"it’s not about helping people to stop becoming irrational, it's about helping them to recognise that they inevitably will. That’s the human condition; you can’t stop irrational thinking."
If you didn’t have time to listen to our latest buddytalks episode with Ian Martin you can read the transcript below.
RT: Hello, I’m Ralph Tribe, hosting buddyboost’s buddy talks. As people will know, this is a series of podcasts focusing on workplace wellbeing, high performance, and happiness. I’m talking with various corporate leaders, entrepreneurs, elite athletes, and clinical experts about their thoughts on physical and mental wellbeing in the workplace. For his contribution to personal high performance and happiness, today, I’m delighted to be talking with Ian Martin who is an extremely well regarded cognitive behavioural psychotherapist and an executive coach. He’s a CBT therapist practising through the Priory and his own private practice; senior lecturer at the College of Cognitive Behavioural Therapy; and the general manager of the D’Oyly Carte Opera Trust. It’s lovely to chat with someone with so much clinical experience, supporting people with their psychological wellbeing and, in this episode of the podcast, with someone who actually could focus on mental health and wellbeing, given Ian’s expertise in this area. So, welcome, Ian Martin.
IM: Lovely to be here with you.
RT: So, just an introduction to start with. Just give us a bit of a sense of you – so the story of how you trained or moved into therapy. When we spoke about this, it was quite an interesting story so just tell us about it.
IM: I’ve been with D’Oyly Carte Opera Company since 1987, and without going into the long history of that company, we reached this sort of end of the road around the year 2000 where we were facing incredible difficulties with funding. The company stopped performing on a full-time basis and I was asked to stay on as general manager and I thought, well, if I’m staying on as a general manager for an opera company that doesn’t do opera, it’s going to get a bit boring, so I retrained. I did an MSc in rational emotive behaviour therapy at Goldsmith’s university London and started doing half a week of psychotherapy and half a week running the opera company, and I still do that most of the time. At the moment, we are in production up in Scotland, with Scottish opera, so I’m spending far more time doing the other company stuff.
When I was working with singers, I noticed that a significant number of performers were experiencing, at any stage of their career, performance anxiety. It would sometimes emerge from nowhere and completely disable them because when you have performance anxiety and you’re a singer, the first casualty is your vocal cords and your ability to sing, as the vocal cords can tighten up. I was seeing people, some of whom had had very long careers as singers, suddenly unable to sing; or they’re anxious about singing, and all of a sudden, their career was under threat. It frightened me thinking – if you are a singer and your entire ability to earn money is invested in your vocal cords and, suddenly, they don’t work because of an emotional problem – what can we do about that? The timing just coincided nicely because that’s when I started training and I worked with quite a few singers with performance anxiety – not just singers, but also actors and public speakers – and I saw very swift recoveries and improvements in the conditions and a very relieved population of people. That encouraged me really to look further into ways of helping people who are experiencing primarily anxiety disorders but also depression, because both of them were the two most common emotional problems that people seek help with. And that’s really where my focus has been since retraining.
RT: I know that you see a wide range of people, and from previous conversations, actually a number of those are executives or people from all sort of conventional workplaces, and I know over the years you’ve come across many people suffering from anxiety or potential depression, and there are techniques to help. Give us a bit of a sense for, in the workplace, the two, three things that you think are real sort of watch-outs or trends in people that you work with. Once you’ve just talked through that, I’m just really interested in the two or three techniques which are sort of quick wins before we move onto perhaps deeper ideas that people can deploy to manage their mental health and improve their performance from perhaps a position of some difficulty.
IM: The quickest interventions and the most, as I would refer to them, elegant outcomes come from philosophical change are changing fundamental beliefs and attitudes that you hold and have possibly never questioned. This is the domain of Albert Ellis, who was the creator of rational emotive behaviour therapy, and he conceptualised a quote that ‘all human beings have a biological tendency to emotionally disturb themselves by taking their strongly held preferences and escalating them into rigid dogma’. So, we start with a philosophy that’s largely flexible, psychologically flexible – we have preferences, ‘I prefer success over failure, but I accept that failure is possible’. That’s a psychologically flexible attitude but what we do, as human beings, we have a tendency – and all of us regardless of whether you’re a business owner, leader or corporate employee – all of us are human and we all have this innate tendency to go from that flexible thinking and attitude, into rigid dogma.
We escalate from preferences to demands and the demand sounds like ‘must’, ‘should’, ‘have to’, ‘ought to’, ‘need’. And the moment we’ve escalated into that attitudinal shift, the emotional consequences are anxiety or even depression because there’s always a chance that your demand won’t be met. That is either anxiety provoking or depressing depending on where your demand is focused. We have demands on ourselves, demands we place on others, demands that we place on the future in terms of threats and dangers, and the territory of anxiety. The demands that we place on the past, almost ridiculously, about loss and failure that we don’t believe should have happened; that’s the domain of depression. So, the biggest intervention, or the most elegant intervention, is helping people to realise that they have escalated from psychological flexibility into psychological dogma and rigid attitudinal focuses.
That can be transformative as soon as people will realise that. It’s an easy fix, well, easy because, philosophically, you might understand it intellectually; the brain is like a machine; it’s a biological, chemical, electrical machine. It’s a habit machine; it gets good at doing what you do with it. The brain works habitually and if you’ve had a habit of rigid thinking, it can be challenging to change. You might get that it’s a good idea intellectually, but developing emotional insight is quite challenging. So, that’s the first intervention that I always work with. However, as Ellis would tell us, you know changing your belief doesn’t in itself change your emotion. It helps to shake the ‘stuckness’ of that emotion but it doesn’t actually seal the deal; behavioural change seals the deal. If you chose to change your rigid belief for a flexible belief, how would you change the way you behave? What would you do differently? What would you stop avoiding? What would you engage with? Behavioural change is the bit that seals the deal, which is why it’s cognitive behavioural therapy. Changing the way we think, and changing the way we behave, those are the two major interventions. Thereafter, it’s about managing the environment, managing your stressors, trying to develop a healthy lifestyle and a focus on wellbeing.
RT: Simplistically then, because I’m a simplistic kind of a guy. So, the point being that people have gone from holding a flexible position which might be regarded as being sort of rational that you may succeed or you may not – but what happens for a lot of us, myself included on occasion, is that you flip from that into something which is less rational; a dogmatic position in that you know this presentation must go particularly well, or all sorts of terrible things might happen as a consequence of it. So, you’ve gone from rational thinking to irrational thinking about something. As a therapist, how do you actually help people, apart from just understanding what’s going on with their thought process is that they are perhaps overdoing their responses to that event coming up in the future? People have heard about cognitive behavioural therapy and some people will have had it, but many people won’t. I think people are always intrigued about, ‘OK, the therapist has got someone to understand the difference between one and the other and the person might accept that but how does the therapist then work with the individual to get to a place where generally they don’t become irrational about those things that have historically made them anxious?’
IM: Well, it’s not about helping people to stop becoming irrational, it’s about helping them to recognise that they inevitably will. That’s the human condition; you can’t stop irrational thinking. As Ellis says, all human beings have this biological tendency, there’s no fix for that, that’s the human condition. But once you recognise that you have that vulnerability; that you have that tendency; you can do something about it. You can’t fix something that you don’t recognise needs fixing. So, the idea that in some way you can fix someone by changing their beliefs, like you rewrite the code; you reboot the system; and restart the brain, and all of a sudden it works better. It’s still human, we’re human beings and we experience human emotions and there’s no fix for that. Depression and anxiety – and there will always be depression and anxiety – they’re human emotions. We will always experience them. But once you recognise the machinery that maintains those emotions then you can work with them, and you can manage them better. It’s not about engineering them out, it’s about recognising that these are human emotions. They can be very damaging.
Ellis had this idea of there being healthy and unhealthy emotions, negative emotions. It’s OK to feel bad and that’s a challenge for people that believe that positive thinking should always feel good and that you should always be positive. I find that nonsensical, because it’s not appropriate to feel good when someone you love dies; it’s appropriate to feel incredibly sad and to cry – that’s an appropriate emotional response to loss. So, feeling bad in a healthy way tends to be we feel sad; we feel concerned about threats and dangers; we feel remorse instead of guilt. These are emotions which evolve quicker and they resolve themselves quicker. They’re not experienced as ‘stuck-states’. The difference is, with an unhealthy emotion is that it’s experienced as a ‘stuck-state’. Depression is a stuck-state and so is anxiety and it’s maintained by the thinking – the spiral of thinking. Depression is usually maintained by ruminated spiral, circular, repetitive, negatively-biased thinking, that spirals downwards into despair helplessness, hopelessness. That’s depression and it is maintained by this spiral of thinking. Anxiety, on the other hand, is maintained by the spiral that escalates called worry. Worry and rumination are the two thinking styles which maintain these two emotional states and they’re both circular, repetitive, negativity biased. Anxiety spirals upwards into high anxiety, into panic; depression spirals downwards into despair, helplessness and hopelessness.
So, if you conceptualise both these emotions as ‘stuck-states’ then how do we go about getting unstuck? We have to break the spiral; we have to break the rumination; break the worry spiral and that’s the focus of most of the integration work, with CBT. It’s helping people once they recognise, ‘OK, I understand intellectually; I get that preferences are healthier than demands’. That’s a big achievement for a lot of people because we are taught that if you want something enough, you have to be single-minded and you have to demand success. How long have we been taught that? And it turns out the evidence doesn’t prove that; it’s the opposite. If you want something enough, you strongly, powerfully, passionately prefer it but don’t demand it because the moment you demand something… In psychology there’s this thing called the law of the reversed effect; ‘whatever happens, don’t think about a pink elephant with a green frog on its back’. As soon as you try not to think about something, you can’t help but think about it more, so when you think ‘I mustn’t fail, I mustn’t fail’, all you can think about is failing; so you now have a negative goal. You’re thinking about how not to fail rather than trying to succeed, so this rigid thinking is a real problem and it runs counter to the culture.
I’m in my 60s now, so I was born in the 50s, late 50s, and all my childhood I was taught this – you know during the 60s, 70s – you’ve got to be single minded; you’ve got to be driven; you’ve got to be focused; always got to achieve in order to achieve value. I now realise the problem with that thinking, because it’s just nonsensical. We’re human beings; we’re not human doings. Our value is propped up in who we are, not what you do and once you transform your thinking in that way, it just becomes a challenge to become more of who you already are. You are already the single best-qualified person on the planet to be you; there’s no one better qualified. You don’t have to practise; you don’t have to do anything. You just challenge yourself to become more of what you already are. That’s revelatory to a lot of people who have been driven to achieve because they believe their value is driven by accomplishment and achievement and there are emotional pitfalls with that type of thinking.
RT: So, people come and see you and their anxiety is provoked by some of the things they experience in the workplace – rigid dogmatic demands of how they must do in the workplace as opposed to elsewhere. I’m guessing there are all simple techniques that they can deploy to help them once they’ve started to understand the process they are going through cognitively, which then can help them habituate more healthy practices of managing that anxiety.
IM: It comes down to the idea of practising acceptance. A preference will always state what you want, but then accept that you don’t have to have it. It’s the acceptance part that we forget when we escalate into a demand. We forget to accept the unacceptable and the unacceptable still exists whether you accept it or not so once you challenge yourself to practise acceptance, it’s a cognitive rehearsal. You’re saying, ‘okay’, if I’m feeling anxious. If I’m feeling depressed, what am I not accepting, because the moment I challenged myself to accept it notionally, philosophically… And that’s not approval, you don’t have to approve of something in order to accept it; approval is a positive evaluation, disapprovals are negative evaluations, acceptances are neutral. I accept something for no other reason other than it exists and that’s a challenge because most of us say well it might exist, but it shouldn’t. We rehearsed this rigid insistence that something we don’t like mustn’t happen or shouldn’t have happened or mustn’t be and that takes a huge amount of energy from us and has complications within the body.
RT: So, let’s say, just to make this all very practical for anyone listening. So, let’s say someone, as many people do, is becoming anxious about an interview. Sometimes it’s something at work which they regard as very important to the future of their career etc. And then they’re scared, perhaps overly anxious about it, and then they start to go through the process of perhaps over-rehearsing which is not dissimilar to someone in athletics overtraining. We all know that links to worse performance, ultimately, or can do. What’s going on very practically in terms of their thinking and what’s the way to think more healthily about it?
IM: To go back to Usain Bolt, the fastest man on the planet, he was interviewed the night before the London Olympics final of the 100 metres. He already had the Olympic gold from Beijing, and so he was running the following day to defend his Olympic record. He was interviewed by a very insightful BBC journalist who said, ‘what are you saying to yourself now?’. ‘Are you saying I must win, I must win, I must maintain my…?’. Was he rehearing his demand or was he ‘I really, really, really hope passionately, I want to win but I accept that there’s these other guys; they might be faster than me; they might have practised more than me; they might want it more than me’? Knowing that he had a good sports psychologist, he answered the latter because it makes sense to do that because the moment you say ‘I really, really, really strongly passionately prefer to win, but I accept I might not’, it’s the possibility that you might not, that you accept, that gives you the additional motivation to do everything you can to win. If, conversely, he’s been saying ‘I must win; I must win; I must win’, he would be focusing on not losing which would mean he had a negative goal. I don’t know if you’ve ever watched Usain Bolt run but he doesn’t run worrying about losing, he just runs as fast as he can and never looks back. Philosophically, he’s adopting this powerful preference and that works better because it helps accept the possibility of loss or failure and helps you to perform to your best.
RT: It’s funny that, because I’ve seen that clip and that is completely coincidental, and it’s extraordinary in the end for anyone who’s even remotely familiar with cognitive behavioural therapy. You can see that his sports psychologist has been working because he says exactly what the guy is saying ‘you must be thinking you’ve got to win this’, and he goes, ‘I’m not thinking that at all and I can’t control how fast these other people on the track with me are, so I have to entertain the idea they might be better and that makes me relax into running the best that I can’. We should try and dig it out, it’s such a great clip. It shows cognitive behavioural technique in perfect motion.
IM: And the very peak of athletic prowess and so translate that to the person that is going to that the job interview and it’s exactly the same principle. If you go in saying, ‘I must; I must win; I must do my best performance; I must get this job’, you disable yourself through anxiety because you’re constantly afflicted by this fear of not getting it and that negatively impacts the performance that you give. There is there is real passionate evidence that this is a much more beneficial attitude to adopt and there’s lots of research to support it now.
RT: Brilliant, I mean that we could we talk for hours about all this I’m sure but while we’re on the subject of Usain Bolt, if you like, obviously you know buddyboost very much looks at wellbeing holistically, but it has a focus on physical wellbeing, but very much as a secondary point, it looks at mood and psychological wellbeing, so just as a final question before we start finish, I would like to understand thoughts on, and the link between, physiological and psychological wellbeing.
IM: All this is well established; we know that when you experience unhealthy negative emotions of the two dominant ones – anxiety and depression – it has a physical presence in your body. When you experience anxiety, you become adrenalised; your body releases various hormones – stress hormones – which have an impact on your body. Now, that can be functional if you’ve got a bus running towards you – it’s quite helpful to feel anxious because it gives you that shot of adrenaline to jump out of the way – but if you’re lying in bed at 4 o’clock in the morning, wide awake, feeling anxious, there’s no function to the adrenaline – it’s pointless. So, what comes with anxiety, is muscular tension; your muscles are tensing ready to take action to deal with the incoming threat or danger and so over a sustained period – most of us can deal with adrenaline and anxiety for short periods of time – but if you in your professional life are running on anxiety, running on stress hormones, for a long period of time, there’s going to be a bodily impact. Muscular tension is going to install itself in your shoulders; your shoulders will head for your ears; your gut will become unbalanced and so this is burnout. So, physiologically, the body mirrors what your mind is doing and what your emotional reality is, so there’s a very clear, well-established link between emotional ill-health and physical ill-health and, conversely, emotional wellbeing and physical wellbeing. When you’re feeling well, and you’re focusing on a healthy lifestyle, you have less awareness of your body because it’s in a state of equilibrium; it’s in state of health; you’re not getting any irritating internal signals saying, ‘you pay attention to me’. When you’re physically ill, your body demands your attention; you get aches and you get pains; and you get you get physical illness and that feeds into emotional distress as well.
RT: Like I said, I’m sure we could talk for hours and I’m sure we will at some point, but as we know, these podcasts are about 26 minutes long because according to the research, and very much embedded in the buddyboost model, 26 minutes of exercise or 26 minutes of thinking about the right things today is pretty good for you. So, we’re going to leave it there and that’s it. Martin, thank you so much for your time; it’s been absolutely fascinating.