The Exchanges

Q good place individually to create that space together and build that safety, no matter where they're at, whether they're at the beginning of the journey or, you know, sort of like they've been together for 20 or 30 years. How do you maintain it with your wife? How do you coach people to sort of develop that at the, you know, we just got married. How do we develop this?

A A couple of years ago, um, my partner Allie and I, what happened was I was sitting at the dining table And, uh, or she was sitting at the dining table and I passed behind her with a load of laundry in my hands. And I was headed down to the basement to do the laundry. And she poked her head up and said, the story I'm telling myself is that you're leaving me. And I said, hon, I'm just doing the laundry. And it was a funny moment, but in that moment, she was able to reveal something that might have been shameful. Like, what are you crazy? She just named the feeling that came up for her because part of her old trigger is being abandoned. I'll, I'll turn it around and I'll tell a story about myself. Just two years ago, um, you, you, you read Reboot, so you know that I grew up under pretty adverse childhood circumstances, a lot of violence in the family, which led to a very, I wouldn't call it full-on body dysmorphia, but a really complicated relationship with my own body. One day, I'm in the, our closet, and I'm getting dressed, and I pull on a pair of jeans, and Allie, who loves me, looks me up and down, Right? In her mind, she's saying, do those genes look good on him? And what triggered in me was shame. It was like a lightning bolt. It went right back to childhood and all sorts of negative experiences I had as a child. Now, I had a moment. I had a choice. My response was going to…

AI assessment note: “She just named the feeling that came up for her because part of her old trigger”

Q Do you have a ritual around journaling? Do you ask yourself the same questions? What does your, your routine of journaling look like? And how is it powerful?

A Well, to be clear, I've been journaling since I was 13. And I turned 60 this year. So, journaling is a fundamental part of who I am. What I do is I take stock of myself. I'm tired, or, um, my back is hurting, or I had a wonder, like yesterday, I had a wonderful phone call with my sister Ann, and, um, I told her about, uh, having visited our home, our childhood home in Brooklyn last weekend. And that brought up all sorts of feelings. Um, and we shared feelings, uh, that, and I wrote about all of that this morning in the journal. And in a way, it's kind of like processing what happened for me, and then it clears the day, and then I meditate, and then I will exercise, right? And that tends to be the ritual. Now, I hesitate because I've often spoken about journaling and morning rituals, and there is a A little bit of a tendency in our world right now to place a little too much emphasis on the form. Where do you, where do you journal? Oh, do you meditate? And I just want to bring people back to the function. Cause the function is taking a fix on your life. How are you feeling right now? And how is it impacting your life these days? So that we're raising consciousness so that we're not operating on autopilot.

AI assessment note: “What I do is I take stock of myself... and then it clears the day”

Q I like that a lot. I want to, I want to take that to relationships and talk to me about how stubbornness manifests itself in a relationship where we end up sort of butting heads with somebody we love and we care about and we don't intend to. We're not consciously thinking about it. How do we get out of this loop where we're, we're both being stubborn about something?

A I promise I won't ask you about your relationships. I think you're absolutely right that this shows up in there. And, and there's a couple of things that I would say about that. One, again, using the same tools of unpacking and understanding what's important to you. So for example, in my own life, one of the trigger points for me, that's very well known in my partner, Ali knows this very, very well. It's very important for me to be generous. And if I feel that my generosity is being taken advantage of, I go from being Spider-Man to being the Hulk. And that goes back to childhood where I felt that my compassionate, gentle nature was taken advantage of. Okay. So that is programming that lies deep with inside of me. And I'm fully conscious of it. And it will still run occasionally. So you asked, how does this discernment show up in, in good relational skills? One thing, uh, that, uh, my partner Ali and I practice that is very, very helpful. And this is a line that, um, comes from Brene Brown and it, and it's simply the story that I'm telling myself. So imagine, uh, Hulk in me gets triggered with discernment, with the self-knowledge, with what I call radical self-inquiry. I know that that Hulk lives within me. And rather than naming that with shame, which I used to, oh, you're right. Oh, it's terrible. I, I've welcomed in that part of me and understand that that part of me shows up…

AI assessment note: “a new line, which is, okay, the story I'm telling myself is”

Q And did normal sort of things that people consume like alcohol or caffeine affect their HRV and how so?

A So alcohol has acute and chronic effects. Um, it's really interesting. Everybody has a different affinity for alcohol. So Shane, you may be able to have two glasses of wine and it doesn't impact your HIV, but the person Across from you may have two glasses of wine, and it decimates their HRV. And just understanding what the inputs are for your body is part of peak performance. So you, if you're someone that we see that drinking two glasses of alcohol has a really large impact on your HRV, I'm going to say maybe you shouldn't be doing that during the week. Well, or, or while you're competing or making, let's say, trading decisions. So we make some decisions together by understanding how the body responds to particular sensory implants. So that's one. There is evidence, certainly, that chronic alcohol use Chronically lowers HRV. Um, and what's interesting is withdrawal. If, if someone is a heavy drinker will also reduce HRV because it's showing the distress on the body, but that changes in time as, as abstinence occurs and the autonomic nervous system rebalances. So caffeine is an interesting one. Um, Two cups of coffee for most people doesn't have a huge impact on heart rate variability such that if you're a performer and you have a competition, I would, I wouldn't say That having two cups of coffee is really going to impact you. Having five cups or more seems to have an impact,…

AI assessment note: “alcohol has acute and chronic effects... chronic alcohol use Chronically lowers HRV.”

Q anybody. You have an onboarding process. Uh, and through that process, you're getting to know each other. They're getting to know you, you're getting to know them. I'm wondering if you can go through some of the questions that you ask people, uh, and I'm sure our audience would, would value going through these as well in terms of how do I get to know myself and where I'm at?

A Yeah, I think one of the great opportunities is to choose happiness today and to choose, you know, a broader definition of what we think of as success. So when we sit down with people, we send them a questionnaire, and the questionnaire includes a bunch of different sections. There's a fun section, because again, I believe if people are having more fun in their life, we're all human beings. Who doesn't want to enjoy their life, right? Like everyone wants to be having a good time to feel good, to feel special, have a great time. And so there's all of the, The bucket list questions, if you will, right? What's the stuff that you've done? What's the stuff that you've been wanting to do your whole life? You know, what are the things that you're curious about? Um, and then we get into more of the philosophical things. Imagine you're at your 80th birthday or whatever late life birthday you want it to be. Uh, everyone you love is gathered around and they say, uh, they're going to toast you. What would those closest to you say about you? Now, if that birthday party was held tonight, uh, what would they say about you today? And, um, if there's a Delta, what do you want to do about it? If your doctor called you right now and was like, you know, you've got one year to live. What would you be doing anything different than you're doing today? And if so, why? And just really asking these sort…

AI assessment note: “Imagine you're at your 80th birthday... What would those closest to you say about you?”

Q And then you take this information and then you have tough, I would imagine somewhat tough conversations with some of these people and you talk about caring deeply and challenging directly and what does that mean and how does it relate to hard conversations?

A Yeah, in the basis of Radical Candor, a book that's often taken pretty out of context because they're like, you know, I'm being candid, I'm being radically candid, um, but that you really do have to, the basis of it is you have to care deeply to be able to challenge directly, and that somebody has to know that you care deeply about who they are in their role, that you care about their performance, that this is coming from a place that's meant to make them better, right? And if it's not coming from that place, And it's coming from a place of punishing or shaming or, you know, humiliating or dominating. It's not a really effective thing to do. It's a, it's a counterproductive thing to do that will work against you. But people can take hard feedback from people that they know are in their corner. And so, you know, it's kind of like, and it was this really silly analogy, but I'll use it anyway. But it's like, if you went to go try on jeans, you don't want the friend who tells you, you look great in every pair of jeans. You want the person who's like, Wow. You definitely should not buy those.

AI assessment note: “the basis of it is you have to care deeply to be able to challenge directly”

Q Aside from being intentional and maybe, um, about the words you're using and the place you're coming from, right? The place of pulling people forward and being better. What are the other tips that you could give people for preparing for hard conversations in advance to put themselves in a position to have the most effective conversation possible?

A Sure. I think that one of the best frameworks people can use, and I think people, um, don't use Don't have hard conversations because they see them as being a conflict, right? It's going to be me versus you, and it's going to be a conflict. So what I try to do is to say, rather than let's just say Ted is his, uh, the marketing department is missing its numbers. I don't want to say when Ted comes in, Ted, you're missing your numbers, right? Like what's going on. Um, I want us to, instead of being me versus you, I want to pull him to my side and be like, Hey, this is us versus a problem. You can do this at home. You could do it at work. You could do it anywhere. And to be able to say, hey, Ted, I noticed that, you know, our numbers are, we're kind of missing here in the marketing department. Can we, like, let's do some problem solving around how we can really pull these up So it's a we, you know, you're, you're intentionally pulling someone to your side. You're forming a collaboration against the problem. So rather than me, and then you are the problem, it is, I'm pulling you to my side of the table, and it's us together versus this problem that we're going to talk about, and it is, um, it's incredibly effective because it reduces defensiveness, it creates openness, it makes you more approachable, and you can have really hard conversations in that way, and I can do that With peop…

AI assessment note: “instead of being me versus you, I want to pull him to my side”

Q And we're sort of talking about this as if this is a constant process happening throughout the night, but are there different states of sleep or different things happen at different points of time in our sleep?

A Yeah, there are three kind of gross states of sleep, but, um, people have characterized as many seven sub states of sleep that, um, happen throughout the night. Uh, typically we have about a Where we go through all the stages of sleep and they start with first the drowsiness, which is kind of stage one where we're being less attentive to the world. And we start to have amnesia. If someone's talking to us while we're in this stage one of sleep, we might be able to hold a conversation, but we won't remember it. We could read a page for reading a book, but we won't remember what was, what was set on that page. Then we go into a deeper stage, which is stage two, and that is where we start to get sleep spindles, which are these 15, 10 to 15 hertz blips in our brains that, um, come and go at different parts of our brains at different times, and these things called K-complexes, which are big surges of activity in our brain. And that's when we are definitely fully unconscious, but if you wake up someone out of that state, or they spontaneously awake out of that state, they will say that they have had hallucinations, kind of like dreams, but not full dreams. They're like, they're called hypnagogic hallucinations, hypno being sleep. You know, that's where some of these hallucinations are quite, um, vivid and scary sometimes, so waking up after just falling asleep after about five minutes…

AI assessment note: “Yeah, there are three kind of gross states of sleep”

Q And how long should it take to fall asleep ideally?

A Someone who's getting enough sleep at night, you know, um, takes about, I think on average, 14, 15 minutes, something like that, to fall asleep. And again, that time shouldn't be stressful, like, oh my gosh, I should be getting sleep, oh my gosh, you know, I can't believe I'm still awake. But if it's taking you 45 minutes, that's too long. That means that you're not trying to fall asleep in the right window of time, that you are stressing about something, or maybe that's, it just means you've had too much caffeine during the day, too late in the day, and that's still working on your brain to keep you, prevent that signal, that homeostatic drive signal from hitting your brain. So that one of the, um, Most effective ways to help people with that kind of insomnia, that delayed sleep onset insomnia, is to do what we said earlier, get out of bed, do something that relaxes and makes you happy, and then when you're feeling sleepy, again, just, just hit bed, and don't worry about having lost that 45 minutes, because, in fact, you probably would have been awake, you know, twiddling your thumbs in bed at that period of time, worrying about it anyway, so get up, do something useful, and not too Um, exciting. And, um, that's called cognitive behavioral therapy for insomnia. That's one of the recommendations of it.

AI assessment note: “takes about, I think on average, 14, 15 minutes, something like that”

Q case? Like, I think it's normal for most people to wake up at least once during the night, whether they're even conscious of it or not, whether they go pee or sort of like some people often wake up at like two or three a.m. and can't go back to sleep for a little bit. What should people do when that happens? Not beat themselves up, I guess, but like

A Definitely don't beat yourself up or get anxious about it, because anxiety will inhibit your ability to go back to sleep. Trust your body, and if your body's saying, hey, I really need to get This one thing done before I go back to sleep. I'm not going to feel good unless I get this one thing done. Get up and do it. You know, just do it and then, uh, and then go back to sleep. You'll feel better. You'll feel better, less anxious, and that will help you go back to sleep. Um, if you're lying there worrying and there's nothing that can be done about it, you know, this, or at least not done at that time, if it actually requires you to go into the, into work to do this thing that you're worrying about or, um, Call someone, and it's the middle of the night, and you can't talk to them. Instead, try and, you know, write a list to help yourself feel more ready for the next, to accomplish that thing the next day. Or, you know, meditate, deep breathe, try and put yourself back into A place where you are happy and relaxed. And some people, you know, I mean, maybe it just requires distraction. Maybe playing a mindless, uh, video game, uh, on your phone with your blue light off. You need to turn down that blue light because that's a circadian clock resetting signal that you don't want. I, I play threes on my phone. I don't know if you've ever seen threes. It's just, You know, it's like you p…

AI assessment note: “Definitely don't beat yourself up or get anxious about it, because anxiety will inhibit”

Q Do you feel a need to be liked by other people?

A I think everybody has some element where they need to be liked. And so, yes, I would like to be liked by everybody. Emotionally, yes. Intellectually, I understand that that's not going to happen. One of the curious things, and this is, I don't think I wrote this down, but this is something I've learned over time, is that with enough numbers, with an audience of enough numbers, um, no matter what it is you do, somebody will not like it. And, and vice versa, like, let's take, I have this book of advice, there's 450, when you ask people their favorite one, the best ones, there's no agreement on the best ones. Everybody's list of the favorite ones is, there's none, there's no overlap. And so, I, I think part of what I've learned is that there's going to be people who, some people who don't like what you do all the time, but they're not going to be the same people, and when I was running a magazine called Co-Evolution and Whole Earth Review, I was the editor, and we kind of ran a little, maybe provocative kind of articles, and my goal was to piss off One fifth of the audience, but keep rotating. Make sure it wasn't the same.

AI assessment note: “And so, yes, I would like to be liked by everybody. Emotionally, yes.”

Q Where does that come from and what does it mean?

A I wrote this book called Hardball, and it was, the subtitles, Are You Playing to Play or Playing to Win? And I wrote it out of frustration and maybe anger, because I was, I thought the business press was misleading, mainly MBA students and middle managers into thinking that business could be played nicely. Cooptition was one of the big words at the time, and the Europeans were masters of cooptition. Might also call it collusion, but the notion was cooperate with your competitors, don't fight them. Well, all my clients were either winning and trying to preserve their winning position, or they were having trouble, maybe even losing and trying to survive. So, that was very much a survival mode, whether they were winners or losers. So, as I mentioned, Boeing Depending on the year is either number one to Airbus or number two to Airbus. So to them, competition is day to day. Komatsu versus Caterpillar. Ford versus Toyota. Toyota versus Honda and Nissan. And there is no time to stop, sit back and take your breath and relax. It's a continuous battle. So the book had, uh, uh, 12 strategies that always worked, but they're hardball strategies. And we just, they were based around clients experiences of, I think almost all of them had clients permission to use their names. And these companies put the edge in competition and the results showed in terms of their bottom line, their growth and …

AI assessment note: “I wrote this book called Hardball... out of frustration and maybe anger”

Q You mentioned earlier that Walmart sort of attacked Kmart with velocity. Can you tell us that story?

A Walmart story as it was described, uh, early in the years of Walmart. Was about, uh, a local five and dime competitor, uh, grows in boondock markets, has greeters at the door to make people comfortable and help find their way around the store, uh, has a Daryl product offering, and that's their success. That's just the tip of the iceberg. What was Walmart was doing. Uh, Walmart was, uh, Actually a logistics company. They concentrated on how fast can we move product from when our supplier gets it to us to when it leaves our store. And they organized around that, how to be faster. And they did that by having their own trucking, not outsourcing it. They did that by scheduling, uh, uh, deliveries once a week instead of once every two weeks or once a month. Uh, they did that by incenting their suppliers to, uh, deliver to a very strict and ornerous schedule by paying the suppliers faster than their competitors paid it. They did it by having very big stores. Um, in fact, it wasn't until recently that Walmart began to change its model on store size, uh, because people, they found that big stores were lower cost and people were willing to drive 30 miles to get lower cost. They're not willing to do that today. Actually, it's more expensive to do that today. So behind the scenes was a whole different model at play. I don't think Kmart actually ever figured it out. They began to see some o…

AI assessment note: “They concentrated on how fast can we move product from when our supplier gets it”

Q Because you would be, even if they're less frequent sales. Are there other ways to use the balance sheet to sort of compete with speed?

A Well, give you an example. Uh, we've done this quite a bit with chemical companies. So when I say chemical companies, you imagine big production facilities, a lot of steam coming out and everything. Uh, We've taken that, we've looked at the company at cost, of course. We've looked at the company quality, of course. We've looked at the company at time, how to deliver. But one of the interesting things that we often do is look at something called working capital productivity. And I just, let me define working capital productivity. It's accounts receivables, uh, plus accounts inventories, minus accounts payables. So cash isn't in there. But actually I use something called absolute working capital productivity, which is accounts receivables plus inventory plus payables, because people can get their productivity of capital up just by delaying payment to their suppliers. So I don't give them credit for that. So I put the three numbers together. And it turns out if you take a look at an organization's working capital productivity and find out where it's being dragged down, almost always it'll have something to do with time. They can't ship the product on time. Uh, why can't they ship the product on time? Uh, cause it's not all parts of the product order are available. So we have to hold the order till they're available. And so once there's digging into this layer at a time through the…

AI assessment note: “finds opportunities to do things that are balance sheet related, that improved productivity”

Q do well and think about is how they're positioned. They're never trying to maximize the current moment, and they're never trying to precisely predict the future. They're trying to put themselves in a position to take advantage of whatever the situation may arise, rather than being mastered by the circumstances, right? They want to master the circumstances. So no matter what happens, they're always in a position to play offense.

A Yeah. No, I think that's right. And, and, and I, the, the way when I began my hedge fund career and I eventually had to start training people, I was a very enthusiastic poker player during the time when poker wasn't like cool. This is like pre internet poker. This is like pre rounders, you know, cause I played in high school. I played in college. I became obsessed with that. And so one of the things once, once they had internet poker, Um, one of the things that I would show people as a metaphor for this was the most popular game today is what's called Texas, the No Limit Texas Hold'em, where you're dealt two cards, and then they put five cards on the table, and you have to make a combination of your two cards with the cards on the table to make the best five card hand. Um, but what was cool about internet online poker is that you could open up lots of windows at the same time. And if you had the pattern recognition down for what a good starting hand was, which in, in no limit is, is what's called pocket aces, which are two aces, um, or what they call premium pair, which is pocket kings, pocket queens, pocket jacks. You could literally just fold, you know, open up 20 windows on your screen and just literally fold, fold, fold, fold, fold, fold, fold. And all you had to do was wait for pocket pair. Or pocket premium pocket pair, and those are the ones you played. And each window y…

AI assessment note: “each window you opened was a form of optionality that allowed you to wait”

Q kitchen near you, and you can try any of the HumanCo sort of brands and, and products, and follow Jason as he, he builds this out in real time. The sign behind you has caught my attention because it says success nutrition facts. Do you want to tell us the backstory here? And it says hustle, focus, persistence, discipline, failure, risks, and patience all at a hundred percent per day.

A So I just thought this was really funny. A friend of mine had sent me this picture, um, because this actually means a lot in a lot of different ways to me, especially because I told you what happened to me in the beginning. Um, so this is called the Nutrition Facts Panel, or in my business, they call it the NFP, which in this country is, is, is a legal requirement on all packaged food products, except it usually has not these elements. It has things like fat, protein, carbohydrates, um, and then it has what are called the micronutrients, like how much vitamin C and vitamin A are in it, and sometimes it shows fiber. So you'll see this on every food product here in the US, um, as a, as a style. So I'm in the food business. Um, someone sent me a picture of this because this is kind of how I, I thought of myself over, you know, since college of all the things that I would prioritize. You can also see it says serving size, 24 hours a day. Servings per container, 365 days a year. Um, And then the bottom says percent daily values are based on high levels of ambition. So, um, I just thought that the fact that this thing existed, and it's a combination of kind of how I've lived my life, plus it's a food business centric thing, was just so random that this thing even existed, so I bought it. Um, but it's, it's also a nice reminder, Shane, that, you know, and I know you and I talked about…

AI assessment note: “A friend of mine had sent me this picture... so I bought it.”

Q I want to talk about that in a second. Uh, there, there was another moment there that made a big difference though, because you wanted to quit the squash team and then The coach wouldn't let you, or he challenged you? What, what is that backstory there?

A Yeah, no, that's right. That's right. Um, I'm glad you brought that up. So basically, after, like, two or three tests, when I was clear, like, I, I, I was good at, at, at, uh, business, I talked with my father about it, and I said, like, maybe I should, maybe I should, like, transfer into business and transfer into Wharton, but it required you to basically have a three-nine or higher. And I'd never had a three nine in my life, and so I was like, I don't, I'm, I'm gonna have to give up the squash experiment. This was after about six weeks of preseason, and this was after he'd already accepted me on the team, and I was 20 out of 20. And I went to the coach, and I said, look, I'm gonna transfer into Wharton. My academics are really important to me. I don't think I can do both. And he and his coach, who happened to be there, he was a guy in his nineties, he was no longer alive, or eighties, They both sat me down, and they both said, like, you should not give up squash. You know, the same speech that my three teachers in high school gave me. We see greatness in you. You can do some really good stuff. It's gonna help you with your life and your balance and all this other stuff. You're special. I don't know if they actually believed it or not, but hearing it felt so important to me that he basically said, don't do that. Stick with it. I wanna see what you become. And I did. And I stuc…

AI assessment note: “They both sat me down, and they both said, like, you should not give up squash.”

Q So talk to me about that, that first time, that was in your, your sort of like early twenties, right?

A Yeah. So what happened was, um, and it's a real like Icarus type of fable that actually was true. A lot of what I did in college was, On the one hand was very empowering because I found that I, I learned how to apply myself to such a degree that everything I did, I became very good at, that I put my mind to. Um, so I became a top squash player. I graduated the top student athlete of the entire university. Um, I think I was three in my Wharton class. I had one a minus in four years and all of these Kind of applications of myself. I started to hone like a process of like, Ooh, if I do this, I'll be really good at this. And if I do this and I started to teach myself how to speed read. I started to teach myself how to go on less sleep, because I started viewing things again through this kind of lens of like, it was like that movie Limitless, where I sort of thought like I was this like freak that had these gifts, and that if I didn't use these gifts, it was a, it was like a waste, and I just kept applying myself more and more, and it kept working. So I get out of Penn. I won, you know, All sorts of awards, and like, all this stuff that I thought was gonna make me happy. I got, you know, a really interesting job out of college, and I didn't, by the way, I didn't even know what a hedge fund was. I was hired as a quant, and I had not studied computer science or programming. I had a lo…

AI assessment note: “Yeah. So what happened was, um, and it's a real like Icarus type of fable”

Q That's so powerful. Thank you for sharing that with us. I want to come, I'm not losing sight of this. I know we're going down a lot of rabbit holes here and a lot of, uh, asides. I think it's incredible. I want to come back to sort of the fourth pillar of integrity, which is being impeccable with your agreements. What does that mean?

A So an agreement, let's just start there. An agreement is anything I've said I would do or wouldn't do. That's an agreement. And an agreement, I can make agreements with myself. I make an agreement with myself to work out every morning at whatever time, something like that. But agreements often exist between two or more people. So an agreement is anything I've said I would do or wouldn't do. And an agreement involves who's going to do what by when. So a lot of drama in life is caused because we have unclear and unkept agreements. Just think about it. So much drama is caused. So much energy is wasted. You're in a team meeting and you say, I thought you said you'd give me that report by five o'clock. And the person says, no, no, I said it'd be next Tuesday. Or the truth of the matter is we never said when it would be, so I just assumed it would be five o'clock. And I thought the scope of the report would be this, and you thought the scope of the report would be that. And so we're just wasting massive amounts of energy and With unclear agreements. So the first key to being impeccable with your agreements is make clear agreements. Who is going to do what by when? So simple. When people in teams get aligned to be impeccable with agreements, they start keeping about 90% of their agreements. Now, when you go in and you look at a relationship or a team that's working together and you sa…

AI assessment note: “the first key to being impeccable with your agreements is make clear agreements”

Q One more question about leadership because I just can't help myself, but like how much of leadership do you think is contextual or as somebody we think of as an exemplary leader in one situation would be, uh, mediocre or below in another situation?

A So, obviously, there's a contextual element to everything, and I think that's something you talked earlier about, about even decision-making, is this idea that there isn't kind of an isolated, perfect universe. We don't live on a Euclidean grid, and, and there's context, and there's certainly social context. Uh, we know from social psychology that, you know, almost everything is, is affected by social context, and, you You never know how you're going to behave, how you're going to react in any given situation until you're there, and that's why we should always be very humble about our own sense of ourselves, knowing that we'll always act in a certain way, because you actually don't know under certain pressures, so you should be very humble about that. So context matters a lot. That said, I think what the evidence very clearly shows me is that I can see leaders who learn how to be effective Across very different kinds of contexts. And so, for example, uh, let's take Eisenhower. Phenomenal example. You're supreme commander of allied forces. Before that, you were relatively undistinguished major. You were brought up by General Marshall and so forth. But, you know, being a five-star, which there have only been five five-star generals, I believe, in the history of the U.S. military, but being a five-star general is a very different leadership context than being president in a politi…

AI assessment note: “So context matters a lot. That said, I think what the evidence very clearly shows”

Q Is there an example where you ever did that, and you got in trouble after?

A Oh, I got in trouble for that. The head of supply chain and purchasing, who managed the food specs, he let me know that that was not my job, um, that I was out of line, that this is not, I do not own this brand, and do not have the right to make these changes. I mean, it, it made me teary, you know, it like, I'm a young employee, and I thought I was doing the right thing, and I had Some reinforcement from some executives, but the one who's, like, approving the specification sheet and who, by the way, when I come back to the U.S., I need to keep working with, was angry, was audibly angry. Luckily, I leaned on the vice president of training. Her name's Cheryl, and I remember calling her, and I was upset, and I felt comfortable being upset with her, and I was like, I'm so sorry. You know, I thought I was doing the right thing. I know you support it, but this Other executive is really upset, and I don't know what to do, because I can't, I'm down, I'm down here, you guys aren't, I can't undo this decision that I still think is the right decision. And just, you know, allies and advocates and mentors and all the words you want to use are so important. She said, don't worry. He's just crotchety. He'll get over it. You're doing the best you can. We'll get better at this as we do more of it. The company was growing, and I was caught in the crosshairs of the company growing faster than it…

AI assessment note: “Oh, I got in trouble for that. The head of supply chain and purchasing”

Q And the working together management system isn't just for organizations. I believe you and your wife use a version of this at home. Can you, can you tell me more about this? How, how does it apply at home?

A My wife just walked by and, and, uh, but she walked by. So I, they, they all, the kids, they all, um, they all think this is so, so fun, but, uh, Nikki and I have been married, I've mentioned, for 52 years, and we have five darling children, and when they started to come along, I was at Boeing, and I'm, I'm program management, and, and lots of people, and I'm watching these seven people now, and so I said to Nikki, uh, I mean, you know, we're, this is in very, uh, we're complicated with our size of our family. We need to do a business plan review every week. And Shane, she goes, Alan, this is not Boeing. This is our family. I waited for a week to, to reflect on this, and that all made sense. And then, so I said the next week, okay, what if we have a family meeting every week? And she said, well, what would we do in a family meeting? I said, well, my suggestions, and I welcome yours, would be after we come back from Mass, On Sunday morning that we have an agenda, uh, for our family meeting. The first agenda I would propose is that all of us, including you and me, we go around the house, we pick up all of our stuff, we take them back to our cubby or back to our room, because after a week with seven people living lives, it looks like a bomb's gone off in the house. And I didn't sign up for a compelling vision of picking up the house every, every week. And neither did any of the pa…

AI assessment note: “On Sunday morning that we have an agenda, uh, for our family meeting.”

Q like tips and tricks that we can learn as a group? Um, because often groups are the, the, the body making decisions, whether it's a, preferably a person, but the group has to work together. And in order to get the best information, you need to be able to be honest about, um, about things. Are there, how do you form that in a group? How do you encourage it?

A I like this practice I, I use with teams a lot called fact and story. I'll say, let's say Shane, you and I are on a team, and I say, um, Shane, the facts are that, um, you led a podcast between the two of us, um, earlier today, and then I would say, here's a story I make up about that. In my, hopefully, I'm holding the story with curiosity, um, and so I, you know, I'll say, I'm, you know, I make up a story that, and then I tell the story, but I can, I, as a Team member, if I can put a fact and story, it kind of helps the person relax a little bit to go. It's just a story, and it gives them a little freedom to speak more candidly to one another, and so I've done this before where I just come into a team, and I say, we're just going to go around the circle. You have to pick a different person each time, and you're going to have a fact and story, and we'd maybe do three rounds of that, and each time you pick somebody new on the team, and reliably, I get Feedback that, that may have been one of the best practices they've done in a long time, that they learned things that had not been learned. Elephants came out. People got valuable feedback, and they realized, like, we don't give any time and attention to being able to reveal these stories in a way that lets us all evolve, and so they all said, like, the decisions they were making, they had a big decision to make about whether they…

AI assessment note: “I like this practice I, I use with teams a lot called fact and story.”

Q I want to come to sort of some of the factors that lead to addiction, but before we do that, when we seek out dopamine, are we trying to get pleasure, or are we trying to avoid pain?

A Really, initially, it's about either getting pleasure or solving a problem. So some people use, you know, not because they're looking to have fun, although that's definitely a reason that many people use. Some people are actively using drugs and drug, drugified behaviors, uh, in order to solve a problem, and that problem can range from, you know, anxiety, depression, insomnia, poor concentration, to loneliness, uh, Boredom. Existential crisis. So there are lots and lots of, um, sort of reasons that people use to get out of a dysphoric state, which also explains why people with co-occurring psychiatric disorders are generally at higher risk of developing addiction than people without those disorders because individuals with psychiatric disorders are more likely to turn to a substance to try to solve that psychiatric, psychological, or emotional problem. Once people have started to take their drug regularly, whether or not they started for fun or to solve a problem, they will eventually end up in this dopamine deficit state where they've changed their reward threshold, and then the drug use, especially the compulsive, repetitive nature of the drug use, is essentially to get out of pain or restore level balance. So in other words, in other words, we start chasing our tail.

AI assessment note: “Really, initially, it's about either getting pleasure or solving a problem.”

Q What are the, the early warning signs that, uh, we can look for in ourselves for addiction?

A One important early warning sign is something called the double life or the lying habit. This is where we start to lie about what we're consuming, how much and how often. Um, and we're lying to other people, but we're also in a way lying to ourselves. It's very easy to minimize in our own minds, um, how much and how often we're consuming our drug of choice. And it's very hard to see the true impact of our drug use on our lives while we're chasing dopamine. So an early indicator is that we need to, uh, you know, pay attention to when we're, um, You know, lying, even if we're just sort of telling the truth about using, but we're minimizing the amounts or the frequency. One of my very beloved patients once told me that when he was in addiction, he developed the lying habit, which, which meant that he was lying not just about his drug use, but really about all kinds of things, even unrelated to his drug use. So for example, if he was having lunch at Burger King and a friend called and said, where are you? He'd say, oh, I'm at McDonald's. If he was at McDonald's, he'd say, I'm at Burger King. And it didn't make any sense, and there was no reason to lie, but his brain had just sort of flipped into the lying habit, so I think that's a really important thing to pay attention to. The other things are the, you know, just the four C's. Out of control use, using more than we plan to on any…

AI assessment note: “One important early warning sign is something called the double life or the lying habit.”

Q The second question was sort of around the, you know, abstinence for 30 days. It's one thing to say that, but people are, there's an addiction here. How is it, are there sort of like, uh, ways that people can, uh, do this that they're unaware of? Cause I mean, it sounds like 30 days sounds like this incredibly long period of time.

A Well, first of all, I, I want to acknowledge that for some people that ask is too much and that people with severe addiction You know, in, remaining in their usual environment will be unable to do that. And, and, you know, it, it becomes pretty obvious pretty early who those people are. They'll just say, I, there's no way I can do that, or I've tried that a million times and it doesn't work for me. And that's where we then recommend a higher level of care. So for example, an intensive outpatient program where people go all day and go home at night, or an even higher level of care where they go and they stay in a residential facility where they don't have access to their drug. And you know, the rehab is sort of like the butt of many jokes these days, but I can tell you as an addiction treatment provider, I'm very grateful for residential treatment settings and for rehabs because I have many patients who would never have been able to get into recovery without a restricted environment that allowed them to get their frontal lobe back in line so they could actually make choices about their lives. That's what people don't understand. They think that people are choosing to use, but once people Are addicted. Their, their reward centers have essentially been hijacked and they've lost a great deal of their autonomy and their ability to choose. They can even, they can want to stop and yet…

AI assessment note: “And that's where we then recommend a higher level of care.”

Q With your fellows, I'm super curious as to what's the hardest thing to teach them, or hardest thing for them to learn?

A My fellows come from many different backgrounds. Some are psychiatrists, but many of them are family medicine and internal medicine doctors. For those doctors, the hardest thing for them is To adjust to having more time with patients. They're used to having, you know, 15 to 30 minutes where they have to go through a list of 10 significant health problems, and for them to have, you know, 30 to 60 minutes to really open up Pandora's box about, um, psychological and emotional problems, including addiction, is, is very, very strange, and it can make them very anxious, but once they start to do it and learn to do it, they love it, and then many of them sort of don't want to go back Practicing primary care, uh, because they just feel like the depth of the connection and the meaningfulness of the interactions is so much more powerful. Um, I think that then, you know, just generally for all fellows, I think the hardest thing is, um, to know, you know, when we're helping patients and when we're enabling them, um, because there are ways in which we as healthcare providers can enable our patients' addiction, um, And so trying to, it's important to be really alert to that. You know, for example, uh, let's say a young person who comes to see us, not because they really wanted to get into recovery, but because their parents insist they come. And so they show up and they're checking the box a…

AI assessment note: “the hardest thing is, um, to know, you know, when we're helping patients”

Q Addiction, like, We seem to use this term very cavalierly, which leads us to sort of discount addiction. Like we even joke around about how we're addicted to something like addicted to going to the gym, or how do you define addiction?

A So when I use the word addiction, I'm really, um, talking about a severe form of psychopathology that is defined as the continued compulsive use of a substance or behavior despite harm to self and or others. When we make this clinical diagnosis, we use the Diagnostic and Statistical Manual of Mental Disorders, which has these 11 criteria. The more criteria you meet, the more addicted you are on a spectrum of mild, moderate to severe, and those criteria can, ah, simply be summarized as the four C's. Control, compulsions, cravings, and consequences. Importantly, um, quantity and frequency are not in those criteria. It's not because quantity and frequency don't matter. If you use more of a drug and you use it more often, you're more likely to get addicted. Uh, but the reason that it's not in the DSM, which is our sort of Bible of diagnosis, Is because they wanted a unifying diagnosis for all different forms of addiction, and so they didn't want to put quantity and frequency in there. Also, we don't really have good data for how much is too much, except for alcohol, where we have pretty good data for that. So quantity and frequency matter. They're not technically in the diagnosis. The diagnosis is based on these complex behaviors that ultimately lead to significant consequences. And the person's inability to stop in the face of those consequences. I think when people use the term a…

AI assessment note: “defined as the continued compulsive use of a substance or behavior despite harm”

Q of like, does that come across with alcohol when, uh, people say their tolerance is going up, right? So originally you have like one drink of wine and maybe you get a little buzz out of it and you're happy, but, you know, fast forward a couple of years and now all of a sudden it takes three glasses of wine to get to the same sort of mental state.

A Yes. So tolerance is definitely a marker of, um, a brain that is, um, entering, you know, that dopamine deficit state chronically, and therefore, um, you know, at risk of addiction, but tolerance alone isn't sufficient to make the diagnosis of addiction. Um, it must be associated with these compulsive out of control behaviors in the face of ongoing consequences. And the other thing is that tolerance is just one aspect of this dopamine deficit state. I think what people really underestimate is the kind of chronic dysphoria that results from chronic exposure to drugs of all kinds. And let me give you an example of a very common clinical scenario that I encounter. I have a patient who comes in, and they're here to see me for depression or for anxiety, which they Identify as part of a major depressive disorder or generalized anxiety disorder, panic disorder, what have you. And I discover in the course of my clinical screening that this person is smoking cannabis every day, or compulsively masturbating to pornography every day, or playing video games for hours on end every day. And what I suggest to them, based on what I know about the neuroscience of pleasure and pain, is that their depression and anxiety Uh, is potentially actually being caused by their compulsive consumption of their drug of choice, and that they've driven their brains into this dopamine deficit state as their br…

AI assessment note: “Yes. So tolerance is definitely a marker of, um, a brain that is”

Q And how long do we have to stop? What is long enough? Is this like seven days, 30 days, half a year?

A It probably differs, you know, from situation to situation, but I can tell you after decades of clinical work, um, and this, this, this is supported, this idea is supported by many of my colleagues and also by, uh, some of the, uh, early neuroscience into this area, is that for people who have become addicted, um, Um, 30 days is the bare minimum to begin to reset reward pathways. Two weeks is almost never enough. What happens when we first stop our drug of choice is that our pleasure pain balance slams down to the side of pain. We experience the universal symptoms of withdrawal. Some are unique to that drug, uh, but, but the others, the psychological ones are universal, and those, um, will persist for about two weeks, and then once people get to week three or week four of abstinence, the sun starts to come out. People start to, Notice improvements in their baseline mood, anxiety, and functioning, sleep, concentration, everything. So in general, I advise 30 days of abstinence. This is, um, also supported by some preliminary work by Nora Volkoff of the National Institute of Drug Abuse, which has, she has shown in imaging studies that if you image the nucleus accumbens, which is the, one of the key areas of the reward circuit, if you image the nucleus accumbens two weeks After individuals who have been addicted to a variety of drugs have stopped using, and you compare their dopami…

AI assessment note: “30 days is the bare minimum to begin to reset reward pathways.”