“Chill pills” for minimising emotional energy discharge in workplaces

PUBLIC and private health systems around the world have committed to creating better workplace culture to improve wellbeing of their health workforce. While the system does its part by addressing some aspects of wellbeing, individuals need to invest in their own wellbeing.

Having experienced and living with our own mental health issues (post-traumatic stress disorder [PTSD], trauma, attention deficit/hyperactivity disorder [ADHD], and anxiety) and observed burnout among our colleagues, we came to recognise that practising kindness and gratitude could simplify our approach to the pursuit of mental wellness. We believe that while recharging initiatives are important, it may be more efficient to invest efforts into minimising emotional energy discharge. The practice of kindness and gratitude could set the foundation for these efforts, delivering joy at work.

It would be remiss of us not to highlight some of the benefits our mental health issues have yielded. PTSD and childhood trauma have given us lenses through which to identify injustices – contradictions between stated organisational values and processes, policies and actions. Creativity and risk-taking aspects of ADHD have given us unlimited access to ideas and the courage to run with a few of them, without fearing risk. Impulsivity offered us the ability to speak our minds respectfully without excessive filtering and political correctness. Insomnia has given us plenty of time to explore and design pathways to constructive solutions and moderate impulsivity.

Kindness is easy to practice, even on individuals we perceive have caused us wrong. Everyone faces some issue in their lives relating to their families, workplaces, finances, health and societies. Everyone reacts to and manages situations differently and based on their genetics, environment and capabilities. If we stop and reflect, we as humans have one common purpose: leading a contented and purposeful life. Gratitude is easy to show to others, even to individuals we believe have not contributed. If we stop and notice, we as humans rely on each other to function as a society through everyone’s contributions – this connects us together and makes us all equal.

One question arises commonly as to how to deal with someone you feel negatively about. We may realise that this person stops to say hello, responds to emails or even agrees to meetings. In these situations, they are donating their valuable time. Rather than taking this for granted, we could be grateful for their time and embrace the opportunity to leverage their strength.

It seems that the benefits of kindness and gratitude can be explained by neuroscientific mechanisms. Distressing emotions are essential for human survival and leading change, as they are warnings that something is not right. Negatively reacting to distressing emotions can drain our emotional energy. If we learn to validate these emotions without feeling shame, and reframe threats as opportunities using kindness and gratitude, then we could bring about calm and solve problems peacefully.

Threats can elicit distressing emotions within us and may have an impact on our self and on our relationship with others. Common distressing emotions are guilt, shame, anger, jealousy, powerlessness, feeling excluded or devalued, mistrust and doubt. Distress could be caused by competition, juggling family, work and training, mistakes, failures, rejection, comparisons, unrealistic expectations, and interpersonal tensions. The system can compound the stress through workforce-unfriendly technology, workload, blame-based governance systems, bullying and harassment, and policies, actions and processes that are in contradiction with values and purpose of the organisations we work in.

We have been searching for a “quick fix”, likened to taking a pill, to prevent emotional energy discharge. We formulated simplified techniques (“chill pills”) that work for us and could be “swallowed” at the time of distress since we may not have time to rationalise our thought processes in that moment. These are listed in the table below.

Table 1: Context of distress, “chill pills” and how they help

How do they work? If the distressing feeling is about self-doubt and esteem, rules for “self” and “patch” are useful. If the negative feeling is towards others such as anger, blame etc, rules for “external to self” are useful.

We spend a significant amount of emotional energy on matters outside of our control and it is useful to recognise that so that we don’t waste our energy by worrying about them and deal with them constructively. Options for dealing with things beyond our control include acceptance, or setting boundaries, or influence change peacefully.

Acceptance doesn’t mean we put up with injustices and feel powerless, rather that we are at peace with the reality. The latter two are feasible when we identify the necessary levers we all have access to as humans and the matter is of importance (relationships, justice, fairness, equity).

Examples extracted from real life observations and anecdotes:

Situation 1: Others’ behaviours and criticism

“When someone points out a mistake in a negative tone, I feel angry with the way it was delivered”.

Take a deep breath and accept its normal to feel angry. Several rules alone or in combination may be helpful here to stop from the negative reaction. The person’s tone is outside of our control. Therefore, don’t waste energy worrying about it. Reframe the threat by using kindness and gratitude. Feel grateful for that person’s time to provide feedback and the opportunity to improve. They react this way due to their own circumstances.

Situation 2: Everyone has their own priorities

“I went home late after performing a complicated surgery and came back to do my rounds before going to the clinics. I was sleep-deprived and was in a hurry. I couldn’t find the nurse to get an update and started complaining to the shift coordinator and my team of junior doctors that nurses always get scheduled breaks unlike doctors. Others also joined me in my rant. We realised that the nurse was attending to a lady who had a fall and fractured her neck of femur.”

In this instance, the doctor thought their time was more important than the nurse’s and wasted energy blaming the nurse and created a negative environment for the team. Use kindness by considering that the nurse could be busy with an emergency, had her own issues or was helping with patients. Next time, arrange a mutually acceptable time for ward rounds.

Situation 3: Mistakes and self-criticism

“I found out that I mistakenly wrote the wrong medication to a patient which resulted in a serious deterioration. I was petrified by some nurses talking about reporting the incident. I could not sleep for few days despite support from my team.”

Take a deep breath and accept that you wrote the wrong dose. Be grateful for this feeling of remorse as a chance to learn and minimise the chance of making the same mistake again. The mistake was not intentional, you are only human and will make errors. Recognise this is outside of your control, and don’t waste energy worrying about it. Be kind to the incident management people since they may be fearful of consequences from their executives. Be grateful for the support given by the team.

Situation 4: Systems, leadership and processes

“In the last few weeks, my clinics have been double booked and I had to do clinics by myself due to my registrar’s sick leave. Medical vacancies remain unfilled from process delays and workforce shortages. Then the printer started playing up. I was angry with the booking team for double booking, and the IT division for not maintaining the printers. Admin team and the nurses were visibly upset. Due to my reaction, energy was wasted by myself, the administration and the nursing teams.”

Take a deep breath and acknowledge the anger. This situation is outside of control and clinics needs to be attended to. Be kind to the administration team by acknowledging that they were double booking to provide timely service. Be grateful for the opportunity to help all these needy people today. Lead change through peaceful means.

In a previous InSight+ article, SS and co-authors wrote about changing or improving external factors causing distress in the workplace.

Training or re-training our neural pathways

For those who are searching for ways to minimise energy wasting in the workplace and life, some amount of investment in retraining and training is required, similar to training for a marathon.

For example, as part of morning and night routine, we prescribe 10–15 minutes with deep breathing and relaxation music reminding us of these rules. Then, before situations that may cause distress, remind yourselves of kindness and gratitude. Then, when situations arise that are causing stress, take a deep breath and keep using the rules (breakthrough dose). This will take time and we may never get this 100% right, but each time we will feel the difference in our inner peace and in how we create the outer peace.

Like physical illnesses, lapses are common, and it is important not to feel shameful. Keep being grateful that we have the capacity to understand our weaknesses and deal with them peacefully.

Professor Sabe Sabesan is a senior medical oncologist at Townsville Cancer Centre. He develops and implements teleoncology models to improve rural and regional health outcomes. Having suffered moral injury during implementation phases and PTSD during war, he has become an advocate for better workplace culture as the foundation for workforce wellness while searching for his own mechanisms for achieving inner peace. 

 Anoj Sabesan is an undergraduate student at the University of Queensland Business School and Day Hospital receptionist at Icon Cancer Centre, Brisbane. Living with ADHD and its associated comorbid anxiety, he is keen for more awareness and acceptance of mental illnesses in workplaces and in society and for the workforce to develop resilience techniques to find joy at work.

The statements or opinions expressed in this article reflect the views of the authors and do not necessarily represent the official policy of the AMA, the MJA or InSight+ unless so stated.

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