Chapter 10

Survivalism at Work

Performance and the Art of Decision
Making Under Pressure

Congratulations.

You’ve likely learned a great deal more about yourself since starting this book, and probably in ways that have surprised you. I hope that you’ve also become significantly more skilled in taking charge of the agitance in your life and living with much more discomfort, no matter where it comes from. There’s a huge piece to my message in this book, however, that I’ve intentionally saved for last. It was necessary for me to guide you through all the previous chapters before getting to this one. Up to this point, I have focused on the role that the survival instinct plays in physical and mental health. Yet these instincts play a substantial part someplace else, and it has everything to do with survival and success. I am referring to an aspect of our lives in which every day our “survivalism” determines the results of our immediate and long-term efforts, for better or worse.

If I had to give one word to identify an area in which full-throttle discomfort—and its immortal and unyielding accomplice, the survival instinct—lurks stronger than ever, I’d have to say performance. When we have to work under pressure, it’s vital to be able to make split-second decisions and react incisively. If we can’t cope well in this situation, then our performance can be dramatically compromised. This is true for all kinds of situations in which there’s a lot at stake: at your job, for example, where you may have to crunch numbers quickly, close a big deal, respond to lawsuits, or manage conflicts; during a test, from an admissions exam that will dictate your future to one for a potential employer; at an event where you’re scheduled to speak to an audience or sell yourself and your services to potential clients; and with your loved ones, who depend on you to perform in whatever capacity is needed (as a parent, spouse, partner, etc.). If you are a professional performer of the arts, then you know the importance of nailing an audition. The sports world is also an area in which the dynamics of fear have been the heart of much research in recent years. And for good reason: More than ever before, it’s not just innate talent or skill that separates the winners from the losers among elite athletes. Most of them have the same physical attributes and abilities. It’s the capacity to manage discomfort and fear that separates them. So as we can see, our ability to manage discomfort and fear can play a critical role in performance—ultimately determining who succeeds and who falters.

Performance is much more than a one-time award that is stuck to a wall or refrigerator as it was in our youth. Now, more than ever, performance is a marathon, not a sprint. As adults we are left with much more important needs that are contingent on our performance ability. And you don’t need to be professional athlete or CEO of a Fortune 500 company for performance-related issues to play a bigger role in your life and health than you ever imagined. Whether you’re completing an urgent work project, scoring on timed exams, trying desperately to impress someone you just met, competing to beat your previous 10K time, or trying to outdo your partner’s score on the golf course, your ability to manage discomfort and fear is key.

I’m a firm believer that one of the reasons we’re seeing so many instances of the survival instinct gone awry in our culture is that few of us are actually trained in how to perform when faced with increasing demands. And therein lies the real problem: Workloads all around have gone up immensely in the past several decades. Ask any student or individual in the workforce if he or she has to do more in less time, and you’ll hear a resounding yes. But when is the last time you were trained to convert your skills and knowledge into useful tools for situations in which you’re asked to perform under pressure? There’s no shortage of companies delivering services that promise to boost your performance or show you how to get more done in less time, but the vast majority of these programs don’t teach people strategies for handling performance-related discomfort.

And for most of us, our first experience with performance under pressure began with school—math tests, oral reports, and so on. Yet, as a society, we unfortunately focus mostly on teaching people facts and information rather than how to perform well. I can’t recall ever learning in school skills that would help me execute at test time all the knowledge I’d cemented into my head during my long hours of studying. Even programs geared to coach students through standard tests, like those to prepare high schoolers for the SAT or premed students for the MCAT, still concentrate on the knowledge and facts necessary for answering test questions. They fail to teach how to excel while under the pressure of a ticking clock, which may have nothing to do with the actual facts that are tested. They also fail to help students manage the competing demands of their discomfort levels, some of which are helpful and some of which are hurtful. As a result, most people are left to fend for themselves, essentially handing the reins over to their inner survivalist. This is why tools to help people manage their time better or practice “stress-free productivity” often miss the mark. Most of today’s self-help books, for example, are rife with ideas on how to prioritize and break big goals down into smaller goals to fulfill, but no one is talking about the core issue here: being able to handle all those priorities calmly and safely by first and foremost managing the inherent discomfort. You have to work from a place of comfort before you can begin to do your best.

If you never learn to transform your discomfort into a source of power to perform optimally, then unhealthy levels of discomfort will inevitably take over, causing a serious obstruction to achievement. In fact, my work and others’ show that discomfort levels account for poor performance in nearly sixty percent of individuals put to the test. It’s sad to think that the mere experience of being evaluated can cause a majority of people to underperform rather than excel as they should. At the extreme, it’s been shown that upwards of thirty percent of test takers in particular have experienced profound underperformance related to their personal levels of discomfort and its physical impact on them. What makes this important is that these early school experiences with test taking constitute the building blocks that influence our performance in later years.

As you know by now, once you become hypersensitive and overly reactive to performing under pressure, then every single demand placed on you, including the most trivial and unimportant, can spark fear. This is when those maladaptive habits start to develop and establish themselves, and as you also know, one of the worst outcomes of this chain of events is that it can lead your survival instinct to activate when there is no real reason. Suddenly, just your thoughts alone—simply thinking about being put to the test—trigger your survival instinct and related symptoms.

The Only Thing We Have to Fear…

…is fear itself. Franklin D. Roosevelt might not have known anything about the physiology of fear when he made this declaration during his inaugural speech back in 1933, but he was right to allude to the profound effects fear can have on us. As I’ve already described, our bodies go to war every day in trying to keep up with our needs, waging battles against threats that are not threats at all (and they surely aren’t on a par with the kinds of threats FDR’s generation faced).

In 2000, a most interesting study was published in the journal Biological Psychiatry. It was led by Charles A. Morgan III, of Yale University, whose team examined the effects of uncontrollable stress on the bodies of two distinct groups of people having to perform in extreme circumstances: Special Forces soldiers and non–Special Forces soldiers. Anyone familiar with the Special Forces, or Special Operations Forces, knows that this is an elite group of military men who are trained to perform dangerous missions that conventional units cannot. Special Forces soldiers need to be physically and mentally robust and have the confidence, courage, and skill to operate individually or in small teams, often in isolation and in a hostile environment. The recently exposed SEAL Team Six, which hunted down and killed Osama Bin Laden, is the navy’s version of one such Special Forces unit. There’s no question that, by virtue of their job, these people endure enormous amounts of psychological, physical, and environmental stress. And because of their uniquely extreme capabilities, they make for an interesting case study.

What the researchers wanted to find out was simply the answer to this question: How do certain biological markers of stress differ between Special Forces soldiers and non–Special Forces soldiers? The biomarker that they studied was neuropeptide Y (NPY), a neurotransmitter that is released by the limbic brain in reaction to stress. Research has found that this peptide increases with stress, and influences decision making and performance during stressful periods. High levels of NPY are correlated with post-traumatic stress disorder, while lower levels are correlated with resilience to stress. The researchers hypothesized that the Special Forces soldiers would have lower amounts of this peptide than would the regular infantry soldiers when exposed to stress. Surprisingly, the levels of NPY among the Special Forces soldiers were much higher than those of the regular armed forces. However, the Special Forces’ NPY levels quickly subsided, while the regular armed forces’ levels remained elevated. In other words, while the regular infantry forces become paralyzed by their discomfort and their survival instinct, the Special Forces were able to quickly manage their discomfort and their response to the survival instinct, and then channel their reactions in a productive and constructive manner. This explains why Special Forces respond so well in extremely trying situations. It’s not that they don’t feel fear and discomfort, but rather they have trained themselves to manage their discomfort and survival instinct much more effectively. As a result of this training, they are hardier and more resilient.

Christian Vaccaro, a sociologist at Florida State University, also explored this idea, leading a study with colleagues at Indiana University of Pennsylvania. Calling it “managing emotional manhood,” Vaccaro and his team looked at mixed martial arts competitors, finding that these men have unique ways of managing fear that actually allow them to exhibit confidence. Those who lost their match generally attributed their poor performance to fear—not to a lack of skill.

Where am I going with this? Not many of us are going to train to become a Special Forces solider, but imagine having a mind and body that can more readily respond like one. It’s possible—without all that hard-core military training. Each one of us can achieve considerably more success if we learn to manage our fear and discomfort in the many areas of our lives in which performance under pressure is necessary. Let’s take a look now at how performance and decision making under pressure are influenced by the limbic and cerebral brains.

Decision Making Under Pressure

Earlier, when I discussed the seat of the survival instinct, I described how the survival instinct presses the HPA axis into action, whereby the hypothalamus of the limbic brain stimulates the pituitary and adrenal glands, activating the sympathetic nervous system. What makes this particularly important with respect to performance is the fact that chronic activation of the HPA axis results in the cerebral brain losing its ability to effectively work in tandem with the limbic brain. By virtue of its fear response, the limbic brain has now commandeered the ship and is reacting and making decisions based on fear, while drowning out the invaluable input of the rational, cerebral brain. The two brains are essentially working against each other. And like an airplane toiling to remain airborne with just one out of four propellers, performance becomes shaky and compromised. Rather than being able to reach its desired location, our metaphorical airplane is now looking to avoid crashing as it seeks a safe place to land as soon as possible. What’s more, since the survival instinct’s fear response drains the brain of the resources it needs to function at its absolute best, it cannot formulate and execute good decisions.

The idea that our tolerance for discomfort is tied to our ability to perform and make good decisions is not a trivial point. In fact, Nobel Prize–winning scientist Daniel Kahneman writes extensively on the psychology of decision making, and in his latest book, Thinking, Fast and Slow, he describes the two competing systems that drive how we think: System 1 is fast, intuitive, and emotional; System 2 is slower, more deliberative, and more logical. Clearly, System 1 refers to the limbic brain and System 2 is the cerebral brain. He argues that the limbic brain is often not the best resource for making good decisions because it can be so flawed and irrational—even when pressure and fear are not present. But what happens when pressure and fear are involved?

In a fascinating study led by Antoine Bechara at the University of Iowa College of Medicine in 1997, researchers described how fear ramps up our aversion to loss. In other words, we are less likely to take chances when we feel fear, and we are more likely to see the potential for negative outcomes than positive ones. As a result, we will make choices that are based more on protection than on potential value. This is true even when there is no externally imposed pressure; in those cases, we are operating from an internal reference point of fear and discomfort that is independent of circumstances in the present. This has particular relevance to those individuals who are already carrying higher levels of agitance and discomfort.

Studies done by others have further demonstrated that we have an innate bias toward negativity. We process bad news quicker than good news, and we have a tendency to interpret situations in a negative way while overlooking favorable or positive elements. In those situations that are ambiguous or uncertain, the presence of fear leads us to interpret these situations in a negative manner, even though a positive outcome is equally likely.

Recall that in chapter 4 I described the heart of the survival instinct as a function of dopamine levels. As dopamine levels drop due to poorly managed discomfort and fear, we can become embroiled in an endless loop in which lower and lower levels of dopamine continue to fuel increasingly more discomfort. Then we form maladaptive habits that are meant to control the fear, which push dopamine levels down further. With respect to decision making, studies reveal that the suppressed dopamine activity directly affects the amygdala of the limbic brain, impairing its ability to “teach” the brain a lesson. In other words, the amygdala is essentially incapacitated by the abysmal dopamine levels and cannot tell the brain to stop the behavior that’s causing the suppression. This explains why addicted individuals continue to make poor decisions and engage in their bad habits despite a constant barrage of punishing experiences related to their addiction. In terms of decision making, if discomfort is not managed effectively, individuals under pressure will continue to make poor decisions.

But what if we take the limbic brain out of the picture? When Peter Sokol-Hessner and Elizabeth Phelps, of New York University, collaborated with Caltech’s Colin Camerer on this question, they discovered that if the amygdala is severed, our risk aversion is significantly impeded. Clearly, we’re not going to sever the amygdala, which acts as the “first responding unit” of the limbic brain. But Sokol-Hessner and his team’s data show that it is possible to change our distaste for fear. Although negative thinking at one time had survival benefits, today we find ourselves saddled with this old negativity bias, which gets revved up even more so during uncomfortable situations. This explains why we are driven to avoid losses far more than we are driven to pursue gains. Or, said differently, we are wired to pursue safety above everything else. As our illogical limbic brain seizes control, our decisions are increasingly shaped by quick judgments that undermine the cerebral brain’s ability to make more accurate, calculating decisions during times of discomfort. All of this ties directly into performance. When we experience pressure-induced fear with respect to decision making, the limbic brain, or System 1, compels us to take protective action, bypassing the valuable input that the cerebral brain, or System 2, could contribute.

Let’s first take a look at the various ways in which we could be asked to perform, and how our agitance and discomfort play a powerful role. You may not see yourself in all of these scenarios, but you’ll certainly be able to relate to one or more of them. Then, I’ll offer guidance on training yourself to perform optimally under pressure while keeping the survival instinct at bay. You’ll be called to employ many of the methods and strategies described in this book, reinforcing all that you’ve learned.

Performance at Work: Hanging Out in the Discomfort Zone

Perhaps our work is the biggest part of our life in which we constantly confront making decisions under pressure. After all, our on-the-job performance can determine our career advancement, our salary, and our self-esteem. As a result, superbly managing discomfort in this environment couldn’t be more essential. Many of the examples I’ve described in this book have in fact been about people trying to cope with work-related challenges. Recall my patient Zach, who struggled in his job at a big law firm, finding it difficult to stay the course in the face of discomfort. He epitomizes someone who needs to develop better skills for dealing with discomfort, especially for circumstances beyond one’s control.

To get a broader perspective and understanding of the role that managing discomfort plays in the work environment, I sought out a successful high-stakes entrepreneur who has navigated the choppy waters of the business world for years. Robin Richards has a long history of triumphs as an entrepreneur and visionary strategist. He is probably best known for being the founding president and chief operating officer of MP3.com, which ignited the revolution of downloadable sound files and was eventually sold to Vivendi Universal. Today he is the chairman and CEO of Internships.com, the world’s largest internship marketplace.

Robin’s personal and work philosophy emerged from growing up in a blue-collar home where money was tight. The few times a year that he dined out with his family were painful reminders of how little they had, as he wasn’t allowed to order certain things on the menu because they were too expensive. His mother couldn’t buy dresses that she needed. From an early age, Robin was determined to make his life dramatically different, and to do everything possible to be the “master of [his] own universe,” never being stuck in a job where he’d have to follow someone else’s rules. This steadfast commitment has guided him very successfully in business and at home.

When I asked him about managing discomfort in his workplace, Robin lit up and emphatically expressed how it was one of the most salient factors in creating success. He had some interesting things to share. “Blasting through discomfort and being able to handle it is where success and the dollars are,” he said. According to Robin, many people “can’t take the heat,” quickly becoming irrational and unraveling when the going gets tough. He feels that this often explains why so many business deals fall apart, as mounting pressure leads one to do or say something out of character. No doubt Robin is referring to what happens when people are reeling from their survival instinct.

Robin believes that anyone can succeed, but that it depends on who can tolerate discomfort and manage it effectively. Confidence for him comes not from success alone but from being able to withstand the discomfort. He feels that expecting to win is easy. But it’s far more challenging and essential to anticipate discomfort and battles in business, which makes the inevitable hits hurt much less, allowing you to “go into the high seas with a greater sense of calmness.” Robin lives by the motto “refusing to lose” as opposed to affirmations related to victory. He also believes that his ability to hang out in the discomfort zone gives him a competitive edge at a time when many young executives fear being uncomfortable and would rather avoid a conflict and discomfort at any cost. He thinks that a business leader gains respect from his adversaries and cohorts when they learn he isn’t afraid of discomfort or conflict and can manage both effectively.

When I asked Robin how he navigates through his own uncomfortable moments, he said, “When a storm hits, I’m panged with anxiety, but it arouses my desire to do battle, and I work myself up in order to get tougher.” As part of this mental preparation or “workup,” he draws on his childhood determination to be the master of his universe. He embraces and welcomes the challenge.

This all sounds quite familiar, analogous to the findings in the study on the Special Forces who are often confronted with fearful situations in combat. It’s not the lack of fear that creates a successful response; it’s how the fear and discomfort are dealt with. For Robin, rather than avoiding discomfort, he welcomes it, seeing it as the ultimate path to success. Even though his initial experience with discomfort evokes a great sense of being unsettled—and no doubt a high level of agitance—Robin doesn’t let it transition to a maladaptive reaction. Instead, he uses the discomfort as a trigger to take positive and constructive action.

But Robin also knows that as a leader, he needs to model and teach his employees how to manage their own discomfort. This isn’t always an easy task, he reports, because so many young employees have grown up in a culture in which there is a sense of entitlement to being comfortable, successful, and happy all the time. Robin appreciates the old adage that says the fastest and shortest path to success is a long one, but this can be hard to teach the younger generations, who expect instant results and harbor a low tolerance for discomfort. He does what he can to psychologically prepare his people for difficult challenges by reinforcing the reality that things won’t always be smooth sailing. In talks he gives in front of his employees, he reminds them that it’s okay to feel stuck, to fight, to take on a battle or two, and to develop a reputation as someone who can handle it.

As with most successful leaders, Robin values the ability to build strong teams in his companies. He likes to create eclectic teams that encourage “cross-pollination”—a combination of different personality types, work ethics, and even discomfort thresholds. Of course, this often generates debates and disagreements, but he finds these teams to be more successful than homogeneous ones. And when dissonance inevitably develops, he encourages them to persevere, and to perceive the discomfort as an important ingredient for success. He also offers himself as a template, showing his employees how he leverages discomfort to spark productivity. Just by admitting his own challenges and educating them on the fact that discomfort is an essential ingredient of success, he can strengthen his teams’ performance and resolve. And, as with Special Forces training, he grooms his employees to transform discomfort into successful action.

Aside from being tested in our roles at work, we all face other, more traditional tests in our lives, which start very early on in our youth—setting us up with the knowledge of how to deal with every type of “test” thereafter, be it work related or in the relationships we keep.

Academic and Test Performance: Working Under the Gun

Unlike older generations, who probably didn’t experience their first encounter with an out-of-control survival instinct until they reached adulthood, or at least until their teenage years, nowadays kids vying for coveted spots at schools are having to wrestle with their survival instinct more frequently and at an increasingly younger age. And, as you can imagine, they are ill equipped in many cases to deal with this in healthy ways. As they struggle with coping, they often fail to notice that this silent battle seeps into other areas of their lives, changing how they behave, socialize, and make decisions until it becomes nearly impossible to overlook.

Take, for example, my patient Jenna, a bright and promising young woman whose excellence in school began to take a serious turn when her levels of agitance exceeded her discomfort threshold and she could no longer perform on her school exams. Jenna was about to begin the eleventh grade when she first came to see me. At the time, test taking had developed into a big obstacle in her life; she experienced panic and anxiety, which necessitated her reliance on medications to manage. It didn’t help that she was entering a grade when the ability to excel at taking tests would become increasingly pivotal to her future success, especially with the SAT and college applications on the horizon. For Jenna, symptoms were fueled by a fear of failure. They started days before exams, as she would find herself with an upset stomach, nausea, and insomnia, even vomiting the day of an exam. During a test, she’d lose focus easily, suffer stomach pains and memory loss, and essentially panic as if her life depended on her performance.

Jenna wasn’t an average student. Much to the contrary, she was a straight-A student enrolled in a number of Advanced Placement courses. Suffice it to say she was a seasoned test taker who had done well during her school years and had high expectations of herself. But over time, her test-related symptoms, negative thought patterns around exams, and particularly her fear of failure began to soar. By the eleventh grade, her anxiety had progressed to the point that it was now part of the test-taking process. In other words, her symptomatic reactions materialized whether they were merited or not—whether the exam was difficult or not. This is what I call test habits.

Like so many of her classmates, Jenna was a victim of externalization. She engaged in many agitance-raising activities, such as watching television, snacking, texting, and studying all at the same time. Her swelling agitance was exacerbated by the fact that she’d work at the computer or on homework all the way up until bedtime. In the past, Jenna’s agitance levels had been under reasonable control, but at the onset of eleventh grade (feared by all college-bound students), they began to peak. Eventually, her high agitance combined with her school stressors, and, like a chemical reaction, her discomfort levels soared enough to ignite her survival instinct, culminating in significantly more frequent symptomatic episodes. Her mood was also changing. Her mother described Jenna as being short, uptight, irritable, angry, and feeling burdened. When I asked Jenna about being so worked up about her exams, she said that she was accustomed to feeling that she needed to be ramped up and upset in order to succeed. This reaction was Jenna’s test habit. But now she realized that being ramped up was taking control of her life and ruining her ability to succeed. It was time to make a change.

I bring up Jenna’s story because it’s so symbolic of how many of us react to the rigors of having to perform in an extreme setting, which in her case was formal test taking. Some of us experience our first test when we “apply” for kindergarten, and from there we encounter routine testing throughout our lives in both academic and nonacademic settings. We can face testing in our professional lives, or as candidates for jobs at companies that want to test our personality, among many other attributes and skills. Often the experience of facing a test entails a serious double whammy: an underground stream of fear or tension springing from our history of taking exams and from the present trepidation related to not knowing how our performance will affect our future.

Jenna, by the way, overcame her problems with test taking and learned to thrive both at school and in her personal life. I began by helping her first lower her agitance levels in general. This entailed modifying her need for constant stimulation and her reliance on external solutions, including the antianxiety medication (Buspar) that she’d come to depend upon to feel an inner sense of calm. My goal for her was to help her approach her studying and test taking from a place of lower agitance, while reducing the factors that were feeding it. It then became possible for her to associate her schoolwork with an entirely different inner atmosphere and to achieve a balance between the limbic and cerebral brains.

She also worked on the act of test taking by practicing answering test questions in a more balanced brain state, while learning to experience discomfort as a performance enhancer. Since it’s pointless and unconstructive to fully eliminate negative thoughts, which will always be there to some degree, it makes far more sense to accept their presence and strip away or neutralize their power. (Besides, anything we try to push away or ignore only becomes stronger.) As I lowered Jenna’s unmanageable levels of discomfort and altered the power of her negative thinking, I helped her to use a healthy dose of discomfort to improve her performance, which ultimately encouraged her survival instinct to retreat so that it was totally out of the picture in her test taking. By doing so, I built a new set of effective test habits for Jenna so that discomfort and negative thoughts related to test taking and studying were now associated with test performance—a conditioning that made test taking success-driven rather than fear-driven. Put simply, it was no longer a success-threatening obstacle in her life.

Survival of the “Fittest”: Sports Performance

Our experience with tests in those early days of our academic life can set the tone for how we perform for the rest of our lives; the same is true for people who play sports as kids. Those experiences on playgrounds, soccer fields, and basketball courts can have lifelong effects on one’s ability to perform. And as with academic performance, the importance of sports performance in our culture has spiraled upward both in the world of professional sports and in smaller arenas—all the way down to the Little Leaguer in elementary school. In fact, one of my earliest memories related to performance under pressure is of standing on the pitching mound at nine years old, with all eyes on me—those of my fellow players, the opposing players, and people in the stands waiting to see my next pitch. Of course, I was hoping that somehow I would not hit the batter and that I would find a way to get the ball over the plate, which was not altogether different from my performance anxiety related to treating Mikael’s hiccups decades later. This type of performance-related discomfort begins early, and it doesn’t stop. If you are like most people, it can continue to haunt you.

We see performance-related discomfort in the sports world every day. Just turn on the TV and admire those players who instinctively react well, versus those who crack under pressure and make poor decisions. Consider the tennis player who defensively hits lobs and keeps his opponent in the game instead of going for a slam to win the point. Consider the professional basketball player who can nail ninety percent of his free throws in practice, but turns to mush during the game and sinks only a miserable fifty percent. Perhaps one of the most remarkable attributes that makes elite athletes in the class of Kobe Bryant and Peyton Manning so great is the fact that they thrive in extremely uncomfortable situations.

Earlier in this chapter I referred to Vaccaro’s study on mixed martial artists, in which the fighters attributed their losses to their inability to manage fear. And with the increased emphasis on sports performance, fear in sports is at an all-time high. But this fear can show up in hidden ways. Take, for example, my patient Martin. When he came to see me he was a college basketball star with aspirations of playing in the NBA. Although never a stellar free throw shooter, during his senior year, when he was being considered by pro scouts, he noticed that his ability to make the hoops had seriously deteriorated, shrinking from seventy percent to thirty-five percent. His off-the-court practice made little difference, and it wasn’t long before his shooting form became stiff and awkward; rather than shooting the ball, he was now pushing the ball to the hoop. What made things worse was the fact that his teammates and coaches were on his back to improve, while the fans had little patience, routinely moaning and ridiculing him when he came to the line to shoot. The prospect of standing on the free throw line with every eye in the arena on him became enormously uncomfortable, spiking dread and fear. The survival instinct eventually took hold, which eroded his confidence and began to seriously undermine even his non–free throw shooting.

After questioning Martin, I learned that his escalating fear in terms of performance was not actually anything new—it had begun years before, in elementary school. Martin was an average to above-average student back then, and what unhinged him the most were the times he had to give an oral report. He could vividly recall the sensation of being paralyzed with fear. He could hardly speak. His classmates made fun of him while his teacher showed signs of being exasperated. Soon enough, just the prospect of giving an oral report led to substantial fear. So when his name was called to stand up, he could see his classmates shifting in their chairs, moaning, and laughing. Now, years later, when the pressure was on him to perform in his senior year, he was freezing again and detecting a similar level of frustration and humiliation in his teammates, coaches, and fans. The experience was a carbon copy of his earlier school days. As he stood on the line to make free throws, it was as if he was back in school giving an oral report, crippled by fear and unable to perform.

Whether you’re a pro or not, some level of discomfort is to be expected at the free throw line during game time. It’s normal. For Martin, the goal wasn’t to banish the discomfort he felt at the line, but instead to manage it more effectively. By learning that his present fear had its roots in his childhood experiences in school, I was able to help Martin separate his performance-related discomfort in basketball from those past fears that were no longer relevant. And he quickly got his game back on.

You’re On!

Now let’s consider Shannon. Shannon came to me after botching several key auditions for television parts. But Shannon wasn’t new to the business. She had a long history of being successful in acting, and she’d had starring roles in several long-standing television series. Now in her mid-forties and up against younger actors, however, she found it harder to find roles and win auditions. She described to me that while under pressure to do well in her past few auditions, she made choices in her delivery of the script that sabotaged her performance. This happened in spite of the fact she could effectively deliver her lines effortlessly and expertly when she practiced at home and with her acting coach. Logically and after many years in the business, Shannon knew that auditions were not always about performance, and that other factors were involved, notably hair color, age, height, and general appearance. But knowing this did nothing to mitigate the fears that she felt. By the time she visited me, this fear of failing had reached stratospheric levels, as it was now compromising her abilities. Days before an audition Shannon would struggle to memorize and recall her lines, a problem that she’d never encountered before. Previously, all it took was one reading for her to commit a monologue to memory. Now, however, her survival instinct was in control, stripping her of skills she’d acquired long ago. Although it’s natural to feel discomfort around auditions, which are inherently nerve-racking, for Shannon the audition experience had morphed into a personal threat. She had to train her brain how to manage her discomfort, to truly depersonalize it and experience it without letting it feel like a threat. Only then could she ultimately overcome her audition fears, and eventually get her next acting job.

Although Shannon was an actress, many of us can relate to situations that seem critical at the time—instead of performing like we want to, we find ourselves looking foolish or unattractive, at the worst possible time. We walk away from these situations feeling dreadful, saying to ourselves, “Why did I say that? Couldn’t I have said this instead?”

This can happen in a variety of scenarios: with someone we’ve recently met and want to impress, with our boss when we want a promotion, or at a party where we feel nervous and uncomfortable, spilling our drink at the table. All these situations have one thing in common: a feeling of discomfort that is poorly managed and leads to unfulfilling consequences.

Grooming Yourself to Thrive Under Pressure

Let’s now turn our attention to strategies that can be used not only to manage performance-related discomfort, but to boost performance as well. These will reiterate the methods I outlined in the previous chapter, as well as offer additional techniques you can apply to your life, no matter what kind of test or performance you face. Although it would be nice to work in a setting in which we are trained to manage discomfort, or to learn these skills in formal education, it’s more realistic that we have to acquire them on our own. Part of my reason for including this chapter in the book is to help you do just that, with a secondary intention of motivating our leaders—school administrators, bosses, and parents—to begin implementing and/or supporting programs geared to help students and workers manage their discomfort better. After all, it’s one of the surest ways of tapping into the true potential of students and workers in every type of circumstance, from formal classrooms and boardrooms to informal playgrounds and stages.

EMBRACE THE CHALLENGE

Recall that I covered how the power of challenge can go a long way toward improving resilience and hardiness in terms of discomfort. Robin, for instance, was able to use the power of challenge to transform his fear into productive performance. Remember, we are not interested in banishing discomfort; rather, like a Special Forces soldier or an elite athlete, we want to convert it into a catalyst that facilitates performance instead of hindering it.

I remember when Kobe Bryant was interviewed at the age of nineteen or twenty about how he felt about performing under pressure for the Lakers. It was common for him to be called into the game at the very end just so he could receive the ball and make a basket for the win. When he was asked about what it was like to be placed in such a position, he said, “This is when the game gets interesting and fun.” So even at an early age, Kobe had already established the ability to embrace challenge in a healthy manner that would produce positive results.

Embracing discomfort as a challenge is something that can be learned and practiced. Where most individuals go wrong is in assuming that accepting challenge means not feeling discomfort. The goal is not to pretend that discomfort doesn’t exist; it’s to find strategies to cope with it more effectively. So in teaching this strategy to students and workers, it is essential to help them understand this critical distinction.

FIND YOUR INNER GLADIATOR

The inner gladiator technique can work in tandem with embracing challenge. This technique is especially valuable if you don’t view yourself as capable of handling adversity well. Although many people present themselves as confident and competent, the fact is many of those same people collapse under stressful or adverse conditions. This is when the fear of not being able to stand up to adversity gives adversity even more power. You may project an air of confidence and strength but feel weak or helpless in the face of crisis. You need to summon your inner gladiator.

In my clinical practice and groups I have conducted on test performance, having people imagine themselves as a particular person or fantasy character whom they equate with strength and fortitude can make embracing challenge even more successful. This is partly due to the fact that it’s easier to attribute strength to someone other than yourself. And the inner gladiator technique takes your instinctual tendency toward weakness or failure under conditions of uncertainty and fear, and makes it easier for you to identify with an inner sense of strength. This technique takes the well-known faking it until you make it to a whole new level of brain community development.

SEEK SOCIAL SUPPORT

Remember, tapping into the power of social support is an important tool for managing all kinds of discomfort. Social support is an invaluable means of teaching workers and students how to manage their discomfort. This method was also espoused by Robin Richards in his use of creating heterogeneous teams that were taught to function in a cooperative atmosphere. All school and work settings would do well to encourage more team-based projects. This strategy has the added benefit of capitalizing on cooperation, which is proven to produce better results than competition. Unfortunately, this often conflicts with the way many of us were raised, given our cultural history: The pioneering spirit embraces the opposite—a competitive, independent individual. This is the ideology America was founded on, which explains why there’s a natural tendency in our culture to “go it alone” and seek individual glory. And although it’s true that competition can lead to great results for individuals striving for a prize, more often than not, the stakes are too high. Only a few people who choose to go it alone actually achieve what they want. In a world of interconnecting economies, cooperation and collaboration will ultimately produce the best performance results for the vast majority of people.

ASSUME RISK

Virtually everyone will say yes to the question “Do you want to be successful?” But why, then, do so many people settle for “just getting by” or giving up entirely? For many, what underlies this paradox is a fear of failure, and playing it safe and not giving their absolute best effort allows them to manage this fear. Not striving for success is a maladaptive habit, and such avoidance becomes a form of protection. Let me describe a case that illustrates this well.

Rachel was a thirty-nine-year-old executive with an MBA working in a high-pressure technology firm. Her typical workday lasted twelve hours, and weekends entailed work as well. Although she climbed the corporate ladder quickly, in the past couple of years she felt she had plateaued and was now being passed over for promotions and higher bonuses. When she came to me, she’d been struggling with an unrelenting fatigue, which crippled her ability to work late. Yet it couldn’t be pinned on an underlying medical condition. But I learned through spending time with her that this fatigue, which was real, also served a different purpose: It gave her an out and a way of saving face in terms of being rejected for future promotions. In other words, she could avoid the risk of future rejections on the basis of being too enervated to pursue reviews and promotions. It was far less emotionally risky to forgo a job promotion due to an illness than it was to commit to the promotion process and be passed over—at which point she’d have to confront the fact that she wasn’t as capable or as smart as her colleague who received the promotion.

Our fear of assuming such emotional risk at work can commonly materialize in a physical manner, like it did with Rachel. I call this condition Resistance to Health, and it’s based on a study I conducted years ago on medical patients in the Psychoimmune Program I founded and directed at an L.A. hospital. In my previous book, When Relaxation Is Hazardous to Your Health, I explain how we can develop a resistance to becoming well, whereby our desire to avoid emotional discomfort can interfere with our ability to heal and sustain health. In a sense, ill health becomes a maladaptive habit and a practical means of escaping discomfort and risk in our lives.

Students may also take a course of action that is meant to shield them from emotional risk. Rather than committing to studying test material, they can easily be distracted by mindless Web surfing or eating when they aren’t hungry as a way to avoid getting serious about their studying. And although on the surface it may seem as simple as poor work habits or procrastination, more often it is a way to blame their mediocre test performance on not having enough time to study as opposed to not being intelligent enough.

I have also seen the fear of assuming risk transpire outside of work, with respect to losing weight. In a clinical program I developed for chronic dieters, I help individuals control problem foods while breaking the connection between wanting to eat and their moods, such as boredom, anger, and fear. Unlike current methods, which direct their intervention to the cerebral brain, I designed my program to directly recondition the limbic brain’s pleasure center through a process I call HypnoConditioning. Since the program influences the pleasure center directly, it particularly shines in several main areas: sustaining weight loss long-term, builiding inhibitions to problem and trigger foods, and creating satiation with smaller food portions.

For dieters in particular, the fear of risk surfaces in a very insidious way. For a certain subset of dieters, rather than emerging at the beginning of a weight loss journey, it tends to creep in after someone has lost a substantial amount of weight, such as forty or fifty pounds. Even though the weight loss has occurred relatively easily and with little discomfort, there is a point that certain individuals come to where they just plateau and seem to lose their desire to go further (e.g., if their goal is to lose sixty or seventy pounds). When I explore this shift in them, I encounter statements like “I have done enough for now; I can live with this.” Essentially, a commanding and nearly hidden voice within them says that they are done pursuing the path of change, even though their level of discomfort has been minimal. Despite their success, there is a hidden fear that lurks within them, and it is often a fear of failure. And somehow not achieving their ultimate weight loss goal serves a protective function for them—much in the same way Rachel’s fatigue did for her.

As we can see, the need to play it safe can take an enormous toll on our work and school performance, as well as our health. Although it may save face and provide some semblance of safety, it’s terribly undermining in terms of our future performance and self-development. Training to assume risk should begin in our schools, where we can teach young students to embrace calculated risks as opposed to all the emphasis being placed on success alone. In the real world of achievement, only successes are rewarded, while failures are not. When I say “failures” I’m referring to failed outcomes from valiant attempts and calculated risk-taking. If a child takes a chance on trying something new and innovative, but it doesn’t pan out well, then his efforts should be acknowledged in a way that encourages him to try again (note that this is different from excessively rewarding individuals to the extent that they expect accolades all the time). Such saluting of efforts can ultimately contribute to much higher levels of performance while lessening the need to play it safe. It can also spur the kind of innovation we all would like to see in our schools and companies.

PUT THE HEAT ON

One of the best strategies for managing fear related to performance pressure is to practice problem solving under time constraints. Even if we don’t need to actually work against a clock, performance under pressure can help us hone our skills. A natural tendency is to want to practice in a comfortable setting or manner, but the real world constantly reminds us that ideal environments seldom occur. Recall the example in the previous chapter about duality, in which my patients who learned to relax and stay focused despite noisy distractions were much more prepared for the real world. The same is true of performance: The more we can practice performing in real-life conditions with plenty of distractions and time constraints, the more likely the discomfort we feel while under pressure becomes facilitative. We can hold the survival instinct at bay.

For individuals looking to excel in their academic pursuits, I often have them practice actual test questions under significant time constraints that are far more pressing than the actual time constraints of the exam. For example, I have lawyers take multiple-choice questions from the bar exam or formulate their answers to the essay questions at a very rapid pace. The goal of this exercise, however, is not necessarily accuracy. Instead it’s to develop a greater comfort in high-pressure, high-stakes conditions.

For those looking for improvement in their work environment, I have them start working on math problems against time. This offers a wonderful opportunity to practice feeling uncomfortable and learning to channel it in a constructive manner. The discomfort is evoked in two ways. First, math problems cause discomfort for a large segment of the population. Second, solving math problems under time constraints compounds these individuals’ feelings of discomfort. In this exercise, the goal is not accuracy or the best score. Much to the contrary, the goal is simply to develop a comfort zone while under pressure.

The end result of practicing in these circumstances is that it truly grooms a mental and physical toughness, and an improved ability to manage discomfort. It also strengthens the association between discomfort and productive performance.

Grooming for Success

As I’ve been reiterating, we can groom and develop the skills to perform our best and make good decisions under pressure. For sure some people are instinctively better able to perform under strenuous conditions. But this represents a small percentage, and it isn’t necessary to become as good as an elite athlete or Special Forces soldier to truly harness your abilities. With respect to students, if the goal is to groom them for maximum performance and the ability to convert their academic knowledge into performance, then it makes far more sense to provide some skills training for our younger generations at an earlier age. Doing so would alleviate so much collateral damage caused by their discomfort, such as low self-esteem, avoiding risks that could prove lucrative, or giving up entirely. It would also improve students’ ability to apply their knowledge to the real world.

But equally important is preparing workers who are employed by a company. To maximize profits and worker productivity, it makes sense to put in the time, effort, and money to develop workers’ abilities to manage discomfort while performing their job duties under pressure. Not only would this maximize returns on employees, but it would also lead to far fewer expenses that are directly related to employees suffering on the job. Health insurance companies are leading the way by rewarding those companies whose employees have healthier lifestyles. It’s pretty obvious that unhealthy lifestyles can be a factor of mismanaged discomfort. And it goes without saying that the healthier the employee is, the more productive and happy he or she ultimately is at work.

Trends in tougher work demands and higher expectations are likely here to stay. We have only two options: play or don’t play. And if we decide to play, then we have no choice but to develop the skills that can manage the related discomfort over the long haul. Life is, after all, a marathon rather than a sprint. The best chance we have for living healthy, productive lives is to hone those skills that manage discomfort in the long run. And the good news is that there are now evidence-based methods that can make this possible.