You can ignore the stone in your shoe for a few steps, but after a while it becomes unbearable and potentially harmful. The same is true of those nagging thoughts and doubts we have about work.

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I want to talk to you today about those times when you know that there's something wrong, but you do anything to avoid, really dealing with them.

So a while back I was at the airport dropping one of my family off for their travels, and I just bought this really nice pair of trainers.

I was really pleased with them.

They're incredibly comfortable.

But a few days before I'd noticed that as I was walking along, on the right foot.

It was digging in a little bit, just over the top of my foot and I sort of adjusted the laces a bit and it felt a bit better.

And so I thought, no, these were, they were expensive trainers.

They're really nice.

Um, I'm just going to keep wearing them.

So I put them on unborn them to the airport.

And as I was sort of.

I thought I got out the car, they felt okay.

But as I carried on walking, There was something really not right.

It kept ticking in.

So I just had to pull the laces around a bit and, and carried on walking.

Now also I dropped my relative off at departures, I was then walking back to the car and I thought, hang on a sec.

This is really irritating me now, in fact, it started to make a mark on the top of my foot.

So.

I bent over and I took my shoe off.

And I thought what's that poking out with my shoe?

And I pulled out this massive bit of black plastic which is sort of bigger than the Palm of one of my hands.

This was in the The top of the shoe.

I just hadn't noticed it as part of the packaging material.

And that really got me thinking.

Because so often there's something wrong with our shoe, we just make a little adjustment or we know there's some grits in it, so we just shake it out and everything's okay and off we go.

And we, we know that when we're walking along and there's that little bit of grit in your shoe, you can't think about anything else until you've got rid of it.

But what about when it's something we don't quite know what it is?

There's something not right, and we either try and ignore it because, you know, that was a very expensive, very nice pair of shoes and if I investigate too much, It might mean that I can't wear them anymore.

I have to take them back.

So we ignore it or we just make little adjustments, but nothing really sorts itself out until we've investigated what it was.

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Now, when it comes to work and life and jobs and relationships.

It's very nice to think that if there's something wrong, we can just make a little tweak and it will all get better.

But life's not like that.

And this happened to me earlier this year.

I was working with somebody, we were doing something together and something wasn't right.

And it was causing me all sorts of anxiety and distress.

And turns out it was causing them all sorts of anxiety as well.

But because we were both really invested in this thing that we were doing, neither of us wanted to really call out that there was anything wrong.

But we were both getting more and more frustrated.

And it Wilson until somebody else called it out that we realized that there was an issue.

And this other person just realized that they were doing something that they didn't want to do.

And they said, gosh, I've just realized, oh, I don't want to do that.

And yeah, what you've suggested, that sounds great to me.

And at the same time, I just felt this massive weight lifting of my shoulders and this massive relief.

Because both of us have been too scared to dig in and investigate what was really going on.

Now life is full of stuff.

Isn't it?

That doesn't work and we can make little adjustments and often little tweaks are all that we need.

And I do talk a lot about these little changes we can make.

It's our lives and our routines that make things better.

But sometimes there's something really big going on.

And that is just too scary to address.

But if we don't address it, we're just going to carry on getting the same result as we've always got.

If we don't address it.

Often because we fare, but able, due to the relationship, if we really address it, well, the relationship goes pear shaped anyway, as resentment builds up.

And what you end up doing is just solving the problems around the edges and just nibbling away at stuff rather than getting to the root of the problem.

I was talking to a younger person recently, who'd been struggling a lot with anxiety and their mental health had really been, not very good in the last year.

And when I saw them.

They seem like a different person.

I said, oh, how you doing?

And they start doing really well.

They just split up in their relationship.

And if it turned out their partner was a drug addict and they'd been dealing with death and that was the massive cause of their anxiety.

And they had tried all sorts of things and it was only by taking the bull by the horns and making that really difficult decision that the anxiety lifted off them.

Now, I'm not saying you should go off, I'm breaking up with people just because they have some issues or whatever.

But what I'm saying is he was trying all sorts of other stuff to sort out his anxiety when the real cause of the problem wasn't being addressed.

See, there would have been no point me sorting out those little things, that those trainers, those little bits of grit in the shoots to make them feel better when there was this massive whopping piece of plastic in the way.

Nothing was going to solve it, but I needed to investigate what this plastic was, because it's not until we start to investigate and work out what the real problem is that we'll be able to solve it.

And if you do that, then you'll find it's better for everybody.

Because nobody wants to be stuck in a relationship that's not working.

Even it's working for you, I don't want to be in relationships that's not working for the other person.

I don't want to be in a role where I'm not performing and nobody's telling me, just to protect me, but long-term, that's not going to be any good for me or for other people.

And if we can really identify these, these massive pieces of plastic in our shoe, it means that we can move forward.

Now that we've got me thinking about why we fail to identify the plastic.

The first reason why we often fail to act when there's a warping piece of plastic in our shoe.

Is that we know what it is.

It's really obvious, but it's just too hard.

It feels too difficult.

We are so fearful of the consequences of acting.

That might be leaving a very, very tricky relationship, leaving a job, making a huge life change.

It's scary.

Isn't it?

And we don't know how to do it.

So that is when we need help and we need support.

We need people around us.

We need to get the skills to do that.

Often there are very, very good reasons why we're scared about it, and this is something we need to think through.

So talking about it and getting the help and support you need is, is really, really vital for those those times where we know what to do.

We just need some supports to do it.

Now the second category, category two is when you know what to do deep down you know what to do, but something is stopping you.

I follow a business coach called Donald Miller who's is very interesting.

And he was saying this in a coaching session, he was saying for his mentor, I'm really confused about what to do in this situation.

And his mentors just said to him, Donald, stop choosing to be confused.

You know what to do, it just feels too scary.

You're worried about the impact and the relationship.

Deep down you know.

It's coming out as confusion and indecision.

You know, deep down, there are lots of things that we know are wrong.

These are the sorts of things that wake us up and three in the morning, and I heard Alain de Botton from the School of Life saying recently that you need to pay attention to those three o'clock awakenings.

Because often that's the only time when your monkey mind is quiet and your intuition and your wise mind can I pop out and go this is the problem.

And that often wakes you up.

So since I heard that my really started paying attention to those things and those thoughts that are waking me up at three in the morning.

Now, some of them are crazy.

Some are just completely mad of course.

And we all know that three o'clock in the morning, things are much, much worse than they are in the, in the cold light of day.

But writing stuff down and just making a list of what is bothering you is a really good way to know what is it?

And, you know, your intuition is often writes.

Because there's a deep wise path of you that recognizes patterns, that reads the emotions.

That's connecting with people on a much deeper level than we ever aware of.

So don't ignore your intuition.

If you feel that something's wrong.

But you're just choosing to be confused because actually you don't want to believe that it's wrong, listen to it.

And a lot of the time they're choosing to be confused is down to some biases that we might have.

There might be a sunk cost bias.

I had a bit of a sunk cost bias about my trainers because you know, I'd already bought then I probably couldn't take them back anymore.

So I really wanted to believe that my trainers were okay, and that they were fitting perfectly and there was nothing wrong with them.

So I would do anything just to, to try and ignore that there was the problem.

And so often we have sunk cost bias then in friendships that have been going for a long time, in relationships, in sports we've started to learn.

I was letting ice skating for a couple of years before I fell over and break my ankle.

And that's a really think hard about whether I carried on with it.

And I thought life I've had two years, so lessons I should carry on, but you know what.

Awesome enjoying it that much.

And the, um, amount of time I was out from the other things that I love to do because of my broken ankle.

It just wasn't worth it.

So I decided to ditch it.

Now that could be seen as flaky.

But there is no point in just grafting on with something that isn't working because you've committed to it.

In other words, sunk cost bias can really be an enemy.

It is much better to recognize something and change your mind, even if you invested a lot of time and energy in it, rather than just plowing on with a route that isn't right.

And I think for doctors, we have a lot of sunk costs, don't we?

We have the career that we've chosen.

We've got the practices that we work in, or the departments that we work in.

We've got the skills that we've got.

A lot of sunk cost, and it feels like we spent so much time on this.

It would be such a waste that we, if we changed our role or we did something different or we decided to go part-time and we decided to do something actually that pleases us rather than other people.

So just the way the sunk cost bias.

Another bias you need to be aware of.

It's confirmation bias.

So confirmation bias is our sort of unconscious tendency to notice stuff which reinforces our beliefs or our wants.

So if I have a colleague say that I'm working with and I really wanted to work out, then I'm going to notice all the stuff that they do really well.

And perhaps not notice the stuff that they're not doing so well.

Well, if there's a restaurant, I go to.

I don't particularly like the decor.

I'll probably notice when the food is bad as opposed to when it's good.

And if there's a restaurant that my mate opened and we go on the first night and the food isn't really good, well, I'll probably do my best consciously or unconsciously to notice the good stuff about it.

Now there's another thing that happens.

This is called motivated reasoning.

And this is a tendency that we have.

To interpret things.

In light of our own beliefs, to match our own beliefs.

So if I believe that everybody who drives a black Honda is an idiot, then every time I see a black Honda, I will interpret the way they're driving as really pad or, you know, if they stopped in the middle road to let an old lady cross a bit, oh, that's ridiculous, why they're doing that?

It would match my beliefs, right?

I don't know why I picked a black Honda, don't know anyone with a black Honda.

But what we do is we cherry pick evidence.

And I think when things aren't going right in our lives, um, it might be with a relationship or a role or a job or something, but we're really infested in, in making it work and getting it right, then we will have this motivated reasoning, going well, it is, it's not working, but that's because maybe I haven't done enough here or that's because of something else, rather than being really honest.

About what's going on.

So we're just deceiving ourselves.

And deep down our wise brain knows.

Now it might not know exactly what's wrong, but it certainly knows that there is something wrong.

And that brings me on to the third category.

That's where there's something wrong.

And we have no idea what it is.

We just have this uncomfortable feeling.

And sometimes we then just put off investigating.

Because of the sunk cost bias, our motivated reasoning, that we really wanted to work out.

All of us, everything in us is invested.

In that thing being okay.

When really it's not.

So it's not even that we wants to solve it.

It's we don't even want to look into it.

And sometimes we don't even know how to look into it.

And that's where you need to, to be a little bit of self-examination.

Journaling, writing down what you're thinking and your feeling can be really helpful.

This is where talking things through with a trusted colleague can be really helpful.

Coaching is brilliant for this because they can ask you questions, get you to look at stuff from different perspectives, even asking what advice would I be giving to someone else in the same situation?

Or if you were an outsider looking at this from a completely neutral perspective, what would you be saying about it?

You could use sort of imaginary third party mentors, you know, what would I be saying about this if I was Richard Branson or Barack Obama or, or Billy Connolly, I don't know, take your pick.

That try and get some different perspectives on it.

And ask around.

Because one of the things I think re really, really holds us back.

Is this idea that we can't change our minds.

That once you've committed to something, we've got to go down that route.

Now, I'm not saying be flaky.

And I'm not saying commit to stuff and then just let people down left right and center.

Course I'm not.

But I know that in healthcare, we have a tendency to go the other way, you know, once we've committed and said we'll do something, we will do it at all costs.

And in the past, maybe that was a mark of character.

I know that all my life I've been quoted, you know, let your yes be your yes and your no be your no.

But, you know what?

When more evidence comes to light, it is okay to change your mind.

How on earth were you supposed to know what being departmental director would be like before you've done it.

Once you're doing it, you know what it's like, you know, if it suits you or not.

It is okay to change your mind.

In fact, I think it's a sign of emotional intelligence to change your mind.

That often means admitting you're wrong as well.

Now, it's quite difficult, isn't it?

It's completely bonkers to carry on down a route that you know is not for you, that you know is wrong, that you know is causing all sorts of problems, just because you don't want to lose face or you feel bad about letting people down or you think that people would judge you because you've changed your mind.

There's a great book about this, about rethinking by Adam Grant.

It's really, really important that we learn to rethink.

And we do this in our practice that we, when new evidence comes out about treatments.

We rethink what we do.

We need to do that about our life.

We can rethink all sorts of things.

Our core beliefs.

Oh, I tend to see.

We do not need to stick on the same track just because we decided, might've been several years ago that we were going to do that.

It is a sign of emotional flexibility and western to admit when it's not working and to change your mind.

But we need to start.

By working out what's actually going on.

So how do we do this?

Well, first of all, slow down.

Slow down and stop, stop for a minute to think.

If you stop for long enough and ask yourself, what's really going on, you will know your, your body keeps the score.

And that's why leaving the stuff undealt with is really problematic.

Because you might think you're doing the right thing, but it will come out in some sort of illness down the road, if you, I just, the pressing your knees and your emotions and denying what you really want.

So slow down,

when we are hijacked by our amygdala, our, our stress system, it's very, very difficult to think logically.

And we'll be attributing stuff to all sorts of things.

We've been separating everything as a threat, and we won't be able to recent things aren't properly.

We need to slow down so that when we start thinking this through with doing it from our parasympathetic system, from our sooth center, from a place of rest, and then we need to be really honest with ourselves.

And, and that often comes with being vulnerable.

Because being honest sometimes means admitting, like I just said that we've made a mistake, that we're going down the wrong track, that it's not working out.

And I don't know about you.

I don't really like being vulnerable.

It feels uncomfortable, but it's the only way to make a, a huge shift.

And often when we're honest with ourselves, we can reconsider or even just consider.

We can change our minds.

We can decide which direction we're going to go in.

Side note for anybody with a religious background, the word repentance, repent, that just means.

Change your mind change direction.

So I love that I'm very happy repenting if it just means I'm going to change my mind and look for the path that suits me, not just the path that suits other people.

So rest and acknowledge your biases.

Ask yourself.

Why do I really want this not to be happening?

Why do I really want this to be okay?

What is it about the situation I'm finding so difficult to even acknowledge there's something wrong or, or even explore where the plastic is in my shoe?

And again, journaling sharing, coaching can already really help with that, or just quiet reflection on your own.

And one of the things I've come across very recently that I think would really help this is just to think like a medic think, well, what is the differential diagnosis here?

If I was sort of writing out a medical history and I remember when I was uh, a house officer, we used to write, you know, diagnosis and then a list of differential diagnosis underneath.

What was your list of differential diagnosis be in this situation?

They don't need to be right.

It just needs to get your list.

Once you've got your list, have a look at them.

Try them on fate, which one fits?

What could be happening?

You don't need to commit to any of them.

But that's a really good exercise just to be able to admit, well, I could be wrong, I could be right.

Let's explore things.

So there might be some, some small things in your life that need rethinking.

They need exploration to, to work out where the grit or the plastic is in your shoe.

Things like certain friendships, which didn't you go to, I don't know what car you drive.

Even your bike, what holidays you like going on?

You can rethink all of that.

There were small things.

You can do this for as well.

But then might also be some bigger things.

You might need to rethink your career or your role within what you're doing.

You might need to rethink some relationships.

You might need to rethink the source of colleagues you have, what you spend a lot of your life doing?

But you know what?

It's really worth it because believe me, when this plastic was out of my shoe.

It was such a huge relief.