be better.
Complaining actually engages our amygdala and limbic system…… complaining turns the system on and makes it even more hyper-vigilant. Whenever we feel the urge to complain, we should already realize that we are in deep, deep, trouble and apply the first step of the R.E.F.L.E.C.T. process; Why did I come here and what do I want?
We all want to feel good; good about who we are and good about what we are doing in our world. Complaining creates a reality for us that is in direct opposition to our goals and desires. Complaining makes us and those around us feel bad. When we feel the urge to complain, there is a way to use the thoughts in our mind to change the chemistry in our brains and our bodies. Just by stopping and remembering what we really want, we can then choose, by using our free will, to turn the complaining upside down and begin to be constantly on the lookout for the good.
Activate with a smile
Simply forcing a smile on our face will start the brain about the task of creating feel good neurotransmitters called endorphins. If you have to, put a pencil in your mouth. It will force a smile and keep you from speaking your complaints. There is always a duality in every reality we face. Everywhere we look there is both good, and bad. The reality we are facing is actually neutral, and our experience of that reality depends solely on what we choose to connect with; the good or the bad. The trick is to look past the negativity, the problems, the chaos and find what is good, wholesome and pure. We can choose to focus and to attach ourselves and our energies to what is good.
Our personal choice to extract the good from our environment is not an easy choice, it is a difficult and even sometimes painful choice. Without using our free will to make this choice to get what we came here for, we will automatically see and connect with the bad and we will complain and lament to all around us This will strengthen the bad and amplify our misery, our discontent will grow as our lack of satisfaction expands. Compassion fatigue will set in and slowly progress to the emotionally dysfunctional state of professional burnout.
See the good
Our brain, our physiology, our amygdala and limbic system will automatically connect with what is negative, dark and dangerous. The only way out of this operating system is to know that there is always good right in front of us, in every situation, and to make the effort to see the good, connect with the good, enhance and amplify the good, so that we can do good, be good and feel good. This is our only opportunity to “do it” differently. This is what keeps me going. This is how I used my last emotional hijacking to reconnect myself back to what I really want from myself.
When we make the choice to extract the good from every situation then our experience of our reality changes and we see and experience only the good. We do not need to fight against the negativity of those around us, we need only feed and add our energies to what is already good in others. In other words, if you want the darkness in a room to disappear, all you have to do is turn on the light! Do what’s right. Care and share. Go the extra mile. Be extra-ordinary. Pick up the litter or clean up the mess in the break room. Smile instead of scowl. Give someone a pat on the back, tell them what a great job you think they are doing under these circumstances.
When times are challenging and we are working so hard and nothing is happening, when we can’t seem to rise above the chaos and the pain, it is our human nature, our automatic physiology, to become frustrated, angry and complain, to become a victim. But if we really want to change our negative experience of life. If we really want to come back from burnout. If we really want to live the high life, we have to feel all these automatic human emotions and take responsibility for revealing our potential through our god given gift of free will and find a way to connect to the good….. ANYWAY!
It is our job in every encounter to find the good, grab onto it, hold onto it, and then milk it for all it’s worth, squeeze every last drop of goodness out of the situation until we can walk away with a smile on our face. This is what will generate our personal satisfaction and fulfillment. This is what will create satisfaction for others. This is our only hope and our only choice: To remember when we are confronted with the negativity and everything seems bad, that the good is there too and it is our job to extract it, amplify it, expand it and enhance it until it outshines the darkness.
This is how we can reconnect to our initial pure uncorrupted desire to care and make a difference, to ease the suffering, calm the pain and make things better for another. This is how we can create quantum levels of personal and professional satisfaction and fulfillment for ourselves and those we care for. This is how we can get what we really want!
“The true secret to high performance and satisfaction—at work, at school, and at home—does not lie in external rewards. It is based on the deep human need to direct our own lives (autonomy), to learn and create new things (mastery), and to do better by ourselves and our world (purpose)!”
– Daniel Pink, Author of Drive
Remember why you came here in the first place! Remember what you want! Connect with your primary mission to care. Understand that our coming back from burnout is dependent on realizing that nothing about our reality is going to change- it is going to be exactly the same. What is going to change is the way we perceive, work with and deal with it.
We will have to take on the mantle of responsibility to use our ability to see our reality in a different way. Until we can learn to do this consistently we will never be able to feel satisfied, happy or complete.
Nothing will ever be ideal or perfect. We know that no matter what the circumstance, there is the potential to feel good at the end of every encounter. Taking responsibility for revealing our potential, to use our free will, to make the conscious choice, to earn our satisfaction for ourselves, to reveal our potential to create what we want, by using the R.E.F.L.E.C.T. framework to see it differently, we can work with it differently and choose to make things different and better for ourselves and others.
This is how we change our experience of life. This is how we feel our own power. This is how we create meaning and significance. This is the way back from burnout. This is real liberty, and the freedom to pursue happiness. This is the high life.
Care, Make a difference and change (y)our world!
Frank D. Gabrin, D.O