TRUST - looking through the prism of a mathematical formula

E = ?

I heard you all say E=mc²

That is the power of a formula, it stays in our memory and gives us a conceptual understanding of the subject.

Out of curiosity, I was exploring can Trust be represented by a mathematical formula?

What made me contemplate about Trust? 

In my opinion (own perception and interactions with family and friends) and from the public discourse, globally Trust has become fast eroding social capital. This contemporary relevance of Trust and Mistrust got me to explore this subject.

Oxford dictionary defines Trust as the feeling you have that somebody or something will do what they should do; the feeling that somebody is honest and good. 

Moving away from language, when I tried to look at Trust from the point of view of a mathematical formula, I stumbled upon a beautiful concept called 'Trust Equation', which I am sharing here for our collective learning: 

TRUST EQUATION:

T = (C+R+I) ÷ S

The concept of Trust Equation was introduced by David H. Maister, Charles H. Green and Robert M. Galford in their book, Trusted Advisor.

Let's look into all the factors of Trust Equation, in details: 

1. T: Trustworthiness
2. C: Credibility 
3. R: Reliability 
4. I: Intimacy 
5. S: Self-orientation

• T (Trustworthiness) is the trust factor between the two individuals.
• C (Credibility) is one's credentials, truthfulness and transparency. In simple words, how believable one is to others.
• R (Reliability) is how others perceive the consistency of our actions and it's connection with our words (integrity).
• I (Intimacy) is the sense of security one generates for people around him/her, so that they feel safe to share and discuss.
• S (Self-orientation) refers to where does one's personal focus lie? Do they have my best interest in their mind or Are they are doing this for themselves?
• C, R and I (Credibility, Reliability, Intimacy) are the numerator 
• and S (Self-orientation) is the denominator of the equation.
• The C and R are the Rational components (In fact these are measurable attributes). 
• I and S are the Emotional components (Difficult to measure directly but can be inferred indirectly from one's behaviour).

What inferences can be drawn from Trust Equation? 

• Trust Equation reflects the balance of Mind and Heart. 
• C, R and I increases Trustworthiness
• Whereas S decreases Trustworthiness
• It takes long term commitment and effort by both the Trustee and Trustor, to build a Long-lasting, Meaningful Relationship (whether it is in personal space or in a business context). 
• In essence, "Relationship trump transactions, with trust at the heart of the matter" - Charles M. Green 

Reflecting upon some contemporary incidences of Mistrust and it's correlation with Trust Equation: (Living in middle of a pandemic, I couldn't think beyond COVID-19 related incidences)

1.  This COVID-19 pandemic, has lowered the trust factor of general public on WHO (World Health Organisation). Several investigative journalism have pointed out WHO's flip-flop on handling the Corona virus outbreak in China when it was still in Phase 2 (localized within Wuhan). WHO's approach towards China has raised questions if WHO (an international organization) applies the same standards for all countries or there is differential approaches based on the country's power quotient? This lowered C (credibility), R (reliability) and S (Self-orientation) factors caused an overall decline of  WHO's Trustworthiness (T) in public perception.
2. Recent publication of a clinical study on the drug HCQ (Hydroxy Chloroquine) in Lancet a highly reputed medical journal has caused a huge dent on it's Trustworthiness which was build over two centuries (a 197 years old journal). 

This study [Hydroxychloroquine or Chloroquine with or without a macrolide for treatment of COVID-19: a multinational registry analysis] claimed HCQ:

• Had no positive treatment outcomes on COVID-19 patients and 
• It caused Cardiac rhythmic irregularities and increased the risk of cardiac fatality. 

On the basis of this published study medical practitioners stopped prescribing HCQ and ongoing HCQ clinical trials were stopped across the globe. Later when discrepancies were noticed by peer reviewers and they demanded to see the raw data, the authors backtracked as they couldn't furnish the data. The paper was subsequently retracted from Lancet with an apology from the authors. 

This incident raises serious questions ranging from conspiracy theory, to  conflict of interests (HCQ an effective cheap drug can potentially lower down the market valuation of a new research drug from an innovator company), to political affiliations (Did Trump's endorsement of HCQ, politically polarized the drug and a section of scientific community developed a bias towards HCQ?). 

Whatever be the truth behind this, such irresponsible act of publishing a unsubstantiated study had put so many life at risk, by depriving them of  HCQ from their treatment protocol. This incident shows low C (credibility) and high S (self-orientation) factors of the authors and the editorial board (conflict of interests or personal biases), reduced Lancet's Trustworthiness (T) which was build over two centuries.

3. There are innumerable accounts of such mistrusts which keeps exploding at institutional or individual levels. Collapses of giant corporations, financial institutions or sportsperson falling from grace due to doping or shady financial transactions all are due to compromise of either or all factors C (credibility), R (reliability), I (intimacy) and S (self-orientation) as explained by the Trust Equation.

 

4. Similarly on a positive note, when a company or a brand or a person commands Trustworthiness, it can be correlated to high standards of C, R, I and S factors as explained in the Trust Equation.     

Summary: 

Trust is the key ingredient for Social Capital. Without trust no meaningful relationship can be forged. Therefore it is important to nurture the attribute of Trustworthiness in us, for becoming effective individuals and to become a better human being, professionally and  personally. 

"Relationship trump transactions, with trust at the heart of the matter" - Charles M. Green 

Trust Equation: T = (C+R+I) ÷ S serves as an easy to recall formula, which gives us the conceptual understanding of Trust, in a simple yet profound manner! 

References:

1. Understanding the Trust Equation and 12 Trust Tips - Webinar by Charles H. Green https://www.youtube.com/watch?v=rfc7Cbmk6WM
2. The TrustedAdvisor https://trustedadvisor.com/articles
3. How Trustworthy are you? article by John Baldoni on HBR https://hbr.org/2008/05/how-trustworthy-are-you 
4. Surgisphere: Governments and WHO changed COVID-19 policy based on suspect data from a tiny US company. https://www.theguardian.com/world/2020/jun/03/covid-19-surgisphere-who-world-health-organization-hydroxychloroquine 
5. China delayed releasing coronavirus info, frustrating WHO https://apnews.com/3c061794970661042b18d5aeaaed9fae
6. Star Cardiologist Mehra and data doctor Desai - story of Indian experts behind HCQ scandal. https://theprint.in/health/star-cardiologist-mehra-data-doctor-desai-story-of-indian-experts-behind-hcq-scandal/436601/

 

Leadership: Strategic & Tactical approaches

Leadership effectiveness emerges out from the confluence of Strategic & Tactical approaches. It is also a poignant reminder to us, not to fall into the trap of overt singular usage of just one skill-set but to be mindful of the inter-dependency of Strategic & Tactical approaches for a meaningful, successful outcome.

The quote "Strategy without tactics is the slowest route to victory. Tactics without strategy is the noise before defeat." by Sun Tzu underlines the importance of strategy & tactics for a successful outcome.

Leadership would be significantly flawed if there is over-reliance on tactics & due importance is not given to strategy.

Though Sun Tzu comes from a military background, the importance of Strategy-Tactics finds application in all fields of human endeavours. For example in competitive Sports, lot of strategising happens between the coach, captain & technical experts before stepping on the field. Once on the field, the players tactically respond to the changing dynamics of the match situation. The break-time, is once again utilized to re-strategise & tactical play returns in the scheme of things when match resumes.

In my mind, strategic thinking & deployment of strategy needs conscious effort & it's not intuitive. As we all are drawn towards the path of least resistance, the tactical approach route has more footfalls than the uphill route of strategy, until it becomes a habit with regular practice.

Why Strategic thinking & deployment of strategy needs conscious effort? 

• One has to learn how to think
• One has to set aside ego & biases
• Acceptance of blind-spots (I know what I know, but I don't know what I don't know)
• Multi-disciplinary approach & Synthesis mindset
• Engage in consultative, democratic brainstorming session
• Embrace contrary views & don't shoot down the messenger
• Demands skills like being proactive, planning, risk anticipation & risk mitigation
• It is about responding & not reacting
• Two way communication is key to be able to strategise correctly, to convey the strategy, keep stakeholders engaged with the strategy over time & to revisit the strategy with the ongoing dynamics of changing realities

After consciously setting the strategic direction, the tactical approach has to be also leveraged for a robust process. The importance of tactical approaches are:

• Recognition of the fact, we are living in a dynamic reality
• Dynamic changes demands real time responsiveness
• Good tactical response is based on intelligence, situational awareness & being proactive
• Keeps the daily actions & activities aligned to the established strategic direction
• On the ground, practical implementation of the strategy    

We would all have anecdotal stories of our positive experiences of strategic-tactical synergies and not so positive experiences when strategic & tactical approaches have not been in sync. These personal stories serves as a poignant reminder, to save guard ourselves from falling into the trap of polarity usage of just one skill-set. Meaningful success outcomes is driven by effective leadership, which demands both, strategic & tactical approaches.

Note: The reference has been deliberately made to the attribute (Leadership) & not to the title (Leader),because I firmly believe being a leader is agnostic of a formal designation or role. The other way to look at it is, many formal leaders come short in their leadership while many informal leaders with strong leadership qualities are not in formal position either by design or by choice.    

Burn-out - decoding & tackling it!

Photo by Danylo Suprun on Unsplash

The acronym VUCA is commonly used to describe today's business environment. Volatility, Uncertainty, Complexity & Ambiguity are the order of the day. Burn-out, Anxiety, Stress, Work-life Balance, EAP (Employee Assistance Program), Counseling, Wellness programs etc are the buzz-words among HR & Management, across companies.

Burn-out as an occupational hazard is not limited only to corporate world, but seen in various people oriented professions such as human services, education & health care. The context varies, in Corporate sector the burn-out can be related to pressures of project timelines, product launch, productivity, demanding customer, while in Human services the prevailing norms are to be selfless & put other's needs first, the service providers  develop with the recipients an intense level of personal & emotional contact.Although such relationships can be rewarding & engaging, they can also be quite stressful, leading to burn-out in long-run.

In the recently published 11th edition of ICD (International Classification of Diseases), WHO (World Health Organisation) revised Burn-out as an Occupational phenomenon (previously it was categorized as a medical condition).

In online search engines, you will come across tons of scattered articles & papers on Burn-out, describing it's various facets. In this article, I have attempted to provide readers a simplified, consolidated, comprehensive coverage on the topic Burn-out, through a single reading.

List of topics we shall explore together:

1. WHO definition of Burn-out
2. Conceptual models of Burn-out
3. Assessment/Measurement of Burn-out
4. Causes of Burn-out
5. Engagement
6. Outcomes of Burn-out
7. Intervention strategies

Definition

"Burn-out is a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed. It is characterized by three dimensions:

• Feeling of energy depletion or exhaustion
• Increased mental distance from one's job, or feeling of negativism/cynicism related to one's job
• Reduced professional efficacy

Burn-out refers specifically to phenomena in the occupational context & should not be applied to describe experiences in other areas of life."

This three dimensional model, clearly places the individual's experience of Burn-out within a social context & involves the person's conception of both self & others. Therefore, Burn-out is a psychological syndrome emerging as a prolonged response to chronic interpersonal stressors on the job.

Conceptual models: 

The earlier theoritical models focused on the relationship between the three dimensions (exhaustion, cynicism & reduced efficacy) of burn-out & these were described in sequential stages.

More recently, burnout models have been based on theories of job stress & the notion of imbalances leading to strain. The first such model was the transactional one, which served as a conceptual bridge between sequential stages & imbalances. It's three stages are: a). job stressors, b). individual strain & c). defensive coping.

Subsequently, three models based on Demands-Resource Imbalance have emerged. There are:
Job Demands-Resources (JD-R), Conservation of Resource (COR) & Areas of Worklife (AW) models.

Job Demands-Resources (JD-R) -  Burn-out arises when individuals have inadequate resources at their disposal for meeting the increasing job demands.

Conservation of Resource (COR) - Burn-out arises when individuals strive to maintain their valued resources, which they perceive are under constant threat.

There are four basic kind of resources: Objects, Conditions, Personal characteristics & Energies.

Objects are physical entities such as transportation, house etc.

Conditions are social circumstances such as marriage, tenure, employment.

Personal characteristics include Skills (technical & social skills) & Personality Attributes (sense of mastery, self-esteem, optimism) that enable an individual to better withstand stressful conditions & achieve desired goals.

Energies are resources which are used to obtain other valued resources.

Areas of Worklife (AW) - This model identifies six key areas in which person-job imbalances arises. These areas of worklife are: Workload, Control, Reward, Community, Fairness & Values. 

The greater the mismatch between the person & the job, the greater the likelihood of burn-out. Conversely, the greater the match, the greater the likelihood of engagement. 

Assessment/Measurement:

Assessment of burn-out has evolved over the years. In 1980's, the focus was only for caregiving occupations such as healthcare & human services. The measures developed in 1980s tended to reflect the experience of those professions. Over the years, the scope expanded to encompass other professions & the assessment tests were broadened with more occupation-neutral wordings, to include experience of non-healthcare, human services professionals.

• Maslach Burnout Inventory (MBI) is the most widely used, standardized, validated test for measuring burn-out. It can be purchased in the link: https://www.mindgarden.com/117-maslach-burnout-inventory 

Other popular inventory tests are: Bergen Burnout Inventory (BBI), Oldenburg Burnout Inventory (OLBI), Shirom-Melamed Burnout Measure (SMBM), Copenhagen Burnout Inventory (CBI).

• A free, informal Burn-out Self-test can be obtained in mindtools website: https://www.mindtools.com/pages/article/newTCS_08.htm

Causes of Burn-out

The organisational risk factors which lead to Burn-out can be categorised under Six key domains:

1. Workload
2. Control
3. Reward
4. Community
5. Fairness
6. Values

Workload: If overload becomes a chronic job condition then there is very little time for rest, recovery & restoring work-life balance.

 Control: The feeling of loss of autonomy, inability to take or influence decisions at work causes a feeling of lack of control at one's work place.

Reward:  Insufficient recognition, lack of positive reinforcement & lack of rewards (whether financial, institutional, or social) devalues the work & the employee, thereby causing a feeling of inefficacy.

Community: If there is lack of support, prevailing mistrust & conflict in the team, there is greater risk of burn-out.

Fairness: Fairness is the extend to which decisions at work are perceived as being fair & equitable. Cynicism, anger & hostility are likely to arise when people feel they are not being treated with respect & fairness.

Values: Values are the motivating connection between the worker and the workplace, which goes beyond the utilitarian exchange of time for money or advancement. When there is a values conflict on the job (gap between the individual's & organization's value), it leads to burn-out.  

Let's think about Burn-out & Engagement as two opposite poles on a continuum. 

Burn-out <-----------------------------------------------------------------------------------------> Engagement

The Positive state of Burn-out is Engagement.

Engagement consists of a state of high energy (Vigor), strong involvement (Dedication) & a sense of efficacy (Absorption). 

So what are the interventions which can be made in these Six key domains of organisational risk factors for promoting engagement?

Workload: A sustainable & manageable workload, provides opportunities to use & refine existing skills as well as to become effective in new areas of activity.

Control:  When employees have the perceived capacity to influence decisions that affect their work, to exercise professional autonomy & to gain access to the resources necessary to do an effective job, they are more likely to experience job engagement.

Reward: Consistency in rewards & recognition, between the person & the job offers both material rewards & intrinsic satisfaction.

Community: Team work, social connect & support, enhances the experience of job engagement.

Fairness: Practice of mutual respect, fairness, empathy enhances the experience of job engagement.

Values: Greater the overlap & congruence between employee's & organisation's values, stronger would be the cognitive-emotional experience of job engagement.

Outcomes of Burn-out: 

There are many undesirable outcomes of burn-out at psycho-somatic & cognitive-emotional levels, such as:

• Job withdrawal
• Job dissatisfaction
• Low organisational commitment
• Absenteeism, more than usual sick leave
• Turnover
• Cynicism
• Lowered productivity
• Impaired Quality of Work
• Increased personal conflicts
• Physical ailments (exhaustion, headaches, chronic fatigue, GI disorders, hypertension, cold/flu episodes, sleep disturbances)
• Work related anxiety, low mood & depression
• Alcoholism 

Intervention strategies to counter Burn-out:

Intervention strategies can be have two broad approaches:

1. Prevention of burn-out & Treatment of burn-out, once it has set in
2. Individual level actions & Work-group/Team/Organisation level actions

Let's explore them in some details:

1. A. Prevention of burn-out: 

Prevention on any given day, is better than Cure. So what proactive steps an individual can take to prevent Burn-out?

• Make your own health & Well-being a priority. Eating right, regular exercise, proper sleep, meditation, having a channel to share/vent out are all the right steps towards self-preservation. 
• Have good role models who have been successful in striking harmony in their life & emulate their actions in your daily life.
• Develop life skills: Stress management, Coping skills, Time management, Problem solving skills.  
• Nurturing social support (both from2 colleagues & family)
• Developing a better self-understanding 

1. B. Treatment of burn-out, once it has set in:

• Changing work-patterns (taking break times, avoidance of over-time work, balancing work with the rest of one's life)
• Utilizing relaxation strategies
• Seek help form a Counselor (counseling sessions; CBT - Cognitive Behaviour Therapy)

   2. A. Individual level actions:

An individual should take responsibility of their own health & well-being. The self-realisation that outsourcing one's health & well-being to government or corporation is being irresponsible & laid-back, is the first step towards being responsible. This self-realisation then needs to be put into action by practicing preventive steps (listed above in 1.A).

2. B. Work-group/Team/Organisation level actions:

A Team Leader, has a very important role to play in tackling burn-out:

• In the daily grind of work, it is easy for people to forget what drew them to their career & organisation in the first place. They start experiencing burn-out by getting disconnected from their values & work at hand. As a Leader, one needs to 'develop a shared sense of WHY' in the team. Remind them why this work important for the organisation, for the customer & for them. When a team has shared values & connection, they are more likely to feel positively about their work.   
• If the team is reeling under chronic heavy workload, it is the Team Leader's responsibility to get to the root cause to break the vicious cycle. It could be work-resource imbalance, skill-gap, process inefficiency, process breakdown, lack of teamwork, project planning & project management issues. Addressing the root cause in a time-bound manner, monitoring & controlling the situation on an ongoing basis, can significantly improve the situation. 
• Be a role model for the team. Being humane, spreading positivism & optimism, exhibiting empathy, compassion, understanding, active listening, goes a long way in re-energizing the team.
• Plan regular short breaks through the day's work & take out time to celebrate team success, milestones & personal occasions.
• Help team members, wherever possible by redesigning their jobs (job-enrichment, job rotation).
• Nurture a good team culture, social connect & social support. Team Well-being, should be put into practice & not remain just a philosophy.   

    At an Organization level, following initiatives can be run for employee well-being:

• A good work culture, is always a top-down approach. Senior management has a very big say, in driving this organisational culture. 
• Initiatives like EAP (Employee Assistance Program - Counseling), Wellness program, Planned Celebrations/Outings breaks down monotony & facilitates team bonding. 
• Two-way communication, Trust building measures between management-employee, employee surveys & addressing the issues, goes a long-way in setting the right tone for the organisational culture. 

Burn-out can be kept at bay. Tackling burn-out is a collective responsibility of an individual, of a leader & of the organisation. With burn-out Out! one's work-life becomes far more rewarding, enriching, fulfilling & meaningful. Let us all collectively strive, for making our work-place better! 

Health Psychology

Pixabay credit Miguel A.Padrinan

For most people, health is staying well & getting over illnesses. This approach explains the lack of pro-activeness in taking charge of one's own health, by practicing health-promoting-behaviours, such as exercise, meditation, eating right, avoidance of substances tobacco, alcohol etc.

The field of Health Psychology is devoted to understanding these psychological & behavioural influences on how people stay healthy, why they become ill & how they respond when they do get ill. Before we dwell into it further, let's look at how WHO (World Health Organisation) defines health.

Health is a state of complete physical, mental & social well-being & not merely the absence of disease or infirmity. WHO presents a bio-psycho-social model of health, i.e. body, mind (psychological) & social influences all put together determines health & illness. This puts the field of Health Psychology, at the very core of healthcare management principles. Let's now explore the practical implications & importance of Health Psychology, in healthcare.

Pixabay

Changing patterns of illness 

Until the 20th century, the major causes of illness & deaths used to be Acute Disorders (Infectious diseases like influenza & pneumonia, tuberculosis, gastroenteritis, plague, cholera, malaria etc). Acute disorders are short-term illness, often the result of a viral, bacterial or protozoal infection & usually amenable to cure.

In the 21st century, the major causes of morbidity & mortality has shifted from acute disorders to Chronic Illness (diseases of the heart, cancer, stroke, diabetes, alzheimer's etc). Chronic illnesses are slowly developing diseases with which people live for a long time. Often, these illnesses cannot be cured, but rather managed by medical interventions & lifestyle alterations.

Psychological & social dimensions are the causal factors, for several chronic illness. For e.g. personal health habits, such as diet & smoking, are implicated in the development of heart disease & cancer. Health psychology explores these causes & develops ways to modify them.

Secondly, because people live with chronic diseases for many years, psychological issues may arise in them with deteriorating quality of life. The chronically ill needs help to cope & adjust psychological & socially to their changing health state.

This changing pattern of diseases & illness in the 21st century, makes a strong case for Health Psychology as a preventive measure & as a vital adjunct in therapy & treatment strategies.

Pixabay credit Basil M K

Health promotion

The role of behavioral factors is very evident in the development of preventable disorders (e.g. lung cancer, cardiovascular diseases, alcohol & other drug abuse, & vehicular accidents).

It is estimated that nearly half the deaths in the United States are caused by preventable factors, with smoking, obesity & drinking being the top three.

This has been true for the past 10 years, the only change being that obesity & lack of exercise are about to overtake tobacco as the most preventable causes of death in the United States. - CDC (Centers for Disease Control & Prevention), 2004.

Cancer deaths alone could be reduced by 50% simply by getting people to reduce smoking, eat more fruits & vegetables, boost their physical activity & obtain early screening for breast & cervical cancer. - Center for the Advancement of Health, 2003.

Thus, successful modification of health behaviours, will reduce morbidity, mortality & expand the number of years during which a person can enjoy life free from complications of chronic diseases.

Health behaviours & Health habits

Health behaviours help people to enhance & maintain their health.

Poor health behaviours are implicated in illness & if not checked, can easily become poor health habits.

A health habit is a health-related behaviour that is firmly established & often performed automatically, without awareness. These habits usually develop in childhood & begin to stabilize by pre-teens. Brushing one's teeth, eating a healthy diet, limited screen time are examples of such behaviours. It is important to establish good health behaviours & to eliminate poor ones early in life.

Examples of good health habits:

• Sleeping 7 to 8 hours a night
• Not smoking
• Eating breakfast each day
• Avoidance of regular drinking or binge drinking
• Regular exercise
• Eating healthy food
• Not eating between meals
• Being no more than 10% overweight  

Specific Health-related behaviours

Exercise:
A mere daily 30 minutes of aerobic exercise (e.g. jogging, bicycling, swimming) can decrease the risk of chronic diseases (cardiovascular diseases), some cancers including breast cancer, obesity & negative moods. It increases immune system functions, strength & efficiency of heart, slow-wave sleep & longevity.

Accident prevention:
The single largest cause of accidental death is motorcycle & car accidents. Safety habits like driving within speed limits, wearing seat belts, wearing helmets, cyclist/motorist making oneself visible through reflective or fluorescent clothing, not riding/driving under the influence of alcohol, avoiding mobile phones while driving, can substantially reduce the risk of road accidents.

Cancer-related health behaviour:
Preventive screening for cancer can help diagnose malignancy at an early stage, increasing the chance of cure. BSE (Breast self-examination), Mammograms, TSE (Testicular self-examination), Colorectal cancer screening can facilitate early diagnosis of cancer, in it's early stages.   

Healthy diet:
Consumption of unhealthy diet has lead to dramatic rise in obesity in several developed countries.
Dietary factors have been implicated in a broad array of diseases & risks for diseases.
Dietary modifications are critical for people at risk or who have been diagnosed with chronic diseases such as coronary artery disease, hypertension, diabetes & cancers (colon, stomach, pancreas & breast).

Eating right, improves one's health. Maintaining a proper diet & getting enough exercise jointly contributes to weight & obesity control. A diet high in fiber, fruits, vegetables, whole grains, peas & beans & low in refined grains, red meat, is recommended for good health benefits (it gives protection against obesity, cardiovascular diseases & lowers risk for several cancers).

Health-compromising behaviours:

Substance abuse & dependence, Alcoholism & Smoking.

Adolescence is a vulnerable age, for health-compromising behaviours to set in. However, several other health problems, such as obesity can also begin in early childhood & alcoholism can be a special risks for older adults.

Many of these behaviours are heavily tied to the peer culture, as children learn from & imitate the peers. Wanting to be attractive to others becomes very important in adolescence, leading to development of eating disorders, consumption of alcohol, tobacco & drugs.

Several health-compromising behaviours are linked to self-presentation process - an effort to appear sophisticated, cool & savvy, in the peer group.

Many of these behaviours are initiated because they are pleasurable, provides excitement & thrill & it enhances one's ability to cope with stressful situations. However, over a period, these behaviours can  become a risk factor for a major chronic disease or lead to dependence/addiction.

Stress

Life events which are negative, uncontrollable, ambiguous & overloaded, leads to stress.

Stress is a negative emotional experience accompanied by biochemical, physiological, cognitive & behavioral changes. Stress is the consequence of a person's inability to meet the demands of the environment. In other words, stress is determined by person-environment fit.

When a person feels well-equipped to deal with a difficult situation, they may feel little stress & instead experience a sense of challenge. On the contrary, when a person feels ill-equipped to deal with a difficult situation, will feel stressed out.

Long-term stress brings about undesirable physiological changes. 
Stress can also affect health via behaviours - first, by influencing health habits directly & second, by interfering with treatment compliance.

Source: Baum, 1994

People respond very differently to stress. Some react at the drop of a hat, while others meet challenges with equanimity, bringing their personal & social resources to tackle the problems at hand.

Therefore, the impact of any potential stressful event is significantly influenced by how a person copes with it.

Personality & coping  

Personality of an individual determines how he or she will cope with the event.

Neuroticism: Certain people are predisposed by their personality for a pervasive negative mood marked by anxiety, depression & hostility.  They tend to express distress, discomfort, dissatisfaction & have poor health. In other words, the chronic negative state of mind has a bearing on one's physiology (illness being psychosomatic in nature, i.e. mind affects the body). 

Coping skills is how a person deploys their thoughts & behaviours to effectively manage the demands of the stressful situations. It is a conscious act by the person over a period of time for dealing with the stress.

Internal resources for coping:

Positive emotional states are associated with better mental & physical health.

Optimism - An optimistic nature can lead people to cope more effectively with stress & thereby reduce their risk for illness.

Psychological control - Self-belief that one can determine one's own behaviour, influence one's environment & bring about desired outcomes; helps one to cope with stress effectively, results in good health & emotional well-being. 

Self-esteem, self-confidence, conscientiousness are important determinants for effectively coping with stress.

Resilience is characterised by the ability to bounce back from negative emotional experiences & to adapt to the changing demands of stressful experiences. Sources of resilience are positive life events, positive emotions, opportunities for rest, relaxation & renewal, purposeful living, development of quality relationships.

Coping style is a general propensity to deal with stressful events in a particular way. Various people use different strategies like avoidant (minimising) coping, approach (confrontative, vigilant) coping, problem-focused coping (involves attempts to do something constructive about the stressful conditions) & emotion-focused coping (involves efforts to regulate emotions experienced because of the stressful event).

External resources for coping:

External resources include time, money, education, a decent job, friends, family, standard of living & presence of positive life events. Individuals who have more external resources, cope better with stressful situations.

Social support is a vital protective psycho-social resource.Social support can come from parents, spouse, partner, relatives, friends, social & community contacts. People with high levels of social support experience less stress & they cope with the stressful situation better.

Coping interventions - not everyone is able to cope with stress successfully on their own. Hence coping interventions help them to acquire coping skills so that they become empowered to effectively deal with stress. Mindfulness training, Disclosure (Counseling), Coping effectiveness trainings (specific coping strategies to deal with specific stressors), Avoiding negative self-talk & engaging in positive self-talk, Acquiring skills, Goal setting, Cognitive-behavioural techniques, Relaxation training & Stress management, are various examples of coping interventional methods.

Pixabay

Coming back to from where we had started - this holistic understanding of health, as a bio-psycho-social model & the importance of Health Psychology, is an empowering knowledge for every individual. 

One can shift from reactive approach of treating illness with just medication, to a responsive approach of taking charge of one's own health by developing health behaviours, by changing health compromising behaviours, by enhancing one's psychological (mind) faculty & by enriching his or her social relationships.

As the old adage goes, Prevention is always better than Cure.

It's time, to become conscious & self-aware of our Health Psychology (attitude, thoughts, behaviour & habits) & to take back the control of our health, into our own hands. 

Happy Father's Day!

Happy Father's Day Card

This Sunday morning, I was pleasantly surprised with a warm bear hug from my son (Kanishk, 10 years of age) wishing me a Happy Father's Day. Soon he locked himself in his room with paper, scissors, sketch-pens. I was pretending to be unaware of his secret plans & was entering in & out of his room. Each time, he would open up a book pretending to be reading, while shoving away his working materials to the corner of his study table. It is quite a fun playing along with my son's innocent act. Sometime later, while I was reading newspaper & sipping my weekend cup of tea, he slipped in greeting card from behind, saying Happy Father's Day!

His sweet act of planning a surprise for me on Father's Day, bought me so much joy. Instinctively I hugged him & told "On this father's day, I have mixed feeling of happiness & sadness". Perplexed he asked me why? to which I replied, "You wished me Happy Father's Day that's why I am feeling happy, but I feeling sad because I can't wish my father".

It's been nine months, since I lost my dad to cancer. With the passage of time, I thought I had come to terms with this irreversible loss, but these moments makes us confront the epiphanies of life. Loss of a parent, leaves a sense of emptiness forever in one's life, never to be refilled with the flow of days, weeks, months & years.

When my mind drifted into the labyrinth of my father's memories, I confronted several epiphanies of life:

In the cacophony of life's daily routine, we lose sight on the truth of impermanence. We fail to remain conscious in our daily act that the people whom we hold dear, may not be there with us tomorrow. 

Life unfolds with fuzzy logic, randomness & unpredictably, only making sense in hindsight when we connect the dots. In contrary, we are all engaged in the endeavor of making our life predictable & we lament when it unfolds according to it's laws, ignoring our insecurities & fears.

Unknowingly we perceive time as limitless, in our daily living. A small act of expressing our gratitude, expressing our emotions & feelings, to our loved ones, gets postpone to tomorrow rather than today. Quite literally, sometimes, that tomorrow comes after the yesterday, when it's already too late.

Only if we can hold on to these epiphanies in every moment of our life, we can make our life truly enriching, meaningful & filled with containment.

I have learned so many life's lessons from my father when he was around. Even in his absence, he continues to teach me so much more. Today, I am a father myself, but my son made me reflect & introspect on life. As he grows, as a father I will also make my son reflect upon so many things about life. The father-son bonding is like a circle of life, which down from one generation to the next generation & next.... Happy Father's Day Pappa! Miss you.

Earthen Pot - an Idea worth considering

Local artisan selling earthen-pot (Thubrahalli, Bengaluru)

Summer has set in Bengaluru, sending temperature north-bound. The road side vendors selling tender coconuts, sugarcane juice & butter milk, and the Juice centres & Ice cream joints are making the most of their peak business season. This summer, on the road side at various places across Bengaluru a group of artisans are selling Earthen Pots, vying for a market pie of this seasonal business.

If you are someone who uses the plastic cans/dispenser at home, then buying an earthen pot, is an idea worth considering! Here's why?

• Back to roots: Traditionally, before the advent of plastic containers, earthen pots were used to store & drink water. Today, we have been going back to our traditions in many practices for example organic farming, ayurveda, yoga, prefering copper bottles over plastic bottles. Buying an earthen pot for drinking purpose, is one such step which takes us back to our traditional practices.

• Preemptive step for health: Storing drinking water in plastic cans, may not be a wise idea due to potential risk of plastic leaching. There is an ongoing controversy of two chemical entities present in plastic - Phthalates & Bisphenol A. The Phthalates are endocrine disrupting chemicals & Bisphenol A has carcinogenic effect in lab animal studies. These chemicals can find their way into the water by leaking out (leaching). Though FDA has not given a categorical classification, as a causal effect about these chemical's exposure in their current amount of leaching on human health is not yet established. But like me, I am sure many of you would prefer preemptive steps & an extra bit of caution, when the risks on health with plastic usage can be so high, irrespective of the probability & proven causality.

• Supporting the artisan community: Pottery as an art, which dates back to antiquity. With modernity stepping in, the noise of economics - efficiency, convenience & mass production subdued the subtle music of age old craftsman. Earthen pot was a natural casualty to mass scale production of plastic can/dispenser. These few artisan community, who are striving to keep this age old craftsmanship alive, surely needs our support to give them a fighting change for self-sustenance. 

• Eco-friendly: The earthen pots, cools down the water naturally. This is eco-friendly & green, in comparison to refrigeration.

• Say No to Plastics: Replacing your kitchen plastic water dispenser with an earthen pot, is a conscious step towards reducing plastic usage at home. (I took inspiration from my cousin Raja, during one of my visit to his home. You never know, your small act could in turn inspire someone).        

This summer, I bought an earthen pot from Thubrahalli (Whitefield) & we have been relinquishing our thirst with the cool water, which feels so refreshing. It's so fundamentally different than drinking from a plastic water dispenser.

Earthen Pot, it's an idea worth considering, this summer. Do give it a try!  

        

Point of View

Stairs leading to a shop - Ashoknagar, Bangalore

As a ritual, we stop by at Sandhya Veg in Ashoknagar for breakfast on weekends, after my son's training sessions at Bangalore football stadium. In the adjacent building, a few flight of black granite stairs leads one to a shop located on 1st floor. One day, while passing by, the text on the stairs written with white chalk caught our attention.

At the very first glance, it says PLEASE DON'T SIT PLEASE.

(A notice for those rich people who have the luxury of time at hand, not to sit on the stairs leading to the shop upstairs). 

But when we stood there for a few extra moments, to go beyond the first glance, we could read the same notice, from different point of views. (mischievous point of view).

See the pic above & read it from 1 to 2: SIT PLEASE.
Or read it from A to B: PLEASE SIT.

Ha ha! isn't that funny?
The shopkeeper wrote a simple notice: PLEASE DON'T SIT.
A rule abiding passerby, from his point of view reads it as, Please don't sit.
However, a rebellious passerby, from his point of view, chooses to read it as SIT PLEASE & PLEASE SIT.

So what's the takeaway, from this daily observation?

Ask yourself, what's your point of view?
Do you hold a straight-jacketed, conditioned point of view of the world around you? 
or
Do you keep a flexible, out-of-the-box, unconditioned point of view?

After all, the way we live our life is a reflection of how we view & perceive the world around us.
So, spare few moments to ask yourself, what's my point of view?

The other kind of Madhu (Honey)

Humour can spring up unexpectedly, even at the most mundane places! 

One evening, I was at a pharmacy store, patiently waiting at the cramped up counter to receive my medications. A new customer walked into the counter & inquired  "मधु है ? (Do you have Madhu?)
[Madhu is the Hindi word for Honey].

The elderly pharmacist, who was visibly irritated with overwork & by managing impatient customers choose to ignore this inquiry. The cycle of inquiry & no response, continued for few more times. I turned back & found an unassuming labourer standing, with wide open eyes, waiting for an answer.

I thought, probably his Hindi dialect is causing the confusion for the pharmacist. Me & another customer said in chorus "He is asking for Honey".

The old fellow, came near to the counter in a huff & asked in an irritable tone to this customer - "कैसा  मद्यु  चाहिए ?, चबाने  वाला  या  हनी चाहिए ? (Which Madhu you want? Chew-able one or you really want Honey?)

I stood there perplexed, chew-able honey! what the heck!

This stalemate was broken, when this person said "चबाने वाला" (chew-able Madhu). The pharmacist, lost his cool, scolded the person & turned him away. He then turned towards us & enlightened us, Madhu is a brand name of घुटका (Gutka) - chew-able tobacco preparation.

It was ironic & surprising, to find someone walking into a Medical store, asking for Gutka. We all exchanged gleeful looks with each other & smiling on his inappropriate act.

Few days back, while walking down the road, I was once again reminded about this hilarious incidence, when I found an empty sachet of Madhu on the road.

Instinctively, I picked it up for writing this blog & for posting the pic. Probably, others around me, might have given me undue credit of keeping the city clean (स्वाच  भारत ), seeing my act of picking it up. A funny conclusion on it's own right :) To conclude, I think humour is all around us, even in our daily mundane act & at places where we are least expecting it. Just that we need to be receptive towards these lighter moments in life.        

The other kind of Madhu 

Change Agent Series (3/3): Aishwarya's Pursuit for Equitable Education

Aishwarya with her students

The Road Not Taken - Robert Frost

Two roads diverged in a yellow wood,

And sorry I could not travel both

And be one traveler, long I stood

And looked down one as far as I could

To where it bent in the undergrowth;

Then took the other, as just as fair,

And having perhaps the better claim,

Because it was grassy and wanted wear;

Though as for  the passing there 

Had worn them really about the same,

And both that morning equally lay

In leaves no step had trodden black.

Oh, I kept the first for another day!

Yet knowing how way leads on to way,

I doubted if I should ever come back.

I shall be telling this with a sigh

Somewhere ages and ages hence;

Two roads diverged in a wood, and I - 

I took the one less traveled by,

And that has made all the difference.

Ever wandered, what makes the poem The Road Not Taken, so endearing for us? 

Possibly it's because we see our own reflection in the traveler.

Metaphorically speaking, we all are travelers in the journey of life and we confront these existential questions, along our journey -  

Should I take the road which my heart says?

or, Should I take the road more practical? 

Should I carve out my own path?

or, Should I follow the herd and take the trodden path?

To pursue one's true calling on the road less traveled, demands soul searching, being truthful to oneself and to stay on-course irrespective of sociocultural expectations.

Not a mean feat! That's why stories of men and women, who take this leap of faith are so special and needs to be told and retold. A beautiful story, can inspire someone who is now standing on the diverging roads in their life's journey.

This is my friend Aishwarya's story, who once stood on the diverging roads, she took the one less traveled by, and that has made all the difference.   

Aurangabad a district in Maharashtra is Aishwarya's hometown. Like any other child from a typical middle class family in India, she grew up recognising the importance of formal education and upholding moral values.

"I studied in Nath Valley school, in Aurangabad through class I to XII. This is where I belong...this is where I made a strong circle of friends and even today, they are my pillar of support."

All along her schooling till class X, she was an average performer. In PUC, she took up Commerce along with Psychology as elective subject. As they say, interest flares up intrinsic motivation. Her interest in Psychology, made her outshine and she secured all India CBSE 2nd rank in her stream.

"Things changed me for in PUC. All along I used to consider myself as a non-ambitious, average student. During my school days, I had thought of pursing Mass Communication, but in PUC Psychology got me hooked. Now I was confused, Degree in Mass Comm. or Degree in Psychology? On top of it, I excelled at an all India level. On a positive note, this did help me to change my self-limiting perception of being a non-ambitious, average student."

Aishwarya's elder sister during that point in time, was residing in Bangalore. Through her, she got to know about Jyothi Nivas College, which was offering a combined Bachelor's Degree on Mass Communication, Literature & Psychology.

"I wanted to apply for Bachelor's in Psychology at Christ University, but had missed their timelines. When I came across this triple combination program at Jyothi Niwas college, I didn't have to give a second thought. It had Mass Communication which I always wanted to do, it had literature which I always loved since a child and it had Psychology, which I grew very fond of during my PUC days."

Three years of college life was fun. The Mass Comm. program was experiential, it involved making short film, Literature syllabus studying various genre of literature (Afro-American, Feminism, Victorian) and the Psychology lectures were captivating.

"Campus life in Bangalore, were the formative years for my independent identity. Living away from home teaches you decision making, independent thinking, understanding freedom and responsibility. I grew up so much more as a person, in these three years."

As they say, nothing lasts forever and good times lasts even shorter. Three years went by in a jiffy.

"I was again confronted with the question - What Next? I had thought of pursuing Masters in Mass Comm, back to Pune, closer home." Meanwhile, she came across notification for campus placement opening - Technical Writer, at Oracle in Bangalore. The requirement was Degree in English Literature. Out of curiosity, she applied for it and got through.

"The What Next decision became complex now. Previously the choice was obvious, a Master's Degree. Now I had to choose between Masters or job at Oracle." After considerable consultation with family, she decided to take up the job with Oracle. This was in the year 2011.

At job, in the first year she underwent training, in second year she was assigned to products for which she had to do technical writing, documentation. Her manager was based out of US and this global working environment helped her to develop a multi-cultural, global mindset. Being a people person, she was actively involved in team engagement initiatives and soon became the go to person in her team.

"On the surface things were going great! I was working with such a big brand, I had a good job, I was in company of so many talented and wonderful colleagues, my manager was a great mentor, I had a good work-life balance, evenings were for my Zumba classes, my weekends were free, infact I had nothing to complain about. However, deep inside I realised, I cannot work lifelong sitting in front of a computer."

Though she realized, she is not meant for a career in technical domain, she was yet to clear all her cobwebs. She decided to put to use her weekends, by taking up a Diploma in Counseling, at Banjara Academy, in the year 2013. This year long course, once again got her in touch, with her lost love - Psychology.

"The Counseling program, equipped me with skills for life - being a good listener, empathetic, non-judgmental. The program, exposed me various realities of the society and made me realise that each person is on their own unique journey."

After her successful completion of Diploma in Counseling, she wanted to stay engaged in some kind of compassionate work. During this search, she came across Make a Wish Foundation and started off as a volunteer, on weekends.

"As a volunteer with Make a Wish Foundation, I used to visit hospitals and spend time with children who were critically ill.  Our work was to make these children's wish (probably their last wish) come true. These interactions hit me hard and I was baffled to see, children from lower socio-economic background having such limited awareness of the world around them."

She was continuing her parallel lives, Monday to Friday - as a corporate executive and on Weekends - as an NGO Volunteer.

"It was a phase of turmoil for me. I knew my heart lied in something else and not in my day job. During lunch hours at office cafeteria, News Channel used to beam stories of rape, child abuse and other atrocities. We all office colleagues would be overtly critical about India and it's state of affairs. Over period, I started to realise we were all in this convenient state of mind of pointing fingers, but none of us wanted to be part of the solution."

Days converted into weeks, weeks in months, months into a year and Aishwarya's parallel life's carried on. This was the time, when she felt her job satisfaction was on a down swing, she was contemplating to quit and pursue a Masters in Mass Communication. In her head, she was still trying to make sense of the ongoing social issues and about her volunteering experiences with children of low socio-economic background.

"I believe in cause and effect. If there are wrong things happening in our society, there has to be a cause. It appeared to me, the cause was people's mindset - insensitive, unemphatic, inconsiderate, immoral. Mindset is largely shaped during childhood, as it is the most impressionable age and I was convinced, if we work with today's children they will grow up into adults of tomorrow, with a healthy mindset, automatically making it a better society."

On a random evening, while watching a stand-up comedy, a promotional campaign caught my attention. It was Teach for India. In Teach for India fellowship, one commits two years of his/her life on a full-time basis, to teach school children from lower socio-economic background (Govt or private school). She applied for fellowship with Teach for India. The robust screening process comprises of online application, essay writing, telephonic round, and final round was in person, at assessment center which included written assessment, group discussion and personal interview. She made it! and was offered the fellowship.

Change management, making transitions are always the most difficult part. In her case, the change was qualitatively and quantitatively different. Moving out from a well paying corporate job, into social sector on a fellowship.

"My monthly income was dropping by 70%. It required readjusting my life - I had to plan and do budgeting differently now.  Initially, most of my well wishers, including my parents, were not convinced with my decision. Materialistically I was going backward - leaving a big brand, taking a huge cut in my income, giving up a well set career where I was poised to have linear progression." Aishwarya's mom metaphorically told her with concern, "People climb up the career ladder and you are throwing away your ladder." She was justifiably concerned about her daughter's well being. She had a comfortable life, her peers were doing well and now all of sudden, she wanted to rock a stable boat and jump into the sea. 

When you are intrinsically driven, when you have clarity and purpose in life, when you have recognised your needs over your wants, outside voices stops to matter as you are tuned into your own voice. This is what had happened with Aishwarya, she had the inner conviction to reboot her life and to start a new journey on the road less traveled. "I knew I will be lot more happier from my daily work, no matter how challenging, as it was more meaningful and would touch many lives." 

In May 2016, she relocated to Pune, Maharashtra and was deployed in a private school which catered to children of lower socio-economic background. She had stepped out of her bubble, into the real world.

"Initial phase of my new journey was far from ideal and the change was enormous. Fifteen of us were living out of a small apartment before being thrown out by the association members. I was all the time into multi-tasking mode and was left with no time for myself, unlike my Bangalore routine when I had my evenings reserved for Zumba classes and weekends for volunteering. Days were cramped up with work and I started skipping lunch on a regular basis."

The community visits was an overwhelming experience. Families living in tin shed houses, their complete lack of awareness on personal hygiene, sanitary napkins, nutrition was hard hitting.
"It hits you hard. Here I was an idealist, wanting to change everything at one go and then you realize there is so much to change and it is going to be a long drawn process."

The RTE (Right to Education) Act, has been a good move for promoting education. However, this has caused other set of problems. "With RTE Act, no student can be failed till class VIII. Majority of the children from low socio-economic, have minimal parental investment in their life. There is a casual approach towards studies, lack of accountability and lack of interest in studies. There are n number of instances of a IX grader's subject knowledge being equivalent to a II grader studying in an upmarket school."

Aishwarya was deployed for two years in a private school, which had children from low socio-economic background. Total strength of the school was 650 students. "At school we have to instruct and teach experienced professional teachers new pedagogy. This is a sensitive aspect, as we are so young, half their age and we are coming and teaching them new methodologies and practices. The job demands to bring all stakeholders together, to work for the child's well-being and keep personal interests and conflicts at bay. Teach for India, message board says, Are You Ready for the Challenge? I now know why, it says so :-)."

Teach for India, functions on a two year rotation basis. One fellow leaves after his/her two years of fellowship and the new fellow replaces him/her. This cycle continues. Aishwarya was replacing a fellow, who had made a very good name for himself at his work. One of the key attribute of this fellow was strictness. "In my mind, I thought I have a big shoes to fill in, I wanted to emulate him and I conducted myself with strictness. This caused me additional distress, because this is not natural self. My expression of strictness was coming out as anger and aggression. I was making the mistake of copy someone and not being myself."

After several weeks of struggle, the realisation dawned into her. "My strength is empathy and I had come here to work with compassion, but I was foolishly exhibiting anger. From that day on, her motto became - "Change the world with kindness, not from hatred."

From this point on, there was no looking back for her. An affectionate yet assertive teacher was now in charge, to shape young minds for the next two years. 

"I realised staying true to myself was most important. I had to work on being firm and assertive without losing my essence. Being my natural self helped me in building personal relationships with my students. Over a period, the children found me approachable and they started to trust me and confide in me."

The journey was not a fairy tale with everything working out well with a magic wand. There were days, when frustration and helplessness would grip her. Factors like lack of financial resources, domestic violence, vulnerable environment were out of her control as a teacher, but these factors would hold back her students from focusing on their studies.  "It would leave me clueless about how to change the situation. Gradually it struck me that I'm here to uplift the kids so that they can change their own circumstances. I knew that with a little more faith in themselves, they truly find their greatness."

This faith, mutual trust in each other and the harmonious, learning environment did produce it's positive outcomes. Several of her kids have excelled academically, while others have shown their talent through several other mediums. They have performed street play on non-violence, a third of her class participated in the musical showcase for the school's annual day. They have conducted sessions on building and imbibing essential values for junior classes. "Marks may be important, but it’s their other, more holistic achievements that fill me with pride."

So what advice would you give to someone who is in dilemma - should I take the road less traveled?
"If you are clear on where your true happiness lies, then all you need to do is to take the leap of faith and trust the process. The journey is going to be challenging and full of ups and downs, but the amount of inner satisfaction, sense of purpose and happiness is unparalleled."

Memories for a lifetime

I asked her, about her reflections through this journey.

" This will be my happiest Once upon a time story :). I may have been too idealistic to think that my journey as a fellow at Teach for India is going to be a step towards changing the face of the nation, but now with a clearer perspective, I do believe that one child at a time we can make this happen. I want this strong cause, of providing equal and quality education, to have a ripple effect leading to the effective transformation of an individual, a society and a country."

Time flies, Aishwarya has completed her two years of fellowship. She is now joining Teach for India, as Program Manager for Pune City. She will now play a bigger role in on-boarding new fellows, coordinating with schools and doing her bit to promote quality education for all and transform one child at a time, to make a better individual, a better society, a better India and a better world.

Two roads diverged in a wood, and I - 

I took the one less traveled by,

And that has made all the difference.