Under Pressure: How To Thrive In Times Of Turmoil

How do you change from a victim mindset to a thriver mindset?

High-pressure situations have a habit of bringing out either the very worst or the very best in us. Chances are there have been times when you took control when things went pear-shaped, as well as times when you felt like you buckled under the pressure. What if there was a way you could change your mindset to always come out swinging when the going got tough?

Dr. Dan Diamond is a physician who's been responding to international disasters for over 30 years. He was the Director of the Medical Triage Unit at the New Orleans Convention Center following Hurricane Katrina. He led one of the first medical teams into Haiti following their devastating earthquake and more recently, he's deployed to the Philippines following Typhoon Yolanda. His new book is Beyond Resilience Trench-Tested Tools to Thrive Under Pressure. I recently interviewed Dan for the LEADx Podcast, to hear his advice on how to thrive in times of strife. (The interview below has been lightly edited for space and clarity.)

Kevin Kruse: What were some of the things that you saw, and what did you learn about human behavior? 

Dan Diamond: It really was the most bizarre experience of my entire life, and I've been doing disasters for 30 years, but New Orleans was really strange. We knew that we were going to have a lot of victims. In fact, we had 50,000 body bags on pallets. We knew this was going to be bad, but what I was not prepared for were the people that did not become victims and it had nothing whatsoever to do with resources.  

It's really easy when you're living day to day life to have a hard time sorting out where people are coming from because people can hide behind their stuff and their clothes and their cars and their houses and their job titles and all that kind of stuff, but when everybody's lost everything and all they have are the clothes on their back and when we got tired—including us, I mean—we had some medical supplies, but when we got tired, we just laid on the ground like they did and so we were all street people.

It's kind of freeing actually. If you're tired and you're in a building, you just look for a corner or get under a table where nobody will step on you and sleep. If it's outside, just lay down in the parking lot. I had a Therm-a-Rest pad. That helped. The first morning I woke up and there was a flat cockroach underneath my head, but aside from that, we were all on the same ground. It was humanity in its rawest form and it was amazing to see the different strategies that people used.

Kruse: Was this the first time that you saw things among the survivors that changed your view of human behavior?

Diamond: I think, you know, different disasters have different impacts. In fact, I try to give one word for each disaster so I can come back and ponder over it later. For Katrina, it was just ‘Bizarre.’ That was the word, ‘Bizarre.’ For Haiti, it was ‘Devastating.’ The Philippines for Typhoon Yolanda, we called it Haiyan here, it got two words. It was ‘Tender Mercy.’

Kruse: Why ‘Tender Mercy’? 

Diamond: I felt when I came home from the Philippines like I had been hugged. It was really a wonderful experience. We would drive down the street and people would line up on the street and say, "Thanks for coming, thanks for coming." It was like being in a parade everywhere we went. It's not like here where, you know, the rescue was expected. But in the Philippines, they were very grateful that we showed up and were there to help.

Kruse: That's not making a certain geographic section of the United States sound too good compared to the Philippines.

Diamond: Well, I don't want to get down on my fellow Americans. It was a strange time. It's like we were sitting there and my staff came up and said, "Hey, Diamond. There's a woman over there that says she can swallow a snake." I'm not shy. I used to be a street mime, and I'm totally okay with walking up and at least interacting with people. Maybe not talking, not as a street mime. I went over and I said, "Hey, I heard that you can swallow a snake." She says, "I sure can." I said, "No kidding." I mean, now there's helicopters and stuff landing all around us. This is a major disaster zone and I said, "Do you have one with you?" She said, "I sure do."

She reaches into her purse and she pulls out a snake about, I don't know, maybe three feet long and an inch and a half in diameter, and swallowed it and pulled it back out and swallowed it again.

I'm like, that's bizarre. You don't see that anywhere else in the world except in New Orleans.

Kruse: Was she asking you for something? For some help? What was the point?

Diamond: No, she was a street performer, though. As a street mime, I respect the street performers. It was an interesting gig, but not mine and if you were the snake, if you ever wish you had arms, that was it. What in the world?

What we saw, though, were some people that shifted into this mode of being the victims and we all knew that was going to happen and the media zoomed in on them. I remember this one woman that was being interviewed by CNN and she's screaming at the CNN reporter, "When is George Bush going to bring me my food?" I'm going, "He's not." She's holding her little daughter's hand and it really bugged me, number one, that she thought George was going to bring her food, but what bugged me more was that she was not saying, "When is George Bush going to bring my daughter some food?" 

It was all about her. I want to understand why it is that some people shift into that mode and then some people show up and they're like, "Oh yeah, I lost my house and everything, I'll get over that, but what can I do to help? You guys need anything? Can I help? Can I bandage patients for you or can I get water. How can I help?" 

Kruse: In your book you talk about one of the keys is ‘target fixation.’ What is it that we're focused on? Tell us more about that.  

Diamond: ‘Target fixation’ is hilarious. Well, it's potentially hilarious or devastating, but it's this idea that you go where you look. A few years back, I was in Eastern Washington over by a town called Wenatchee and there's this mountain bike trail called Devil's Gulch. I ride with a bunch of guys that are not necessarily—Well, I don't know that I want to use the word ‘lazy.’

We park a car at the bottom and then drive our bikes up to the top in a truck and ride down. It's a 3,000-foot drop. It is a fantastic ride, but we just didn't like going uphill. That's all. It makes sense to me and to us. We're flying down this thing and in a couple places, the trail is about two-feet wide with a cliff face right next to you on your left-hand side that goes straight up. You can't turn left. On the right, it's about a 150-foot drop off. 

I'm the lead rider and I'm flying. It's a beautiful thing, this is so much fun, and I start thinking about the fact that the state police, when they're training their officers how to drive in these high speed chases, they say if your car goes out of control, don't look at the tree that you're afraid you're going to hit. Look where you want to go because your car will go in the direction that you look.

I'm thinking this through in my head as I'm flying down this mountain. Just for a second, I thought “Nah, I don't believe that. It goes against physics. How do my eyeballs change where I go?” And I looked just for second to my right and I launched off that stinking cliff. I landed in some shrubberies that were sticking out. My bike got snagged in there. My buddies didn't know, so they're zinging by. I'm down there yelling “Hey! Hey! Hey!” Eventually, they figured I wasn't ahead of them and they turned around and rode back uphill. I don't think they were real happy with me, but they ride back up and find me. I passed my bike up to them and then I hold onto my bike and they pull me up the side of this cliff.

Ever since then, I've been a firm believer in this idea of ‘target fixation.’ From a leadership perspective and from a work perspective, if you start in the morning and you say, "I can't stand my job for the following three reasons," by the end of the day you'll have five. If you wake up in the morning and you say, "I love my job for the following three reasons," by the end of the day you'll have five things that you like about your job. It's where you look and it's exceedingly powerful. If you don't believe me, I'll take you to Devil's Gulch.

Kruse: You've come up with a model. You call it the ‘Thriver Matrix.’ Can you try to summarize what this is and how can leaders get people into that thriver quadrant?

Diamond: This was the big epiphany that I had after I came back from Katrina. If you start with this woman who's yelling at this CNN reporter, she believes that she has no power. There was a psychologist back in the 50s named Julian Rotter, and he came up with this brilliant idea that he called ‘locus of control.’ Victims have an external ‘locus of control.’ Power is external to them, and it comes in their direction. Things happen to them.

Thrivers, on the other hand, have an internal locus of control and power flows out from them. The first dimension is ‘Power,’ the other dimension is ‘Purpose.’ So you divide the world up into ‘Givers’ and ‘Takers.’ If you look at these two dimensions, you make a two by two grid and you have the power running vertically, so you have the powerful at the top and the powerless at the bottom.

You have the horizontal axis, which is ‘Purpose’ and you have ‘Takers’ on the left and ‘Givers’ on the right. In the lower left-hand quadrant, I've got the ‘Victims.’ This woman was a powerless taker. It's all about her. She's looking for somebody else to solve her problem, her rallying cry is “Help me, help me, help me,” and where she's putting her eye, and if we link this back to ‘target fixation,’ is on the fact that she doesn't have what she needs. She believes in the scarcity economy. It's all about her and nobody's taking care of her so she needs somebody else to give her what she needs and it's all about her. She doesn't even care about her daughter.

In the upper left still in the ‘Takers’' category, we have the powerful takers and those are the ‘Controllers’ or the ‘Manipulators.’ Remember after Katrina, there was a bunch of guys went into Walmart, and they started stealing big screen televisions? I remember watching that and thinking, "What's wrong with you? Do you think you can just go into a store and start taking stuff?" They're thinking, "Well, it's my time. If I don't look out for number one, who's going to?" Well, it didn't occur to me until a couple years later, they had no place to plug them in. What do they do? They take their big screen TV's back to where their house used to be and they put it in the street and they invite all their friends over, but they don't have any place to plug it in. Doesn't make any sense.

The ‘Controllers’ look like they get ahead for a while, but then they don't really win in the end. In the business world, these folks that are in that ‘Controller’ quadrant—the upper left—they're ‘Powerful Takers,’ believe that it's all about them. They will say out loud, "If I don't look out for number one, who's going to?" I would counter back, "If you look out for number one, who's going to?"

It's the opposite. If I go into your workplace and everything is all about me, and I'm using my power to make your life miserable and your whole existence is to make me successful, if I go to step out in front of a bus, you're not going to stop me. You're going to say, "Oh, bummer. That's so sad.” These guys that are in this controlling quadrant, they believe in the scarcity economy. That there's not enough stuff to go around. We see this in disasters. We see guys that were stealing television sets. There were people that were shooting at the rescue workers. Come and get us first and shooting at the rescue people. Nobody's going to go back in the next trip and get you if you're shooting at people.

I tell some stories when I do my keynotes, my workshops about people that were being shot at and then I usually ask my audience, "Have you ever been shot at?" There's usually a couple people that have served in the military or police officers and they'll raise their hands and say, "Yeah, I've been shot at." Well, what about the rest of you? You ever been shot at? They're just looking at me like, "Well, no." I said, "Well, have you ever had your boss shoot an email at you?" They all raise their hands going, "Oh, yeah." When we in leadership send an email out demanding that they meet our needs, we set ourselves up for failure because nobody will have our back. We saw it so clearly in the disaster zones. It's like, man, you just bought yourself a long wait in line.

Nobody's going to hurry and come and help you. It's the people that were laying down their lives to help other people that became so valuable. If we continue on in the model, in the lower right-hand side, now this is going to be the ‘Powerless’ – the ‘Powerless Givers’. They're bystanders. They say stuff like, "Oh wow, somebody should do something. I wish I could help, but what can I do?" We see that in people that come to work. They're kind of passively engaged. They show up, they clock in, they hang around all day long, they'll do the tasks that you give them, but then, at the end of the day, they clock out. I don't know what they do when they go home. I think they just sit around. Watch Honey Boo Boo and Hoarders or something.

The bystanders show up, clock in, clock out, hang around, do nothing other than the tasks. They take a lot of energy because if you're leading the bystanders, you have to say, "Hey, come over here. Could you do these three things?" Then, they come back later and say, "I did the three things, now what do you want me to do?" As opposed to a ‘Thriver,’ the ‘Thrivers’ are living in the right upper quadrant. They are the ‘Powerful Givers.’ They're looking at it like “I'll do anything I can to help you be successful. It's not about me and I don't care who gets the credit.” Those people are worth their weight in gold.

I'll never forget when I was in New Orleans. It's kind of a dark humor experience because you get warped after you've been in these disasters, but I remember this. We were setting up. It was on the first day and some of the local people came. Some of the local emergency medical personnel and so there was a woman there that had a shirt on. On the front it said, ‘New Orleans Emergency Medical Services’ and on the back, in big letters, it said ‘Paramedic.’ I said "Oh, god. I'm glad you're here. I know exactly what to do with you. I'd like you to come over here and work with Dr. Bob. If you could help start IV's and get the fluids going and that kind of stuff, that would be really helpful." She said, "Oh sure, yeah, I'm happy to do that."

We're working, I don't know, a couple hours into this and I'm thinking, "Man, she's smart," so I pulled one of the other guys aside and I said, "What's the deal on Julia. She's the smartest paramedic I've ever met. Is she a paramedic?" The guy says, "No, dude. She's the Director of Emergency Medical Services for the whole city of New Orleans." I went, "Oh, no." I went back over to her. I said, "Julia, I'm so sorry. I thought you were a paramedic. I'd had no idea that you were the Director of Emergency Medical Services. Please forgive me coming into your town and setting up and saying I'm the director. I'm so sorry. I work for you. We'll stand down," and I'm just babbling on because I'm so embarrassed. She says, "You really don't get it." I said, "What?" She said, "We have begged God that he would send you because I bought a new house and I hadn't moved into it and I haven't got out of my old house yet, and both my homes got destroyed. So, we've been working for the last four days trying to save all these people, they've been shooting at us, they've been doing all this stuff. We're working 20-hour days. We haven't had any sleep. We're just sleeping in the back of the ambulances or on the ground. We begged God that he would send you, so please don't go away. Don't stand down. You're fine. I'll just come in and help when I can and I'll work under you. It's one less thing I have to worry about." I said, "Well, that's cool and I appreciate that. Again, I'm sorry, but I do have a question. What's with the paramedic shirt?" I'm never going to forget this. She said, "It's the only shirt I own. I just lost all my stuff. This is all I have and I've been in these clothes for four days."

I just wanted to fall on the ground and weep because here's somebody that lost everything, but she's still working 20-hour days trying to serve people, trying to improvise, trying to lead her teams and that's the kind of people that you want on your team. She doesn't care who gets the credit.

Kruse: That's what's I was going to say, and the key is absolutely no ego. Just shows up to help. That's really incredible.

Diamond: Yeah, they'd lost communications. Their radio equipment was on the first floor. Lesson learned. When a flood happens, then you don't have any communications for fire, police, and emergency medical services so she's trying to lead her team and the radios are down and she's got her units all over the place. They're trying to rally and figure out how to communicate and you know, some of them had lost family members and homes and that was the untold heroes' story of New Orleans, was emergency medical services. There were some fabulous people that really laid it down, not to get any glory, didn't care about that. It was just “I have the power to make a difference and it's not all about me.” It made a huge impact on me. It comes back when you weave that in with target fixation, where do I focus has a lot to do with my attitude and my mindset and it's hard to stay in that mode of I'm going to be an empowered giver and put other people first and complain at the same time. I don't have time for that.

I have to take those thoughts captive, the negative ones, and say, "Nah, that's not who I am. I'm going in a different direction."

Kruse: I like to challenge our listeners to get 1% better every day. What's something you can challenge us to go out and do today? 

Diamond: I've got gobs of research to back this that's published literature and medical literature, this is one of the most significant things you can do to change your focus. You ready for this?

It's not going to hurt, not going to cost you a million dollars: Keep a gratitude journal. Now, I'll give you some rules on how to run a gratitude journal. There's an app, by the way, it's called the Five Minute Journal, worth its weight in gold. Every day, you write down three new things that you're thankful for and you can't have any repeats. That's an important thing. No repeats. It's not that you can't have repeats that you're thankful for, like I was in the shower this morning going, "Man, I'm so thankful for a hot shower. It's so much better than showering with a bucket under a drippy faucet in the middle of Haiti. This is beautiful. I love my shower," but I don't count it as one of my three.

It's just something I'm grateful for. Three new things every day. The reason you do the new things is it's really easy to get into this habit of being thankful for the same things and then you forget about them, so I'm thankful I have a car, I'm thankful I have a house, I have a hot shower, I have food, I have soap. Maybe you didn't think about being thankful for soap because a lot of the world does not have soap.

Then, when you write the three things down, spend a little extra time to write down why you're thankful for them and pause just long enough that you feel it on the inside. I'll give you an example. Monday I always keep my gratitude journal and I thought, "I'm really thankful that oranges come in slices because if I'm eating an apple, and I go see a patient, then I come back, the apple starts to look like a science project, but oranges, you can eat a couple of slices and come back, it still looks like an orange." Now, you can laugh and I do, I laugh about that all the time because it's funny, but it's also profound because now every time I eat an orange, I smile.

In my brain, there is all kinds of chemical stuff that's going on with dopamine and serotonin and neuro pathways that are being stimulated because I now enjoy an orange like I didn't before and I appreciate it like I didn't before. It makes me laugh a little bit. Oranges never made me laugh before. If you write down, "I'm thankful for my executive assistant. She works long hours and I feel like things don't fall through the cracks. Like, I've got great support, and then you ponder. You stop for a second and go, “Oh yeah. That's good,” Then you write the next one down and the next one.  

On the five-minute journal, you write down three things you're thankful for every day. You could put a picture in there too if you want, and then three things you're going to do to make today great, and one affirmation. Affirmation is I am, fill in the blank. You don't write stuff like I am a loser or a knucklehead, but you might write down, "I am persistent.” or it might be "I'm worthwhile," or "I'm great." At the end of the day, you write down three things that went well that day and one thing you can do to make it better. It's a five-minute commitment and it will have profound impact.

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Kevin Kruse is a New York Times bestselling author, host of the popular LEADx Leadership Podcast, and the CEO/Founder of LEADx.org, which provides free world-class leadership training, professional development and career advice for anyone, anywhere.