Using HSD to Shift Cognitive Distortions: The Road to Leading Myself While Leading Others

I am a change management / transformation specialist in Fraser Health, one of Canada’s largest health authorities. As I write, I am furtively glancing over my shoulders—for I have a dirty secret to share . . .

I sometimes hate uncertainty.

If you haven’t fallen off your chair with this news, or if you haven’t eye-rolled in disgust, (after all, I get paid to operate and lead in ambiguity), you might be one of the many normal people who feels the same way, too. If so, we are in good company. There are countless studies demonstrating the neuroscience of change and the ‘fight or flight’ response evoked when certainty is removed. As blood is reduced from the pre-frontal cortex where our most considered thought processing occurs, our ability to think clearly is reduced and memory is impairedⁱ. This, coupled with the inevitable anxiety, ramps up perceived threats associated with loss or deprivationⁱⁱ.

Fraser Health recently underwent a wellness review which found that its people were experiencing levels of anxiety and burnout similar to other organizations in terms of size and scope. Anxious people can experience cognitive distortions. These are the ways people twist or distort information from their environment—often towards a bias of reinforcing negative thought patterns. This then leads to increased anxiety and difficulties in managing everyday stress. Most people experience these regularly. Can you relate to a few examples?

Now imagine individuals, teams, entire organizations experiencing elements of this while working through organizational change. How can this impair our ability to innovate, adapt or grow?

When I took up a new leadership role, I joined several other newly promoted leaders in our evolving Innovation, Planning and Transformation Team. Fortunately, many of us were lucky enough to be included in HSD cohort 52. 

Recognizing that as an individual, I am inherently a complex adaptive system, my focus was on using HSD tools to shift negative thought patterns within myself in order to show up as a leader capable of navigating through uncertainty, by creating safe spaces to leverage uncertainty for productive work. I became interested in some of the basic principles of cognitive-behavioral therapy (CBT), and how integrating those with HSD tools could shift patterns in thinking within myself, in order to support those shifts within my team.

The CBT triangle looks like this: In laypersons' terms, it means my thoughts influence my feelings, which also impact my behaviours. By working to shift those negative patterns, I can re-orient my thinking away from the distorted, towards healthier patterns—thereby influencing how I feel about myself, and show up for others.

In using the adaptive action model, my aim was to challenge the negative thoughts (What?), that influence the feelings and behaviors (So what?), such that I could constructively explore the ‘Now what?’ from a position of curiosity and self-reflection, rather than judgment.

This process began by describing the patterns within myself:

• Irrational worry leading to a pattern of internally catastrophizing / panic attacks.
• Negative or critical feedback received ‘deeply’ as indictment of that negative ‘self.’ 
• Constant self-criticism leading to persistent feelings of sadness, anxiety and shame.
• Fear of stretch and growth holding me back from taking risks or leaps professionally. (lower resilience to change).
• Fear of judgment resulting in feeling self-conscious when presenting to colleagues.
• ‘Disease’ of perfectionism leading to ‘all or nothing’ attitude / paralysis.

What followed was an exploration of the patterns I wanted to shift or see:

• Desire to move from a judger path to a learner path (when receiving critical feedback).
• Approaching situations from a perspective of inquiry (i.e., be curious about the thought; ask myself open-ended questions that lead to exploration vs judgment; and turn defensiveness into self-reflection.)
• Challenging negative thought patterns in ‘real time’. This includes a conscious commitment to speaking to myself with the same compassion and support I would offer a best friend or colleague.
• Forgiving myself.
• Accepting ‘good enough for now’, when prefect is not an option. 
• Acknowledging the positive (accept compliments) vs brushing them off or dismissing them.

During this personal adaptive action cycle, I used the following HSD models:

• Four Truths (subjective, normative, objective and complex)
• Same and Different
• Inquiry (appreciative)
• Six Questions (to challenge thinking patterns in uncertainty)

Here are some practical examples:

Every time a self-critical thought surfaced, I would stop and consider the Four Truths. Is this statement a reflection of objective truth? Or is it my subjective interpretation? (If I felt I couldn’t identify the objective truth vs normative truth, I would ask a trusted friend or colleague for their opinion). I also explored the ‘Same and Different’ model in terms of how I saw myself and my value proposition against how clients and colleagues saw me. In this context, I was curious around what was same and different in terms of thought patterns during times of relaxation / joy, vs times of pressure / stress.

If the criticism was external, I also chose to be curious about the feedback. What could I learn from this? Rather than assume that the relationship was poor, I would turn disagreement into a shared exploration of observations, wants and needs to move forwardⁱⁱⁱ. The Six Questions were also a great framework for those conversations:

1. What are 3 most important things about present situation?
2. What do you want to be same / different in the future?
3. What is for sure and what are your questions? (observations)
4. What contradictions to you see?
5. What will make a difference in the future?
6. What surprises you?

The complex truth within this story is that leadership is an infinite gain and journey. It is a constant exploration and series of adaptive action cycles as I grow into my true self. When I take all of the ‘truths’ into account, I am empowered to decide what is most useful for me.

My primary measurement of success in this journey, focused on one indicator initially - simply being mindful that the negative thought was there in the first place and not an underlying part of my psychological make-up. By acknowledging its existence as an ‘intrusive’ or ‘unhealthy’ thought, I was able to identify patterns around situations that give rise to such thinking. From this vantage point, I was to apply further adaptive actions in relation to self-care to reduce these instances.

The second measure of success related to the actual process of ‘challenging vs accepting’ these thought patterns. By applying the tools to the CBT triangle, I was able to mentally note those occasions when the thought arose and shift the patterns of thinking in the moment. Over time, the patterns began to shift as new neural pathways were created. Recognizing that we, as individuals, are complex adaptive systems in ourselves, we have the power to make whatever necessary shifts are required to elevate our own personal and professional experiences.

Leading Others

Translating the principles in leading myself has helped me consider the bigger picture in our culture work across the organization. I began to consider how these tools could support psychological safety in our organization.

As the organization looks to develop its people and culture strategy, and as it places a greater emphasis on care provider experience (recognizing the inextricable links with patient outcomes), how do we build resilience in ourselves and in our teams within a culture of 24/7 service that is constantly changing?

Recent workplace wellness summits across the organization were compiled and analyzed. The improvement ideas that were generated came from what teams chose to focus on. These will help inform the future development of our People and Culture Strategy and include:

1. Workload management
2. Supported self-care
3. Involvement and influence
4. Organizational culture
5. Psychological protection
6. Recognition and reward

With these focus areas articulated by front-line care providers, how can we shift our thinking to build in opportunities for teams to stretch and fold in ways that build resilience and inspire innovation?

Can we shift subjective truths that perpetuate the myth that all stress is bad, and or that we need to operate in stress-free mode all the time?

Can we use the Four Truths to check and create psychosocial safety when encountering a change, or being open to creating innovation / adaptations?

Can we utilize Same and Different to evaluate growth in these areas within teams, celebrate success and discern priorities?

Can we view our leaders with the same level of compassion, knowing that our very human Executives may be experiencing some of the same levels of anxiety and distorted thinking?

AND

Can we create human-centered models that promote psychological safety in the workplace to build adaptive capacity within individuals, teams and the organization when dealing with uncertainty in complexity?

The journey from adaptation of self to adaptation across systems is an infinite game. As I work in partnership towards the next challenge of translating these principles into the development of our organization’s People and Culture Strategy, I will keep a close eye on how HSD can support this journey. And on this note, stand by for that learning experience in a future blog . . .

ⁱHilary Scarlett, The impact of organisational change on the brain

ⁱⁱAnxiety and Depression: An Information Processing Perspective, Aaron T. Beck & David A. Clark University of New Brunswick, Fredericton, New Brunswick, Canada

ⁱⁱⁱClear Leadership: Sustaining Real Partnership and Collaboration at Work, Gervaise R. Bushe, 2010.