557: How to Outthink Fear with Dr. Mark McLaughlin

Pete Mockaitis
Mark, thanks so much for joining us here on the How to be Awesome at Your Job podcast.

Mark McLaughlin
My pleasure to be here.

Pete Mockaitis
Well, I’m excited to dig into your stuff. And, first, let’s hear, so you currently work as a neurosurgeon, but before that, you wrestled so well, you made the Hall of Fame. Tell us the story here.

Mark McLaughlin
Well, I’m from northern New Jersey and I took up wrestling as a young boy, had some very influential coaches along the way who helped me, gave me the tools to succeed. Wrestling kind of let me wet my whistle in terms of concentration and intensity, and as I got older and wanted to move onto medicine, I went on to become a doctor. And I picked neurosurgery because it’s the closest thing to wrestling that I could get after wrestling.

Pete Mockaitis
Well, that’s so intriguing. Please explain, what’s the crossover or similarities?

Mark McLaughlin
Well, it’s intense, it’s grueling, it’s extremely personal, there are high risks, and it just gave me the same pump and the same exhilaration that wrestling did, so I thought I got to go for it.

Pete Mockaitis
All right. Well, so then in the midst of operating in that, literally, operating in that capacity, you made some discoveries about how to deal with fear. Can you tell us the story of how that came about?

Mark McLaughlin
About 10 years ago, I got invited up to West Point to give some talks to the cadets, and so, I began to compile stories about patients and stressful events during surgeries or during my decision-making processes in taking care of these patients. And so, as I began to compile the stories, I’d start sharing with them things that I used to keep myself out of trouble and to save lives.

And so, those would be different techniques that I had in neurosurgery but I realized that they were real-life skills that you could use in the military or you could use in your personal life or your business life. So, I began sharing some of those things with the cadets, like the rules of neurosurgery, for one. So, rules of neurosurgery are things like never cut what you can’t see, always leave a drain, never worry about a patient alone, measure millimeters in miles. These are things that are drilled into your head during your residency, but you can apply them to anything in life.

Like, never cut what you can’t see is one of those things in neurosurgery that you never want to close your scissors unless you know exactly what’s between those two blades. But, similarly, that’s an allegory for life, isn’t it? You never want to make an important decision or make a move unless you know exactly what’s up in front of you. So, that’s how it all started.

Pete Mockaitis
Well, that’s intriguing. So, you say they keep you out of trouble in terms of these are just kind of best practices during the course of conducting a brain surgery. And then I want to know, kind of what the West Pointers wanted to know, what are you saying to yourself during the course of doing these surgeries?

Mark McLaughlin
So, those rules are ingrained in you, so you’re following steps through a surgery, but usually what I try and do is get into a mindset. So, before I start a surgery, I have a very specific routine, I call it my 5Ps. I take a pause, I think about that exact patient I’m operating on, I’ll say to myself, “This is a 42-year old accountant. He’s been suffering from severe sciatica for five weeks. He’s in excruciating pain. This is the most important day of his life. Let’s get him fixed up.”

Then I move onto my plan and that’ll be my exact step-by-step passage through the surgery mentally. Then I’ll put out a positive thought and that’s, “This is why you’re here today. This is what you trained your whole life for. You’re in the right spot. You’re ready to go.” And then, lastly, what I’ll do is I’ll say a prayer. And a prayer for me, one might say it doesn’t affect the outcome of a surgery, but it always affects me. It always calms me and it always helps me perform better.

Pete Mockaitis
Okay. Cool. So, that’s the process and so you’re working with that and that is getting the job done for you. So, then let’s zoom into the typical professional who’s listening here, they’ve got a different job. It might be less high-stakes in terms of its immediate consequences in the moment. If you screw up, most of our jobs, if I butcher this podcast, no one’s going to die. We’ll have 20,000 people mad that we destroyed that hour or 45 minutes of their life, that’s less than a full lifetime though if you multiply it out. But, anyway, regardless, the stakes are probably, for most of us, lower hour to hour. But what is at stake with regard to us when we are dealing with fear, when the mind is on fear, what to do?

Mark McLaughlin
That’s important. Everything is important in work and in life and in your relationships, and they are life and death in some respect, they’re your life, and so they’re important. And I would just say that fear is a universal experience that we all have. I mean, we’ve all experienced fear every since we started looking under our bed before we went to bed at night, right? And it’s something that we have to manage in our lives. Some people do it better than others, but we could all improve on it.

So, it’s important to understand that fear, it’s just an alarm bell going off in your mind. So, what I see it as, it’s almost Pavlovian. We’re moving along, things are going great, nothing unexpected happens, we’re calm, we’re homeostatic, or we’re even feeling confident or assured or secure. And then something unexpected comes to us and that’s the first inkling that we might have something different or something interfering with our goal in life. And so, that unexpected event can do some type of anticipated anxiety or stress. Or let’s say it’s something real, something dangerous jumps into your way, like an intruder in your house, then it’s real fear. That’s real terror.

But fear is not the solution to the situation, it’s only the alarm bell. Figuring out what to do about the alarm bell is what you need to focus on. And that’s what I talk about in my book, is, “How do we look at fear and unpack it into its structural components and literally map it out in our minds so that we can outthink, so that we can know what the problem is, and attack the problem?” And, immediately when we start doing that, our fear level goes down. It dials itself down a little bit.

Pete Mockaitis
Well, so that sounds cool and appealing. And so, can you maybe let us in on perhaps the why behind that a bit? Is it okay to be afraid and to experience the fear or is it counterproductive or harmful at some level?

Mark McLaughlin
No, having fear is a good thing. You never want to be free of fear. Imagine the stupid things we would do if we didn’t have fear. It’s absolutely essential, and for survival in our earlier stages of development in life on earth, I mean, we wouldn’t have survived without it. But the thing about it, as far as the brain goes, and neurophysiology and neuroanatomy is, is that it’s almost like there’s an operating system that’s been built on an operating system, that’s been built on an operating system, and all the earlier operating systems are still running in your brain.

So, the fight or flight response is still very real in your mind and in your brain and in your neuroanatomy, the circuitry. You have to be careful about that. That’s great when someone is stalking you in a dangerous confrontation. But it’s not helpful when somebody says something that might be insulting to you in a business meeting. So, you need to know where your neocortex is working and how your executive function can override that.

Pete Mockaitis
And so, if we are not overriding that and we just sort of allow our earlier lizard operating systems to run wild and do what they want to do, what could be the consequences?

Mark McLaughlin
Well, you’re going to blurt out something that you probably would regret or you’re going to act in a way that’s not becoming of a leader, and you’re not going to have the most optimal outcome. And that’s the goal. The goal is to perform at your very best, so you have to recognize this. So, for instance, like if I’m at a business meeting with my partners, and one of my partners says something that I get very irritated about, and I can see that he’s anxious and irritated, what I try and do, one of the things I try and do is just identify.

I’ll say, “Listen, I know you’re raising your voice, and I am too, and that means that this is important and we care about this and that’s a good thing. But that’s not going to help us solve the problem that we need to solve. So, let’s talk about what the specifics are. Let’s break this down and line up possible solutions. Let’s start thinking about it.” So, identifying that is very helpful in this process.

Pete Mockaitis
So, certainly, there’s some interpersonal consequences there that you might really damage the relationship if you scream or tell them exactly what you think in that moment. And then, I guess I’m curious, even internally, what does the research have to say about how we go about thinking, processing, problem-solving, creativity, decision-making, when we’ve got the fear OS at work?

Mark McLaughlin
There’s a lot of cross-chatter among the higher functions of the brain and the lower functions, and it’s really interesting how we can map out the neurophysiology and thought patterns of fear and see what it looks like on functional MRI scan. And there’s some good studies that show that meditative mindfulness practices can decrease some of that chatter, some of that crosstalk that we have that creates anxiety and stress in our minds. So, it really is an important practice to perform and I’m a big believer in meditation for part of controlling and managing fear.

Pete Mockaitis
And is crosstalk a bad thing? Is that like concerning when you’re seeing that on the FMRIs?

Mark McLaughlin
Yes, I mean, generally it is because it means you don’t have like a focused pathway. So, the brain, when we do things, it creates connections, neural networks. So, you have a neural network for riding bike, that’s why you can jump on a bike 20 years after you’ve jumped on a bike the last time and you can still ride a bike. That neural network is that pattern of firing is all set. But if you have patterns of firing that are disrupted or they’re not clean and clear, you’re going to not think properly, you’re not going to react the way you’d like to react in a situation when you need your best.

Pete Mockaitis
Okay. Well, so then let’s get into the particulars of how this is done. So, you say you can deconstruct and look at the patterns and structures of fear and go after them and effectively outthink it. So, how does this work in process and practice?

Mark McLaughlin
Well, I talk about a technique of using lateral thinking. So, lateral thinking is a concept where we try to dislocate the normal thought patterns that we have when we solve problems. So, normally, people think linearly and logically about how to solve a problem. A good example of lateral thinking is the King Solomon story. When the two mothers come to King Solomon and say, “Will you please…this is my child,” “This is my child,” and he says, “Okay, we’ll solve the problem. We’ll cut the baby in half, and you’ll each get half of the baby,” because he sort of knew that the real mother would say, “No, no, no, she can have the baby.” That’s how he knew who the real mother was.

It’s like thinking differently about things. So, I’ll give you an example in medicine. So, in medicine, you may have somebody that comes in and they’ve got a pretty straightforward problem, let’s say. Let’s say they have a headache and a stiff neck and a fever, and their roommate had meningitis two days ago, and you immediately jump to the conclusion, “Ah, they’ve got meningitis.” Okay, that’s one, that’s a logical step-wise progression. But a lateral thought process would be, “What are three other things that could be causing this that I haven’t thought of?” And that’s really important to do in medicine, and I think in business too.

So, we usually jump to the first solution but the first solution isn’t always necessarily the right solution or the best solution. So, if you can sort of train your mind to think of other solutions, and even if they don’t seem the best one right away, just get them on paper, talk about it with other people. You can sometimes come up with better solutions than you initially thought of. So, lateral thinking is another technique that I talk about, and it’s very important in medicine, but I think it can also help in business.

Pete Mockaitis
And so, that helps you in getting more ideas. Does it also help with the fear?

Mark McLaughlin
I think so because, again, fear comes when something is unknown. The more you know, in general, the less fear or stress or anxiety one has. So, in my opinion, that would be another way of just using your brain to sort of dial down the fear measure in your brain, definitely.

Pete Mockaitis
Okay. And then what are your pro tips in terms of staying calm in high-pressure situations? Maybe you’ve got some fear associated with entering them or maybe just the stakes are high, whether or not you’ve got butterflies in your stomach?

Mark McLaughlin
Right. The most important thing is really to be yourself. I always try and say, “Be yourself. Don’t be anybody, try to be anybody else.” I use a technique called narrating the room. So, when I’m flummoxed with something, I’ll start with, “Okay, I need to think this through, everybody.” And I’ll speak aloud, “All right. I was expecting to see this, but I don’t see this right now, so let’s take a step back. I’d made an incision over the frontal area, I’ve got down through the skull,” and I just, literally, will talk myself through exactly where I was and where I went.

And, it’s funny, because I had a chance to interview Sanjay Gupta for this book, and when I was telling him about this, he said, “Oh, yeah, I do that all the time. That’s I narrate the room. I narrate the room.” And so, that’s his process of talking things through. Even, again, acknowledging, “Okay, a little stressful here right now, everybody. I understand we’re missing…”

Let’s say, during a surgery we oftentimes have to count for the sponges. The sponges have to be exactly correct at every moment during the surgery, and sometimes the sponge count is off, and so that needs to be checked very carefully. And people are getting worked up about it, I’m like, “Okay, we’re going to find it. I just looked through the wound, I don’t see it there. Let’s look through all the collection, the papers that we have, the collection bags. We’ll get through it. It’s standard process.” So, just talking about it, I think, is a very important part of it and being one’s self. Those two techniques are helpful.

Pete Mockaitis
Well, tell me, anything else you want to make sure to mention before we shift gears and hear about some of your favorite things?

Mark McLaughlin
Well, it’s been interesting writing a book. It took me about four years to do this, and, gosh, it was such a huge effort, but I’m thrilled that it’s done. I feel like I’ve got a frame around a body of knowledge and I feel like being a neurosurgeon has helped me think about fear and stress in a different way. I have a lens on the world that other people don’t have, but I think the techniques to solve it are really transferable to anyone. In fact, I talk to my young wrestlers about it sometimes. I told them about sometimes when I feel overwhelmed and I feel like I’m in over my head, and I just step back and I say, “No, I’m not. Go to your basics. Just talk about it. Talk about your exact basics.” For wrestlers, that’s like risk control and control the tie-ups and things.

So, I say, “Whenever you feel like you’re out of your league, you’re wrestling somebody too good, go back to your basics. Risk control, control the tie-ups, focus on what you do, get back to your referee’s position.” And I think everybody feels it, and the better we cope with it, the better we’re going to perform.

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Pete Mockaitis
Well, now, could you share with us a favorite quote, something you find inspiring?

Mark McLaughlin
My favorite quote of all time is Julie Andrews’ “Some people regard discipline as a chore. For me, it’s an order which sets me free to fly.”

Pete Mockaitis
Thank you. And how about a favorite study, or experiment, or bit of research?

Mark McLaughlin
I talk about this in the book, the story of the invisible gorilla. When everybody’s focused on the task of counting basketballs and passing, and how they literally missed a gorilla 50% of the time that walks across the screen. I just think that’s such an interesting concept to understand that we all have blind spots. Everybody has blind spots. And when you know you have a blind spot, you’re less likely to miss something.

Pete Mockaitis
And how about a favorite book?
Mark McLaughlin
I love the “Traveler’s Gift.” That’s a book by Andy Andrews. It’s a story of a person that goes through time and meets a number of famous individuals: King Solomon, Abe Lincoln, Christopher Columbus, Anne Frank. And it’s just literally like getting a summation of their philosophy in a very short time. And it’s a book that I gave my father, and we shared a lot of discussions over that book, so I really love that.

Pete Mockaitis
And a favorite tool, something you use to be awesome at your job?

Mark McLaughlin
I use an app called Ten Percent Happier which is a great meditation app. Dan Harris wrote a book called “10% Happier,” a guide to meditation for fidgety skeptics. And the only app I’ve ever purchased on my phone is Ten Percent Happier. It’s a beautiful compilation of guided meditations, and it works to help you sleep, to help you think more positively, and have more gratitude. I’m thrilled with it. I’ve been using it for over a year, and I highly recommend it.

Pete Mockaitis
And how about a favorite habit? Sounds that might be it, or maybe you’ve got another one.

Mark McLaughlin
My morning habit is very important to me. I do three things. And that’s I meditate, I file. I have an old-fashioned David Allen filing system with 31 files for the days of the month, and then 12 files for the months, and the one extra fie which I call my someday maybe. So, I file, I look at my file for that day. And then, lastly, I’m a Franklin Planner guy. I use a paper book because I can’t see the month and the week as well as I can on my phone so I work on my Franklin Planner, and I plan my day out. I call it my triple threat. My triple threat is if I do those three things, five to six times a week, I’m going to really do a lot of good work.

Pete Mockaitis
Okay. And is there a particular nugget you share that really seems to connect and resonate with folks as you’re sharing your wisdom here?

Mark McLaughlin
One of the moms and friends of mine in our wrestling club, she has a great quote which I love too, and that is, “Gentle pressure applied relentlessly.” I’ve always loved that. “Gentle pressure applied relentlessly,” and I think that’s truly how you get better. That’s how I’ve worked on myself and over the years, and that’s what works.

Pete Mockaitis
And if folks want to learn more or get in touch, where would you point them?

Mark McLaughlin
My website MarkMcLaughlinMD.com has a number of videos, talks about the book, and I have a blog that talks about a number of these topics.

Pete Mockaitis
All right. And do you have a final challenge or call to action for folks seeking to be awesome at their jobs?

Mark McLaughlin
I would say just be present, be yourself, and keep getting a little bit better every day. Gentle pressure applied relentlessly.

Pete Mockaitis
All right. Mark, this has been fun. Thanks, and good luck in your adventures.

Mark McLaughlin
Thank you. It was a pleasure, Peter.