"Dr. Crawford's presentation was the highlight of the conference and a much needed reminder for all of us (especially nurses) to keep it all balanced. Bill's psychology background surely protruded through his messages and I know it was well-received by all!"

– Nancy Perovic, RN, BSN
University Of Chicago Hospitals
Chicago, IL

Articles
 

Articles by Dr. Crawford

Team Building from the Top of the Mind: A New Approach

Everyone knows that teams at their best can be an excellent source of innovation and productivity. At their worst, however, they can also be a caldron for competition, back biting, rebellion and what can easily become the super bowl of the blame game. To address these problems organizations have created team-building programs that are designed to educate employees on the benefits of working well with others. Unfortunately, many of these programs have proven to be less than effective because employees tend to see them as a waste of time, and/or see the team-building activities as "silly games" that have little or nothing to do with their experience at work. Therefore, what is needed today is new information, not just soft skills, but hard science that allows teams to access their best, regardless of the situation.

The origin of this new information is rooted in the new developments in brain science. For example, most people know that our brains are divided into three parts: the brainstem, the limbic system, and the neocortex.

The brainstem (the lower part of the brain) is where our fight-or-flight responses are located, and is also the part of the brain that regulates our heart rate, blood pressure, etc. The middle of our brain is called the limbic system, and this is, for the most part, where our emotions are housed. In addition, it is also the part of the brain that scans incoming data for signs of threat or danger. The upper 80% of our brain is the neocortex, and this is where we have access to our interpersonal skills, judgment, creativity, communication skills, etc.

As we move through the day, data comes in from our five senses, and is first examined by the limbic system. If the limbic system senses any problem, anything that it has identified as a stressor or a threat to our peace of mind, then it sends the information immediately down to the brainstem, bypassing the neocortex.

Unfortunately, when we try to deal with the perceived stressors from this lower, reactive brain, we are often less than successful, which, of course, has us feeling even more stressed, frustrated, and ineffective. The limbic system interprets this additional frustration as even more negative data, and dutifully sends it right back down to the brainstem creating a self perpetuating cycle.


The key to creating and sustaining successful teams, therefore, is to first see stress for what it is, not something that is being done to us (“deadlines really stress us out”) but instead recognize that stress is actually a signal that we are becoming trapped in the lower 20% of our brain. Next, we must be able to shift to the upper 80% (or “The Top of the Mind”) so that we can access the team-building skills that will allow us to bring our best to life and influence others to follow our lead.

In my books and seminars, I give people several models for making this shift, staying in this “Top of the Mind” perspective regardless of the situation, and then engaging others (who are themselves stressed) in such as way that they shift from their “resistant brain” to the more “receptive brain” which allows them to hear our suggestions as valuable information.

While describing all of these models is not possible in an article of this length, I do want to give those interested in “Team-building from the Top of the Mind” at least one tool for engaging this most purposeful and powerful part of the brain. The effectiveness of this tool lies in the power of questions.

You see, when we are talking about engaging very specific parts of the brain, questions are like Google on steroids! Unfortunately, when we are stressed and/or frustrated, we tend to ask what I call “brainstem questions,” which are questions about the perceived stressor. Examples include: “What’s wrong with these people?” “What were you thinking?” “Why does this always happen to me?” “How many times have I told you . . .?” etc. Regardless of the specifics, questions such as these engage the lower 20% of the brain, and as such, are a big part of the problem.

Therefore, to address this problem, I have created an alternative set of neocortex questions (questions that can only be answered by the upper 80% of the brain) that I call “The Four Criteria.” The value of these interrogatories is that they allow us to not only evaluate any reactive response, but to also identify a “Top of the Mind” alternative.

These Four Criteria or neocortex questions are:

1. Has this thought, emotion, or action been chosen deliberately, or on purpose? Most teams would say that they don’t choose to be stressed or frustrated on purpose, it just seems to happen to them.

2. How is it working for us? Meaning to what degree do we feel that our stress and/or frustration is helping us become more effective and/or encouraging others to hear what we have to say? Again, most people would not identify these reactions as highly effective or desirable.

3. Is this thought, emotion, or action making the statement we want to make about who we are as a team? This question goes way beyond just avoiding the problem and speaks to the fact that everything we do makes a statement about who we are. Just as most teams would say that they are not becoming stressed, annoyed, and/or frustrated on purpose, most would also say that these would not be the words they would choose to define who they are (“We are people who are reactive, frustrated, stressed, annoyed, etc.”)

However, when we say that the challenges we face “make us” feel or do one thing or another (“Deadlines make us nervous.” “Red tape is really frustrating,” etc.) then what we are really saying is that the negative situations and people in our lives have the power to define us!

Given that we do not want to be defined by the negative aspects of life, I believe we must take personal responsibility for this process and define ourselves on purpose.

As mentioned, the first step in this process is to determine what part of the brain we are coming from, and evaluate whether our current thoughts, emotions, and/or actions are ones we want to feed or change. The first three questions of “The Four Criteria” can go a long way toward making this determination because, as discussed, they are “neocortex questions,” and thus engage the upper 80% of our brain in the process of evaluation.
However, the fourth question is one that many teams report being even more powerful than the first three combined:

4. Would we teach this thought, emotion, or action to a child or to someone we cared for? When I get to this point in my seminars and ask this question, a knowing silence always falls over the participants. The reason for this is that no thinking team member would teach his or her children (or anyone they care for) to be stressed or frustrated. Thus, this question completes the initial evaluation of our thoughts and emotions in a very powerful way.

Now we are in the position to use the Four Criteria to come up with a solution, meaning that we can now ask: “Okay, if we were choosing our thoughts, emotions and actions on purpose…in a way that we believe would be most effective…in a way that makes the statement we want to make about who we are …and in a way we would teach/recommend to someone we cared for,”… what would that look like? How would our team be thinking, feeling, and acting differently if this were the case?

Once we have this new vision of what we want to practice (versus just what we want to avoid) then we can begin to bring this new perspective to life by using the situations in which we find ourselves to make a purposeful statement about who we are. In doing so we will be drawing on the most intelligent, creative and collaborative part of the brain which will having us create our teams “on purpose.”

Bottom line: if your team-building development program doesn’t include information on accessing this most intelligent, capable part of the brain, your potential for success will be limited. Soft skills can only go so far if they are not backed up by the latest information on exactly where the team-building qualities you seek reside and how to bring them to life.

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A Radical Approach to Being Laid Off: When Just Surviving Just Isn't Good Enough!

Everyone knows that being laid off can negatively affect one's health and well-being. Feelings of rejection, being unfairly treated, and fear of the future can lead to stress, resentment, and anger, which can create health problems such as ulcers, headaches, insomnia, and of course, depression. What everyone doesn't know, however, is that these problems could be minimized if we just knew what was really going on "under the hood,” or what happens in our brain and our body that triggers these negative physical, mental and emotional reactions. In other words, to deal with the trauma of being laid off in a way that goes beyond “just surviving,” we need to understand that the negative emotions and health problems we experience are simply chemical changes in our body triggered by a very specific part of our brain.

Here is how all this works: After being laid off we are thrown into "survival mode" by the part of our brain responsible for survival, the brainstem. This lower 20 percent of our brain then triggers the release of "fight or flight" chemicals such as adrenaline, nor adrenaline, and cortisol, which produce emotions such as anger, frustration and resentment. The reason this does not help is that we are not in a “fight or flight” situation! Quite the contrary, what we really need to deal with the situation at hand (being laid off) is access to our best thinking, or the clarity, confidence and creativity that allows us to do more than just survive. What we really need is the ability to shift to the upper 80 percent of our brain (the Neocortex) and shift our focus from stopping the problem (worry, depression and resentment) to starting the solution and moving from surviving to thriving.

You see, after being laid off, most of us find ourselves asking brainstem questions such as, “How could they treat me this way? What did I do to deserve this? Who do they think they are laying me off after I have been a loyal employee for so many years? What am I going to do now?” etc. Basically, we are asking ourselves questions about the problem, which almost always revolve around “Who is to blame?” or “What’s wrong with them? Or what’s wrong with me?”

While understandable, these questions only serve to engage the lower 20 percent of our brain, which responds by increasing blood pressure, heart rate and muscle tension. Of course, this only has us feeling more stressed, frustrated, angry, etc. which again re-engages the brainstem and has us feeling “all stressed up and no where to go.” This is why so many people feel trapped, confused and paralyzed after being laid off. They are trying to solve the problem from the part of the brain that is incapable of the kind of clarity, confidence and creativity they need to deal with the situation successfully.

What’s the solution? First, we may need to “grieve the shattered dream,” or allow ourselves to feel the emotions of grief over the loss of what we had hoped would be a job where we would finally be recognized for the valuable people we are. After a “good cry” (which often, women are able to accomplish more successfully than men), we will want to shift from a focus on the pain of past to our ability to become more influential in our present and future.

We do this by asking ourselves Neocortex questions, or questions that engage the upper 80 percent of our brain where we have access to the clarity, confidence and creativity necessary to move forward. Interestingly enough, one of the most powerful examples of such a “Top of the Mind” question is:

If my grown child were in this position, what would I advise him or her to do?

For example we might encourage someone we loved to shift their focus from the past and “Who’s to blame?” to the present and future. We might encourage them to take stock, or become clear about their attributes, or the qualities and characteristics that make them valuable to potential employers. One way of doing this is to ask ourselves the Neocortex question: “If I was the person responsible for hiring, would I hire me?” If so, why? And then make a list of these attributes. You see, we know who we are and what we bring to our roles as professionals better than anyone. And thus, as we become clear about the qualities and characteristics we possess that would be of value to any organization, we begin to recognize our self-worth.

This clarity allows us then to look at the world of work from a very different, Top of the Mind perspective. Now we know that some organization will soon be very fortunate to discover that we are available, and therefore we can begin to evaluate potential employers in terms of whether we want to work for them, (a Neocortex perspective) rather than the fear that we are now, somehow “damaged goods” (a brainstem interpretation and certainly not one we would recommend to someone we loved).

It also makes it easier for us to contact our friends and let them know of our availability. Because rather than coming from the shame and/or resentment of being laid off (brainstem),we now know that when our friends recommend someone as qualified and valuable as ourselves to their friends and colleagues, it will reflect positively on everyone!

Plus, this clarity of our value and worth allows you to go into future interviews confident in the fact that this organization would be fortunate to have someone like you working for it. This confidence is contagious in that when prospective employers sense that you are confident in yourself, they can be more confident in making the decision to hire you. It also allows you to respond to questions and participate in the process of finding a new job from a more creative perspective because you are coming from the clear, confident and creative part of your mind.

Bottom line: when we want to do more than “just survive” after a lay off, we must access the part of our brain responsible for more than just survival. We must access the wise, supportive and intelligent “Top of the Mind” and treat ourselves like we would treat someone we loved. Then, as we take this loving wisdom and apply it to our lives, we too move from surviving to thriving and are able to bring our best to life and our new position!

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The "C3" Lifestyle and Life from the Top of the Mind

Many people think that the way to achieve success in today's dog-eat-dog world is to fight tooth and nail for your position, defend your territory at all costs, and basically intimidate anyone who opposes you into submission. They're wrong!

I'm not saying that these tactics are never effective. We certainly know individuals and even organizations that seem to be using these "do unto others before they do unto you" tactics in their dealings with others. However, I am going to suggest that any success they achieve will be short-lived. Why? Because anyone who is fighting, defending, and/or intimidating their way to the top is by definition coming from a part of their brain that is defensive and/or combative in nature, and this mindset will never be able to access the qualities of clarity, confidence, and creativity, the components of my "Top of the Mind" formula for long-term success.

This isn't just a plea for ethics and/or compassion in business. These suggestions on improving performance are backed up by the latest neurological research which shows that when we look at the world as our enemy, we are thrown into a part of the brain where our options are limited to fight-or-flight, and thus, we are just that . . . limited. Someone with limited options is not in a position to respond effectively to the challenges of today's world, nor are they someone that others find especially inspiring. This is also why trying to frighten people into productivity will never work long-term, because when people are threatened or frightened, they again are thrown down into their brainstem which is only capable of these two responses (fight-or-flight).

If you want to improve your performance and/or the performance of those within your organization, then you must come from the Top of the Mind, a part of your brain (the neocortex) that broadens versus limits your choices and builds on the skills you already have, such as, your interpersonal skills, problem-solving skills, etc. Unfortunately, we can't just flip a switch and access this part of our brain, however, there are ways we can shift our thinking from the brainstem (fight-or-flight) to the "Top of the Mind" perspective of clarity, confidence, and creativity:

1. Understand that how we accomplish something is just as important as what we accomplish. If the corporate scandals of Enron, Worldcom, etc., have taught us anything, it's that you can't stay successful for long treating people like underdogs. Sooner or later, these tactics will come back to bite you in the . . . well, let's just say that coming from our "bottom brain" will effect more than just our "bottom line!"

The antithesis of these corporate pit bulls is Herb Kelleher, former CEO of Southwest Airlines. In a time when the majority of his competitors are filing for bankruptcy, Southwest Airlines is not only turning a profit, but giving its employees raises, increased benefits, and stock options. Why? Well, of course, there are many reasons, including a sound business plan, however, one of the hallmarks of this organization has always been how it treated its employees. There is a quote that I admire which says, "Every thought, emotion, and behavior is a statement about who we are and who we are becoming," by Neale Donald Walsch. In order to thrive (versus just survive) in today's uncertain world, we must be coming from a part of our brain where who we are (or the statement we make about how we define ourselves) is as important as what we accomplish.

2. Make sure this clarity of purpose is reflected in our communications. Given the interdependence of today's global economy, partnering with others is an essential component of success. Therefore, once we have chosen the qualities we want to represent (and that we want to represent us) we must ensure that these qualities come through as we communicate with others. It's not enough to walk the talk, we must ensure that the tone of the talk has been chosen on purpose, and that others see the congruence between who we are, what we say, and, of course, what we do.

3. Make sure that the images we are holding in our mind reflect the qualities and characteristics we have chosen to describe and define who we are. As we have discussed, the latest brain research has discovered that our internal images determine what part of the brain becomes engaged. Therefore, if you want to engage your brainstem and be limited to fight-or-flight, keep seeing those around you as "the problem" and the world as a threat! However, if you want to have access to your clarity, confidence, and creativity, you must shift to images that are congruent with these qualities. As you begin to see yourself bringing these qualities and characteristics to life, you will then by definition be coming from your neocortex, and thus be in an excellent position to achieve and even exceed your expectations. These are not only the findings of the latest neurological research, but the promise of Patanjali, a Yogi that lived over 2000 years ago who said the following:

"When you are inspired by some great purpose or some extraordinary project, all your thoughts break their bonds; your mind transcends limitations, your consciousness expands in every direction, and you find yourself in a new, great, and wonderful world. Dormant forces, faculties, and talents become alive, and you discover yourself to be a greater person by far than you ever dreamed yourself to be." – Patanjali (1st to 3rd century BC)

4. Be willing to deal with obstacles from a perspective of creativity versus consternation. The truth is that no matter what we try, we will always encounter obstacles. If we see these barriers to success as frustrating, unfair, the result of someone out to get us, or a sign of our failure, we will throw our thinking into the under-mind (where we will, of course, feel "undermined"), and thus engage our fight-or-flight response. If, however, we can see these obstacles as interesting, curious, challenges, or even "good information," then we can engage them with all of our clarity, confidence, and creativity at our disposal.

The bottom line is that we don't want to be stuck on the bottom line or in the bottom brain. To increase performance, we need access our Top of the Mind, higher order thinking which means we must reverse the evolutionary fight-or-flight tendencies that have become so commonplace in today's world. Not an easy task, to be sure, but one that is worthy of our time and focus. Because when we unleash all that potential that has been trapped for so long in the lower part of our brain... when we apply our best thinking, problem-solving skills, and interpersonal skills to the challenges before us... when we bring our clear, confident, creative, Top of the Mind perspective, performance is a foregone conclusion.

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Change and The Natural Law of Cycles

All problems (and solutions) present themselves as a cycle of cause and effect. When this cycle is negative, there are three ways to change. You can change the cause, change the effect, or choose the most powerful option ... become the cause!

Change the cause: On some level, this is what most people try first, meaning that when feeling angry, frustrated, or stressed, most people try to fix the problem by changing what they believe made them upset in the first place. However, because so many of the things we encounter in life (the economy, traffic, other people, etc.) are beyond our control, this tact generally results in our feeling worse, and thus the cycle of stress and frustration is created and exacerbated.

Therefore, my suggestion around changing the cause isn't about changing the world so that we feel better. What I mean when I suggest that we change the cause is that we take responsibility for creating our surroundings in such a way that we are well served. For example, we make sure we get the rest we need, we eat when we are hungry, we become very purposeful about how and with whom we spend our time, we take a different route to avoid traffic, or at least choose something pleasant to listen to while we drive, etc. Basically, what we do is take 100% responsibility for taking care of ourselves by honoring our body's signals (fatigue=rest, hunger=food, massage=Ahhhhhh:-) and changing what we can.

The second option involving the natural law of cycles is more powerful, however, it is certainly a road less traveled, because most people don't even think it's possible. It's about dealing with the cycle of cause and effect by changing the effect. This involves changing how difficult situations and people effect us by choosing how we want to respond.

This tact begins with the assumption that we are not responding to all the problematic situations in our life "on purpose." This means that we are not deliberately becoming stressed, frustrated, angry, overwhelmed, etc., and thus the first question we must ask ourselves is how would we like to respond, or what qualities and characteristics would we choose if we were responding more purposefully? When asked this question, most people choose qualities such as patience, confidence, compassion, integrity, etc. Once these are chosen, the next step is to practice responding in this more deliberate fashion. In other words, we use traffic as an opportunity to practice responding with patience (or however we would like to be), meetings as an opportunity to practice responding with confidence, etc.

Because anything that is practiced (i.e. repeated over and over) will eventually become a habit, we will, in time, become skilled at responding in this more purposefully chosen manner, and this will change how life effects us. This is certainly better than continuing to be effected by life, however, as nice as this option is, we are still the effect, which leads us to the most powerful option in dealing with the natural law of cycles ... becoming the cause!

This third option is even more unorthodox than the first two and, thus, it is even more rare, however, I believe that this is the most powerful way to deal with the natural law of cycles. As I mentioned, rather than advise you to change the cause or change the effect, I am suggesting that we flip the cycle and become the cause.

This means that we first identify the best of who we are. Chances are this will look very similar to the purposeful qualities and characteristics identified in option two, however, rather than seeing these traits as a response to the challenging aspects of life, these qualities (clarity, confidence, creativity, etc.) become what we carry into each scenario, almost as if the situation were a scene from a play and our mission was to first define our character, and then step on stage and be who we are.

I call this "becoming the cause" for two reasons. First, given that we have defined who we are in advance, and have identified our purpose as being this person, we will have "become the cause" (versus the effect) of our experience of life. Plus, given the reactive nature of people (both individuals and groups) we will very likely begin to have a marked effect on those with whom we interact. Of course, this effect will vary from person to person depending on their perspective. Some will find these qualities very attractive and thus will look for opportunities to join with us on projects and teams. Others, however, may be confused by someone who is so consistently "purposeful" and thus may mistrust or even recoil from such a person. In fact, their confusion may at first be so unsettling that they may try to make us return to the more familiar, reactive stance that they know so well. The beauty of "becoming the cause," however, is that we are not invested in their reaction.

This doesn't mean that we don't care, it just means that we don't require them to treat us with respect to know that we are respectable, or to value us to know that we are valuable. Because we have defined ourselves on purpose, we know that we are a person of patience, confidence, compassion, integrity, etc., and however people react to us is good information. If in seeing someone be patient, kind, and confident, they become aware of how they can be impatient, unkind, and less than confident and thus feel uncomfortable, this is not a problem, but an opportunity for them to change. Regardless, however, we are clear about who we are and the qualities we want to bring to life.

The second reason I call this perspective "becoming the cause" is that when we have defined ourselves on purpose and are looking forward to bringing these characteristics to each situation, we can then be in the world, but not of it. This doesn't mean that we are not engaged in life, far from it. In fact, because we are not needing the world to be a certain way in order to be who we are, we can engage in each situation in a very profound manner. What this means is that because we have decided that our highest purpose is to be who we are, we are not caught up in the petty or problematic aspects of life ... and this becomes our cause!

So, one question could be, what cause do we stand for, and to what degree are we willing to make this our highest purpose? Is our banner one of reaction, habit, frustration, and resentment, or are we willing to define who we are on purpose, and practice bringing this "cause" to life? Given that we are always practicing something, maybe the real question is what are we going to practice . . . coming from protection or purpose, the Undermind or Top of the Mind, blaming the cause or becoming the cause? The choice has been, and always will be, ours to make!

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Defusing the Dogfights: The Cost of Conflict in Corporate America

"Now, wait just a minute! Don't you try to pin this on me! I told you six months ago that this wouldn't work, but did you listen? No! Now this entire project is crashing around you, and you are trying to say this is MY fault? . . . No way, buster, this is your mess, and I'm just going to sit back and watch you go down in flames!!!!!!!!!!!!!

Sound familiar? . . . It is. So familiar, in fact, that the Bureau of Labor Statistics estimates that this sort of conflict among coworkers (not to mention conflict with customers) cost corporate America upwards of 4 billion dollars a year in lost productivity. Why? Because this sort of conflict isn't just a couple of coworkers disagreeing. It's about people being so caught up in blame and defensiveness that they are more than willing to sacrifice the success of their organization just to be right! In other words, they are so focused on the fight that they are totally oblivious to the effect it is having on the entity that pays their salaries! Multiply this by all the potential disagreements that are taking place in cubicles and offices from New York to California, and you have some idea of why productivity in corporate America isn't what it should be. Further, If you happen to be the manager in charge of defusing these dogfights and refocusing your people on the mission of the organization, you are probably scratching your head wondering what to do.

Let's start with what most people do, and why it doesn't work. Most managers start by telling the combatants to stop arguing and get back to work. While this would seem to make sense, have you noticed that this admonition almost never produces the desired results? In other words, it's rare that upon hearing this, combatants turn to the manager and say, "Oh, what a wonderful idea, why didn't we think of that? Yes, get back to work, that's what we should do." No, far from it. In fact, telling people to stop arguing generally has them either arguing with you about who started it and the righteousness of their position, or taking their resentment (which now includes their resentment of you) underground and looking for others to confirm the validity of their perspective.

Other managers try to become the referee or the "judge du jour." However, this rarely solves the problem, either because once again each combatant then turns all of his or her energy and resourcefulness to convincing you that they are right, and once again the mission of the organization is not part of the discussion.

Now, in order to defuse the dogfights that break out around your organization (or anywhere else for that matter), you must know three things: (1) The anatomy of conflict or how our brain reacts to stress and threats, (2) What part of the brain creates solutions versus problems, and (3) How to motivate people to shift their thinking from their Undermind (the brainstem) to the Top of the Mind (the neocortex). Or put another way, how to get them to start thinking like top dogs versus pit bulls.

Now, while this may sound like you have to be a combination of brain surgeon, psychologist, and dog trainer to pull this off, the actual process of defusing conflict doesn't have to be all that complicated if you understand the nature of the beast. First, it's important to understand that most interpersonal conflict (that goes beyond simple disagreement) is about people feeling threatened and then reacting in a predictable manner that narrows their options to fight or flight. The part of their brain that is engaged here is the brain stem where their survival and protection responses are located. It is not the part of the brain that allows us to do our best thinking, and therein lies the problem. This means that it is rarely a good idea to try to resolve a conflict in the heat of battle because the participants are so locked into the underdog mindset, or the lower part of their brain, that they are literally not thinking clearly. The challenge therefore is to help them shift from a problem-focused to a solution-focused perspective which will allow them to stop thinking like underdogs, and begin to approach the situation with the clarity, confidence, and creativity generally associated with a Top of the Mind perspective.

There are several ways to accomplish this, however, the most desirable is where the combatants solve the problem without your help. For example, one way to motivate them to shift their focus is to make finding the solution more desirable than staying stuck in the problem. If these are your supervisees, you might say, "Folks, there are two ways we can resolve this. One, you can both write a report on what you see as the problem and the solution. I will then read both and inform you of my decision. The second is you two get together, work out a solution, and let me know what you come up with. I'm fine either way, which works for you?" This is effective because either option is about creating a solution, and given that most people abhor more paper work, you have made their solving the problem more desirable than continuing the debate.

Another option that gets everyone thinking like top dogs is to ask the question "Given what you know now, how can we do this differently in the future?" or "If this were a problem-solving exercise, what would you want the members of our organization to learn?" Both of these questions are effective because they shift the thinking of the participants from the struggle over who's right to the part of their brain that taps into their best, most creative thinking.

The bottom line is that we all know how costly conflict can be to the morale and productivity of any organization, and if you are in the position of defusing these dogfights, you must go beyond just stopping the fight. In fact, the solution here is not about what to stop but what to start. What you want to start is the participants thinking like problem-solvers versus fault-finders, like leaders versus combatants, and like top dogs versus underdogs. Then, once you have their best thinking focused on solving the problem, you will have their best efforts focused on why you are all there... the success of the organization.

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Dr. Bill's Colonoscopy

The following article was originally posted on my Quotes and Wisdom from the Top of the Mind newsletter and the response extremely positive with many readers suggesting that we add it to the Articles section of the site so that others may benefit.
.: Printable Version of this Article :.

"Courage isn't the absence of fear,
but the decision that what we want is more important than what we are afraid of."

- Bill Crawford

In lieu of the traditional "quote and comment" this week, I thought I would write a few words about a procedure I recently had done with the hopes that this information might be of value to others who may be considering a colonoscopy, but have put it off due to their concerns about the experience. I probably should start by letting you know that I am a 57 year old male who has had no symptoms that might indicate any problems in that area, but who does have a family history of cancer of all types (both of my parents died of cancer within about six months of each other when I was 21 years old).

Like many others, I have been told that having a colonoscopy would be a good idea for quite some time and . . . like many others, I had "just never gotten around to making it happen." I am a person who believes in best practices, preventive medicine, and taking the advice we would give others, however, and thus with my wife's encouragement, I finally began to research some of the physicians that were accepted by my medical insurance. After locating a doctor who specialized in these procedures and had a 5 out of 5 "patient satisfaction" rating on healthgrades.com, I began talking to friends and looking on the internet to see what others had experienced with respect to their colonoscopy. Here I found both a wealth of valuable information, as well as a few horror stories that made my skin crawl. Because I am not a big fan of horror stories, however, I decided to focus on the valuable information and do whatever I could to make the experience as comfortable as possible.

The first aspect of the procedure (and what almost everyone says is the most difficult) is the preparation which generally consists of being on a liquid diet for at least a day before the procedure. This, and the laxatives prescribed allow for the "cleaning out of the colon" (diarrhea) so that the doctor can accurately locate, and if necessary, remove any "polyps" or pre-cancerous growths.

In the not-too-distant past, this preparation included drinking very large amounts (up to a gallon) of what I understand to be a rather thick liquid laxative which many people reported to be almost intolerable. In fact, the nurse at Dr. Keith Fiman's office said that when he (Dr. Fiman) had a colonoscopy, he had to drink this concoction, and reportedly swore he would never make his patients endure this. Instead, he prescribed two 1.5 ounce doses of FLEET PHOSPHO-SODA (actually it was an over-the-counter purchase) which turned out to be very tolerable.

Below are my recommendations for a colonoscopy experience of maximum comfort and minimum inconvenience:

1. Select a physician who does this procedure all of the time and has a high patient satisfaction rating, and a facility that is set up for your comfort. If you are in Houston, I found Dr. Keith Fiman and the Physician's Endoscopy Center to be an excellent choice.

2. Schedule the procedure for early in the morning. This allows you to have breakfast after it is over and minimizes the potential that other procedures will delay your physician getting to you on time.

3. The day before your procedure, you will be instructed to follow a "clear liquid" diet. The good news is that this includes Jell-O, broth, Gatorade, Coke, and even coffee and tea (although without cream). I don't like coffee without cream so 25 hours before my procedure, I had my regular morning coffee with Jell-O as my breakfast.

4. The rest of that day I had Jell-O, chicken broth, Gatorade, and Sprite whenever I was hungry, and it worked well in that I didn't feel particularly deprived. They encouraged me to drink plenty of clear liquids that day, so I tried to have something around pretty much all of the time to sip on.

5. At 4 PM on the day before the procedure, I was instructed to mix one 1.5 oz bottle of FLEET PHOSPHO-SODA with 4 oz of Crystal Light lemonade or ginger ale. I choose the lemon-ginger flavored version of the Fleet and mixed it with ginger ale, and it tasted just fine. They said to follow this with 8 oz. of clear liquid and I chose Gatorade...again, no big deal.

6. Because I had read that you will spend A LOT of time in the bathroom after you take the laxative, I had prepared the room with a small TV and a VCR. I had also taped several of my favorite shows to watch while I was on the "throne," and let my family know that I would be pretty much indisposed that evening. All of that worked very well, and towards the end of the evening, I felt thoroughly cleaned out and ready for bed.

7. The one challenge with an early appointment time is that they want you to take the second dose of Fleet Phospho Soda three hours before you leave for your procedure. I fudged this a bit and took my second dose about two & a half hours before, but this still had me getting up at around 4:30 a.m. They also said to follow this with four, 8 oz. glasses of clear liquid, and this combined with the early hour was probably the worst of the experience. Still, on an inconvenience scale of 1 to 10, it was only about a "4," and was over quickly. Of course, given that the Fleet is a laxative, I was once again "king of the commode" for a while. However, having programs to watch that I enjoyed made the experience no big deal.

8. When my wife and I arrived at the Physician's Endoscopy Center, I was taken back to the preparation room where I was instructed to change into one of those lovely hospital gowns that are open at the back (for obvious reasons). Here is where the attention to patient comfort and satisfaction by the center and the staff was a big plus. For example, once I was in my new gown, I was given a blanket that had been warmed in a dryer (nice touch). Plus, there was relaxing music playing in the room, and in general, the staff were very attentive and comforting.

9. When it was my time, my bed was rolled into the room where the procedure would take place, and I met Dr. Fiman for the first time. Because this was just a screening procedure, I didn't feel the need to have an office visit prior to the actual colonoscopy. Dr. Fiman was not only okay with this, he actually works with many of his patients this way because he feels it removes one more block (the hassle of an office visit, a co-pay, etc.) to someone coming in for the screening (he calls this "Open Access"). Imagine, physicians working with the patient to reduce the hassle and the cost...what a concept!

10. He was very pleasant, explained what the procedure was all about, and asked if I had any questions. The only thing I wanted to ensure was that I felt and remembered as little as possible. I had learned from my research that the type of anesthetic they used was called "conscious sedation" which concerned me a bit because I frankly didn't want to be conscious of anything! However, I had been assured by the staff that they could always give me more of the sedative if I was uncomfortable, and therefore I told Dr. Fiman to err on the "unconscious" side, and that my goal was to wake up and wonder if it had already been done.

11. He smiled and agreed, and in fact, this is exactly what happened. The last thing I remember is the nurse telling me that they were going to start the IV, and then I awoke to see my wife, Georgia, sitting next to my bed. Never felt a thing! YES!!!!!!!!!!!!!!!!!!! :-)

12. Dr. Fiman came in shortly after I awoke and told both Georgia and I that everything was fine, and I wouldn't have to do this again for another 10 years. Of course, given that I was still a bit "under the influence," I actually don't remember much of this conversation which is why they require that you have someone to drive you home after the procedure, and suggest that this person be in on the conversation with the doctor. Good idea!

13. We then went by Blockbusters where I rented several movies to watch when I got home (my favorite, ironically, was "Sicko" by Michael Moore) and the rest of the day was a nice combination of food and rest, although towards the middle of the afternoon, I felt that if I had really needed to get something done, I would have been able to do so.

Bottom line, with research and preparation, this experience was nowhere near the uncomfortable ordeal I had feared. Instead, it was minimally inconvenient, and certainly worth the peace of mind I now have about the health of my colon. Basically, I decided that what I wanted was more important than what I was afraid of, and this decision allowed me to move forward in a proactive manner, and I'm very glad I did.

My hopes are that this recounting of my experience will give you or anyone you know information and motivation to do the same, or, as another of my favorite quotes says: "Worrying does not empty tomorrow of its troubles, It empties today of its strength." Here's to a choice that moves past worry and instead embraces the strength we need to face our fears and take care of ourselves in a way we would take care of someone we loved.

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Golf from the Top of the Mind

We all know that even though we love the game, golf is an exacting sport that can be somewhat frustrating at times. Slices, hooks, penalty strokes, blown putts, repeated bunker shots, etc., can easily turn what was supposed to be a relaxing event with our fellow golfers into an exasperating experience that often has many among us questioning why we keep paying good money to subject ourselves to this sort of frustration. Of course, for those of us who love a challenge, the fact that golf is a challenging game is also one of the reasons we keep coming back. Most would agree, however, that the stress and frustration we experience when things go awry only makes the situation worse, and that having more influence or control over the mental and emotional aspects of our game would serve us well as we search for ways to lower our score and raise our level of enjoyment.

For this reason, many professionals in the field of mental health and sports psychology have developed systems and methods to help golfers relax and think clearly while on the course. Unfortunately, while suggestions such as, "relax, take a deep breath, and think positive thoughts" are good advice, it seems to be the opposite of what we want to do when we hit a bad shot. In fact, even though it rarely works, many of us find ourselves trying to use our anger and frustration to "bear down" and "quit screwing around" in order to fix the problem. I believe that there is a good reason for these reactions and, further, that if golfers only knew what was really going on "under the hood" so to speak, or what is happening within their brains and bodies when they found themselves becoming increasingly frustrated, they would be in a much better position to respond in a more effective manner.

In other words, what most of us don't know is that the stress and frustration we experience when we hit a bad shot are really the result of very specific chemical changes that are triggered by a very specific part of the brain. Therefore, rather than suggest that people just "relax" and/or "don't worry, be happy," my method, which I call "Golf from the Top of the Mind" actually shows golfers how to change the chemical makeup of their body and shift to the most intelligent, capable part of their brain in order to play their best. This puts us back in control of that five-inch space between our ears that Jack Nicklaus says is where the game is really played.

In order to pull this off, we need to know something about how information is processed in our brain. Most people know that our brain is divided into three parts. The brainstem, which is the lowest part of the brain, controls our breathing, blood pressure, muscle tension, etc., and is where our fight-or-flight responses are located. The middle part of the brain is the limbic system, and in addition to housing our emotions, it also scans incoming data for signs of stress or danger. The upper 80% of our brain is the neocortex, and this is where we have access to our best thinking, problem solving, and intelligence.

So, here is how all this works. Data (in this case, information about the course, our lie, our shot, etc.) comes in from our five senses and it is first scanned by the limbic system. If there is no problem (we hit a spectacular nine iron that lands a foot from the pin) the limbic system sends the data up to our neocortex, we do our happy dance, the brainstem works in the background regulating breathing, blood pressure, etc., and all is well.

However, if the limbic system senses anything it doesn't like, i.e., we hit a shot "fat," "thin," blow a three foot putt, hit a banana slice or duck hook, fail to get the ball out of the bunker YET AGAIN, it sends the information immediately down to the brainstem… bypassing the neocortex. At this point, the brainstem releases chemicals designed to prepare us for fight-or-flight, which results in an increase in blood pressure, muscle tension, and heart rate. While all of this is understandable, it is also exactly the OPPOSITE of what we need to play our best golf. Plus, given that many of us try to use our anger and frustration to "bear down" and fix the problem, we often take this frustration into our next shot, which only results in our continuing to play what I call "brainstem golf"

To play neocortex golf or "Golf from the Top of the Mind," we must first understand what is going on here and then be able to shift to the most intelligent, purposeful, productive part of our brain as we move to the next hole, or the next shot. In my book "Life from the Top of the Mind," I outline a comprehensive, step by step method for both making this shift and then staying in this upper 80%, but for the purposes of this article let me give you one tip. Shift from asking "brainstem questions" to neocortex questions.

Brainstem questions, which are almost always about the problem and the past, send data down to the lower 20% of our brain, and almost always guarantee that we will continue to play "brainstem golf.” Examples of these sorts of questions are: "What is wrong with me? Why do I keep (fill in the blank with the problem: i.e. looking up, topping the ball, swinging too hard, leaving the putt short, blowing the bunker shot, etc.) when I know better? Sound familiar?

Neocortex questions, on the other hand, send the data up to the most intelligent, capable part of our brain. They interpret all incoming data as "valuable information," and are almost always about the future and the solution. One excellent neocortex question that I particularly like is: "If I had the opportunity to do this shot again, what would I do differently?" or even better, "If I were teaching my child how to hit a shot like this, what would I want them to learn?" and "How would I want him or her to be able to react to their mistakes?" This has us picturing the solution versus the problem (a "Top of the Mind" perspective) and, given that we very likely will have an opportunity to hit a shot very similar to this in the very near future, we now know what we want to practice (versus what we want to avoid).

Of course, there is much more to the method than just asking neocortex questions, but I wanted to give you at least a glimpse of how my method of mental and emotional control differs from others. It's not just about "calming down and relaxing," but about shifting to the most intelligent part of our brains which also changes the chemical makeup of our bodies, i.e., changes the chemicals being produced from adrenaline and cortisol to endorphins.

Bottom line: If we want to bring our best to the game we love, we must be willing to purposefully access our best thinking and then bring this "valuable information" to the execution of our next shot. Plus, as we become skilled at playing and learning from this "Top of the Mind" perspective, we are able to dramatically increase our enjoyment of the process which by the way, is why we are playing the game in the first place, isn't it?

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Tribute to The Crew of the Shuttle Columbia

 

"Excellence is the result of:
Caring more than others think is wise...
Risking more than others think is safe...
Dreaming more than others think is practical, and
Expecting more than others think is possible."

 

I have chosen this quote at this time because I believe it both represents the spirit and celebrates the lives of the crew of the space shuttle, Columbia. Plus, as many of you know, this is one of the quotes that I use in almost all of my presentations because I believe that it offers a great deal of wisdom to those looking to lead more meaningful, purposeful lives. Therefore, I suggest that we look at it line by line to discover how these words might serve both the functions of tribute and wisdom.

"Excellence is the result of caring more than others think is wise."

Clearly, the people who have dedicated their lives to exploring space care deeply about their calling. You can see this passion for excellence in the detail with which they test and retest every aspect of every mission. You can also see this caring in the grief etched on their faces and in their hearts when something goes wrong.

Many people would say that caring this much about something isn't wise. They would say that it only sets one up for disappointment, and the more prudent path would be to develop a sense of detachment, or learn to care less. I suggest, however, that to care less or to lose this passion for excellence is to resign one's self to a life of mediocrity. While it may be true that we may not experience the disappointment of failure in this less invested state, we will also never be able to bring our best to any venture. To care less is to be careless, and this is something those at NASA will never do, even though it might protect them from the grief of days such as these. The bottom line is that to summon our best, we must care deeply about someone and/or something. Does that mean that we will care more than others think is wise? Probably. Does that mean that caring isn't wise? No. It means that those who dedicate their lives to the pursuit of excellence will by definition bring a deep commitment or caring to everything they do, and this will make their lives and the lives of everyone they touch more meaningful.

"Excellence is the result of risking more than others think is safe."

Ah, here is the question, isn't it? To what degree do we risk bodily harm to follow our dreams and achieve those lofty goals that caring and passion have spawned? Certainly those in the space program know that what they do is risky, and yet, year after year they stand in line, and even make it their life's purpose to take these risks. Why? Because they know that the life they want cannot be found in the relative "safety" of avoidance. I say "relative safety" because statistically speaking, the most dangerous place on earth (and in space) is in and around our own homes. I'm going to suggest, however, that the real danger in life is claiming avoidance as one's highest purpose. I'm sure you have heard the phrase, "To risk nothing is to risk everything." Given that we can never know the future, all reaching for the stars, both literally and figuratively, will entail some risk. Does this mean that in the pursuit of excellence we will risk more than others think is safe? Probably. Does this mean that this risk is unwarranted? No. Of course, safety should always be part of the equation (as it certainly is at NASA). However, whether we are talking about a baby learning to walk or mankind learning to fly, the willingness to take calculated risks will always be inherent in all great ventures and adventures.

"Excellence is the result of dreaming more than others think is practical."

It's probably fair to say that the crew of the space shuttle, Columbia, were dreamers. Given all the trials and tribulations one must go through to become an astronaut, only those who are able to hold fast to their dreams can achieve such status. However, the term "dreamer" has always been somewhat of a double-edged sword. In its pejorative sense, it has been applied to children who don't seem to succeed in highly structured, academic environments. It has been applied to adults who chose to pursue nontraditional careers that involve art, music, the theater, helping the poor, etc. It has certainly been applied to those who have suggested that we explore space. The question, therefore, would seem to be, is being a dreamer a good thing or a bad thing? I believe that history can help us with this answer. Was Leonardo DaVinci a dreamer? Were Michaelangelo, Thomas Edison, Albert Einstein, and the founders of our nation dreamers? Was Martin Luther King a dreamer? Dreams are simply a vision of the future and unlike nightmares, are generally positive. Therefore, I suggest that we embrace our internal dreams and external dreamers, for herein lies the hope for mankind. Does this mean that we will find ourselves dreaming more than others think is practical? Probably. Does this mean that dreaming isn't practical? No. In fact, it's practically essential to all achievement.

"Excellence is the result of expecting more than others think is possible."

While it is probably fair to say that the crew of the space shuttle, Columbia, were dreamers, we can assume with a great deal of certainty that they and all of their colleagues at NASA can be described as people who expect more than others think is possible. Again, this is a curious phrase because there are so many that advise against this sort of philosophy. Similar to the admonition not to care too much, they say that one shouldn't expect too much either, because it will only lead to disappointment. Further, they would probably become even more adamant about the wisdom in this philosophy if they determined that what is being suggested is impossible! In fact, I would imagine that these words, "Forget about it. That's impossible!" were heard when someone first brought up the ideas of sailing around the world, curing polio, forming a nation that is governed by elected representatives of the people, building an airplane, and going to the moon. To some, however, the fact that others think something is impossible is only one more reason to accomplish it. In fact, those who care more than others think is wise, risk more than others think is safe, dream more than others think is practical, and expect more than others think is possible are pursuing their special brand of excellence every day of their lives.

It is to these people of passion, these courageous risk takers, these dreamers, and these individuals who hold themselves to the highest of expectations that we pay tribute to today. It is also to that part of us that resonates with these qualities that we can turn when bringing our own passion and dreams to life. For, just as the space suits of the crew of the Columbia were only a protective, outer layer and did not contain the essence of who they were/are, the bodies that are our "space suits" cannot contain the passion and dreams that we bring to life.

We will all mourn the loss of the physical aspects of those who have set their space suits aside and moved to another plane of existence, and certainly the family and friends of those crew members will experience this grief in a profound way. At the same time, we should never mistake absence of proof as proof of absence. I believe that the passion, courage, and dreams of those crew members are too powerful to die. Therefore, I suggest that we continue to care enough, risk enough, dream enough, and expect enough to keep them alive in the part of us that will never die as well.

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