Volume 3, No.6
In this issue
SAVVY- SKILLS | SOUL
David Mee-Lee M.D.
Welcome to the October/November edition of TIPS and TOPICS. Summer vacation time usually means a combined edition of TIPS and TOPICS. So what’s the excuse for skipping a month now? Well around our place we have been in summer mode again. With extended family visiting from Australia, we’ve taken time to hike in Yosemite, show off California sights and sounds, and generally enjoy family conversation.
Therefore I have tried to practice what I always preach about striking the right balance between work, love and play. I set aside my sense of duty to produce a monthly newsletter, and put family first. (It also helped me to remember that this is a free publication anyway, so you have to put up with my time schedule—sorry, but you get what you pay for!)
It is now a cliché to say: “The only thing that will not change is that there will always be change.” Whether that is adjusting to budget cuts, layoffs, a new boss, new job or a new policy, most everyone it seems is in survival mode. So when I was asked to do a workshop on “How to Survive Integration Implementation” (a workshop about coping with implementing county-wide integration of mental health and addiction services) that resonated with what many people are experiencing—just trying to survive.
I subsequently received another message from the training committee. They asked me to modify the title to “How to Survive and Thrive During Integration Implementation“. That got me thinking. Yes, it isn’t just about surviving. Could people actually thrive while adjusting to change? Could change, crisis and turmoil actually be an opportunity to grow and thrive versus staying stuck in victim-role, trying to keep one’s head above water?
Here are some tips that might inspire you (here’s another cliché) to turn lemons into lemonade.
- Turn frustrations into systems solutions.
Michael Gerber has had 30 years of experience working with thousands of small business owners. He has studied how technologies and people work best together to produce optimum results; how to create an organization/ business/agency which can do great things, and achieve better results than any other organization/ business/agency.
Everybody has frustrations.
Here is Gerber’s definition of frustration:
A frustrating condition is a series of specific recurring events in the business/organization/agency over which you feel you have little or no control. It is an undesirable pattern of specific events which can be eliminated by the installation of a system.
We know that frustrations happen at home as well as at work. The following suggestions can also help you thrive at home too.
There are 3 types of frustrations:
(a) A technological frustration: This is where your concern is clearly and undeniably a matter of ‘systematology.’ You are simply needing information or a system to install in order to eliminate a particular condition. This is systemic thinking. For example:
-> Problem: “I don’t know what questions to ask in an interview”
System Solution: You could create a laminated sheet containing the questions to be asked. A system is then in place.
-> Problem: “I don’t know what our census is at any given moment”
System Solution: All three programs in the agency could agree to call in each day at 9 AM to a central administrative assistant or voice mail box to report their current census. The census system is then in place.
-> Problem: “The photocopy machine keeps breaking down”
System Solution: A preventive maintenance contract can be established with a company that checks the machine monthly. A system is then in place to eliminate or minimize the technological frustration.
(b) A self-directed frustration: This is the kind of frustration that results from myself being the source of the problem at work or the frustration at home. Compare (a) & (b). A technological frustration is a reflection of “I don’t know how,” whereas a self- directed frustration reflects, “I can’t”, “I won’t” , or “I’m stuck.” For example:
Problem:“ I find it hard to balance the importance of client needs with my needs.”
Perhaps you planned an hour to catch up on paperwork and then a client knocks on your door. You respond to the client’s need to talk and feel frustrated that you are now behind on your paperwork.
Problem: “I’m too nice when it comes to conflict or disciplinary measures, sometimes contributing to the continuation of problems. I wonder whether people feel as though they got away with something.”
As a supervisor, you feel frustrated that you too readily buy peoples’ performance excuses.
Problem: “I allow myself to get distracted too easily when it comes to sticking to a schedule or getting my paperwork done. It’s easy to find excuses and put work off.”
Paperwork is no fun. It is frustrating to see the hour you set aside disappear with a much more interesting lunchtime discussion.
When you see yourself as the problem, all your energy is focusing on YOUR need to change. Gerber believes that this self-focus is basically a waste of time. It chews up your thinking and energies which are best spent on analyzing what is getting messed up. Phrased another way- how does this self- directed frustration prevent getting the results needed at your agency/organization? You can make it impossible for yourself to ask the questions necessary to create the right system when you are waiting for yourself to change. (Self-analysis has its time and place, but not here.) Deciding on action steps and taking those steps is a much more productive use of your personal resources and energy. When you get yourself out of the way, you can begin to ask productive questions such as:
Systemic Thinking: “What kind of appointment or scheduling system would allow me to be responsive to clients and also protect time for me as well?”
Systemic Thinking: “What kind of disciplinary or termination system would both give me what I need as well as be fair to my supervisees?”
Systemic Thinking: “What kind of time management or scheduling system would provide me with the least distractions, and assist me in getting my paperwork and other duties completed?”
Once you are able to ask the result-oriented questions, this directs your attention to changing the business instead of yourself. You will begin to identify options, possibilites and solutions previously obscured because of your self-directed focus.
(c) An outer-directed frustration: This occurs when you largely hold someone else or something else as accountable for an undesirable condition at work or home – i.e. “he/she/they/it can’t- -” or “he/she/they/it won’t—.” For example:
Problem: “Other professionals have unrealistic expectations of what we do at our program.”
You are frustrated when referral sources send you dual diagnosis clients your agency is not fully set up to manage yet.
Problem: “She has a negative attitude and it infects others.”
It is frustrating to have “bad apples” in the team which affects staff morale.
Problem: “The pool of counselors out there is so limited that we can’t hire qualified people.”
It is frustrating to have so few candidates from which to choose. Why aren’t more people committed to this field like in the old days?
A similar problem exists in the case of outer-directed frustrations. When you view someone or something outside as the cause of your frustration, there is the need to change something you cannot control. You cannot change people, time, the pool of counselors, the economy or when a person gets sick. You can only change those things you do have control over, namely your business. Thus while there certainly are outer-directed frustrations, it will not service your efforts to define problems or solutions in outer- directed terms. Success depends on the creation of a system designed to produce a specific result. Whenever your focus is on people, you are forever searching for extraordinary ones. When you focus on the system, you need only find people who are willing to help you build and use it.
Look at the problems stated above from Gerber’s viewpoint. The frustration we experience around others’ unrealistic expectations about our program above is viewed not as a referral source problem, but rather a management problem, a technological problem requiring a technological solution.
Do not ask yourself the question- “How can I get referral sources to be realistic about what clients they send to us?”
Ask yourself this question- “What’s missing in the structure of our business that is permitting referral sources to send us clients with whom we do not do well? What system do we need to establish that will encourage appropriate referrals, so we are not consumed with placing clients we cannot manage well?”
If you find technological solutions to people problems, you will move forward and minimize frustrations. Redefine your ‘people’ problems in technological terms, and reframe problems first as technological frustrations. Then translate your self-directed or outer-directed frustrations into a specific condition in the business you want to address. Remember these 2 important points in this process:
-> You can only change those things over which you have control – you only have control over your business. Changing the structure of your business is the only way to get what you want from it.
-> Determining what to change demands that you be willing to look very specifically at what it is about your business that is not working. What is it about your business (not your people) that generated your original self-directed or other-directed frustration? Get specific/ concrete in naming your frustration. This then will tell you how to eliminate it by transforming the frustration from a thought or feeling to a condition in the business that you can do something about.
The material above has been adapted from Gerber Business Development Corporation’s Key Frustration Process. Mailing Address: Michael Gerber, E-Myth Worldwide, 2235 Mercury Way, Suite 200, Santa Rosa, CA 95407/Corporate Offices: Phone: 800-300- 3531 or 707-569-5600 Fax: 707-569-5700
- When you find yourself clashing with another person or feeling like a victim of circumstances, turn that into an opportunity to grow – emotionally and spiritually.
Eckhart Tolle’s book “The Power of Now – A Guide to Spiritual Enlightenment” has sold over 2 million copies. Oprah Magazine stated: “It can transform your thinking—the result? More joy, right now!” Sounds like advertising hype and it is. But I found it also to be true for me. Here are a couple of quotes that may help you thrive when faced with that team member who you feel just doesn’t get it. (Or your spouse or partner too.)
*** Relationship as spiritual practice
“So whenever your relationship is not working, whenever it brings out the “madness” in you and in your partner (or team member, or client, consumer, family member etc), be glad. What was unconscious is being brought up to the light. It is an opportunity for salvation. Every moment, hold the knowing of that moment, particularly of your inner state. If there is anger, know there is anger. If there is jealousy, defensiveness, the urge to argue, the need to be right, an inner child demanding love and attention, or emotional pain of any kind – whatever it is, know the reality of that moment and hold the knowing. The relationship then becomes your sadhana, your spiritual practice. If you observe unconscious behavior in your partner, hold it in the loving embrace of your knowing so that you won’t react. Unconscious and knowing cannot coexist for long – even if the knowing is only in the other person and not in the one who is acting out the unconscious. The energy form that lies behind hostility and attack finds the presence of love absolutely intolerable. If you react at all to your partner’s unconsciousness, you become unconscious yourself. But if you then remember to know your reaction, nothing is lost.” pp. 131-132
*** Here is another another nugget when you feel you are a victim of circumstances beyond your control:
“As an alternative to dropping a negative reaction, you can make it disappear by imagining yourself becoming transparent to the external cause of the reaction. I recommend that you practice it with little, even trivial, things first. Let’s say that you are sitting quietly at home. Suddenly, there is the penetrating sound of a car alarm from across the street. Irritation arises. What is the purpose of the irritation? None whatsoever. Why did you create it? You didn’t. The mind did. It was totally automatic, totally unconscious. Why did the mind create it? Because it holds the unconscious belief that its resistance, which you experience as negativity or unhappiness in some form, will somehow dissolve the undesirable condition. This, of course, is s delusion. The resistance that it creates, the irritation or anger in this case, is far more disturbing than the original cause that it is attempting to dissolve.
All this can be transformed into spiritual practice. Feel yourself becoming transparent, as it were, without the solidity of a material body. Now allow the noise, or whatever causes a negative reaction, to pass right through you. It is no longer hitting a solid “wall” inside you. As I said, practice with little things first. The car alarm, the dog barking, the children screaming, the traffic jam. Instead of having a wall of resistance inside you that gets constantly and painfully hit by things that “should not be happening,” let everything pass through you.” – pp. 159-160
Tolle, Eckhart (1999): “The Power of Now – A Guide to Spiritual Enlightenment” New World Library, Novato, California.
To thrive, not just survive, in the midst of change takes commitment to actually try some different solutions. Sometimes it’s easier to complain and blame. But if you would like to move from that position, here are some ideas to try.
- To translate the Self-Directed or Other- Directed Frustrating Condition into a System Solution requires careful assessment and quantification.
What follows may seem a bit obsessive compulsive, however it is a necessary process if you are serious about not being frustrated all the time. You could skip this TIP, but don’t blame me if you and your team keeps feeling frustrated.
STEP 1. Identify how a self-directed or outer- directed frustration impacts your agency, organization or business.
Ask these 3 questions of any frustration you might experience.
Q1: What does not work well in our organization because of this frustration?
Q2: What are some specific, detailed examples on what is not working well?
Q3: What are the concrete results and effects of this on our agency/organization?
Follow our example below with this sequence of 3 questions. Then insert your example.
Frustration Example: “I find it hard to balance the importance of client needs with my needs.”
Q1: “What does not work well in our organization because of this frustration?”
A1: “Things don’t work well when I am not meeting my commitments on time.”
Get more specific. Dig more deeply about what is not working well. Be explicit and detailed.
Q2: “How do I not meet my commitments on time?”
A2: “I don’t keep my paperwork up to date in a timely fashion.”
Become progressively more specific, and identify the results and effects this has on your agency.
Q3: “What is the concrete result in my agency/business when I do not get paperwork done in a timely fashion?”
A3: “I am not getting my treatment plan reviews done on time.”
Not getting treatment plan reviews on time is the frustrating condition in your organization, but you can deal with this ‘condition’ far more effectively than the original self-directed frustration because:
-> It can be eliminated by the installation of a system
-> It is specific and when solved, it moves you closer to being able to get your work done. It enhances the whole health of the agency/business.
STEP 2. Quantify the specific, technological frustrating condition, wherever possible.
This adds clarity as you ultimately determine the most appropriate solution. This makes the frustrating condition very precise.
Ask these 3 questions around quantification of any frustration you might experience.
Q1: What percentage of the time does this frustrating condition occur?
Q2: How many times does this frustrating condition occur each (day/week/month) on average?
Q3: What are the usual expectations of your agency so you can identify how big or small a problem you are dealing with?
Follow our example again with respect to quantification. Then apply your example.
Q1: What percentage of the time does this frustrating condition occur?
A1: In the case of “late treatment plan reviews” it is 75% of the time or more.
Specify and quantify further.
Q2: “How many times does this frustrating condition occur each (day/week/month) on average?”
A2: “Usually each month I am four days late in turning in my treatment plan reviews.”
Specify and quantify even more. You will be looking to find how big or small a problem you have.
Q3: “How many treatment plan reviews are expected?”
A3: Nine are expected per month. I thus turn in six (75%) of my treatment plan reviews on an average of 4 days late each month.
Each answer to a previous question should be progressively questioned. If you do, this will lead you to the most appropriate solution.
Question even the solution further: “If I can’t eliminate every late treatment plan review, can I cut them down to less than 25% or two per month?” Or “If my late treatment plans are as high as 75% late, is administration making unrealistic demands on my time and duties?”
Quantifying with “real” numbers is far more valuable than approximating. Approximations can often simply reinforce an inaccurate perception. If you actually quantify, you might discover you have a very different condition than you thought existed in the first place.
STEP 3. Seek system solutions
Ask this question.
Q:What system can I set up that will achieve the results I want in the organization or agency?
Follow our example again with respect to the systems solution. Then apply your example.
System Question: “What system could I set up that would allow me to get my late treatment plans under 25%?”
System Answer: Perhaps all paperwork could be done in an office away from easy client contact. When treatment plan reviews are approaching the due date, the chart has a yellow sticker on it to alert the counselor.
Obviously your exact system will be based on an analysis of your specific frustration, plus quantification of what are the most recurring conditions in the frustration. The solution is not a random stab at quick fixes.
Or another System Question: “What system would monitor and quantify what consumes counselors’ time to help develop realistic expectations?”
System Answer: A time management monitoring system would track all clinical and administrative duties for 1 month to gather data to allow the development of realistic expectations.
It takes commitment to develop a systems solution— or you could just complain and feel like a victim.
The material above has been adapted from Gerber Business Development Corporation’s Key Frustration Process. Mailing Address: Michael Gerber, E-Myth Worldwide, 2235 Mercury Way, Suite 200, Santa Rosa, CA 95407/Corporate Offices: Phone: 800-300- 3531 or 707-569-5600 Fax: 707-569-5700 Web: http://www.e-myth.com
- Choose to Thrive as a Conscious Choice and Process.
Whatever you are doing now in your career and daily work has probably evolved dramatically over the years. That may be good, and you may have engineered all those adjustments. On the other hand, it might be that where you work and what you do no longer fits with the original job and mission you signed up for. The agency/program has changed under budget, policy, and political priorities etc. You find yourself working in an environment with quite a different mission from what you chose initially. For example, perhaps you did not plan on working with people with co-occurring disorders.
-> If you want to thrive, it is a conscious choice to move away from victim-survival mode.
-> You decide if “who you are” and “what you want” fits with “where you work”- the agency’s current mission.
-> Develop your own primary aim or personal mission statement and values to alert you when you are “off track.”
For example, I frequently get job offers and interesting opportunities presented to me. By now, I am clear which opportunities do or do not fit my personal mission.
Here is my mission statement and values:
I am actively creating a unique forum using my talents of bridging the gap for people between disparate fields and concepts, in a very persuasive, challenging and inspiring manner; simultaneously influencing systems in a global way for the greater good, with rich personal satisfaction and financial reward.
Mindfulness – awareness of body and feelings
Spaciousness – expansiveness and open mind
Seeing Through – not reactive
Spiritual Nourishment – non-egocentric; gain nourishment from others’ success
Loving Presence – being there without resentment
-> Check to see if there is a good fit between your primary aim or personal mission and where you now work.
Today I mowed the lawn. I think mowing the lawn is the most satisfying of all household chores. You start with a straggly, messy expanse of green. In less than an hour, you have almost a golf course green in front and back of your house. Of course this assumes you have a house and a lawn to mow; and that if you do, that you are like us, and don’t keep it manicured every week.
Even though we have weeds, it still looks good immediately after mowing. In fact I often go out a couple of times in the next 12 hours and the next morning to admire my handiwork. In a few days, it will not look so great. Then I often wait until I see the neighbors doing their mowing for the guilt to rise sufficiently to get out the mower again. I get to experience the satisfaction of a job well done, yet again.
Mowing the lawn may not do it for you. Maybe it is cleaning your car, washing the dishes, doing your laundry, shortening the guilt pile of unread journals, or clearing your desk of all those papers.
For a lot of us, we have worked for many years with people, programs and projects which bear fruit, and have their great satisfactions. Results are often long- term, and you need to exercise a great deal of delayed gratification to keep the vision alive and stay focused. (I have been working with the ASAM Patient Placement Criteria for over 15 years now). The impatient side of me likes faster results. That’s one of the reasons I was drawn to addiction treatment— people can actually get back on track, turn their lives around faster than many other behavioral health problems. It is a pity that so many in the mental health field who have not witnessed recovery in others still feel hopeless about people with substance use disorders.
When the going gets tough, it’s nice to know you can always mow the lawn. Satisfaction is immediate. Rewards are concrete. The experience is grounding in all ways. It is easy to be tempted to long for those other fields where the grass appears greener on the other side. But a friend reminded me: the grass may be greener, but you still have to pull the weeds and fertilize!
Until Next Time
Next month it will be one edition of TIPS and TOPICS for one month—-I promise. Thanks for reading. See you in December.