H: So before we start digging into the details of the six months that you and I spent working together, I wanna set the frame for the listeners by saying Kirsten is the business owner of an occupational therapy practice in South Africa. She has a team and a lot of what we're gonna talk about today is being a female business owner with ADHD who's also the boss, the boss of herself and the boss of several other people. Wouldn't you say that was probably the bulk of our work together?
G: Absolutely.
H: So let's talk about where you were when we first started. You know, when I went back and reviewed your getting started questionnaire and, the notes from our free consultation in our first meeting, you were feeling like, I know I'm really good at what I do, I've been at this for a while. I'm very proud of the fact that I own a business. It's a successful business. We have an excellent reputation. We do good work. And although I sometimes flirt with burnout, like all healthcare practitioners do, I'm really proud of myself, my team, and what we're doing.
But it wasn't perfect. You were working too much. You were feeling like some of your systems and structures were not optimized so they could be more efficient. But one of the things you were really craving is better balance between work and life because a lot of you was going into the business.
G: Yes. A hundred percent. And I just felt overwhelmed all of the time. And I just felt so tired of that feeling, you know?
H: Yeah. I think it's something for anyone listening who is in health care. And because I've worked with a number of occupational therapy group practice owners, physical therapy, medical, you know, law, any profession where we are helping others. It's a lot of emotional labor. And what often happens is we go into a profession because we wanna be a professional. We like having a professional identity, and we become, really infused with our professional identity and doing it to the best of our ability. But it's a whole other situation when you decide to run a group practice because you still bring those really high standards of yourself, really high expectations for yourself, and you kind of apply those to everybody else. But we learn the hard way that someone who is a business owner and someone who chooses to work in someone else's business don't usually come to work with the same mindset. So what are some of the struggles that you have experienced with that in particular?
G: I think one of the biggest challenges has been leadership, you know, not really knowing how assertive to be with my team and being in a constant fear of losing team members, you know. Am I paying them enough? Are they enjoying their work and people pleasing with my team, which I think led me to be the one that constantly overworked if I needed to work around their calendar, work around their deadlines and I'm then trying to run the business at the same time. And I think I was also then working in the team as one of the most productive, team members and then running the business. And it just meant that the actual running of the business was happening by moonlight and when I was exhausted, and it was never a priority. And it means you are always on the back foot if you never have the time to think ahead. And that's where the exhaustion and the overwhelm tends to come in.
H: Yeah. Something I wanna touch on and go a little deeper into, Kirsten, is that, you know, a lot of people who employ others in their business have that thought that you just shared that, am I doing right by them? Am I paying them enough? Am I treating them well enough? Am I creating a work culture and a work environment and work conditions that will keep them a loyal, productive member of the team because I don't wanna lose them. And I remember when we first started working together, I didn't realize that the conditions in South Africa are that that wasn't just your overachieving, overgiving, overdelivering tendencies. It is a reality that it's a competitive job market for occupational therapists, and somebody could just go work elsewhere, with a lot more ease than you can replace them. Can we talk a little bit more about the conditions that make it so? Because I think a lot of people would hear someone say, oh, I'm afraid if I don't treat them right, they're gonna go elsewhere. And they might say, well, that you're just being insecure or doubting yourself. Well, maybe, but that doesn't tell the whole story.
G: Yeah. So I think one of the biggest issues that we face in the OT industry in South Africa is that we are sought after across the world. And so the immigration rate is unbelievable, because the South African rand just can't compete with what someone might earn in the UAE, in the US, in Canada, Australia. People are getting unbelievable offers overseas. And so we've got very few OTs and a massive demand for OT, which is amazing. But what it means is that there's options. A lot of practices also work on a locum and commission basis, but it just leads to this tendency toward job hopping. And it's unusual for someone to sit in a practice.
You know, you speak to people where it's like, yeah, I've been at my job for ten years. You don't speak to a young OT here who's it's unusual. It's strange, why have you been there for so long? You know, and so I think that plays a huge role. And on top of that, then it's difficult to develop long lasting relationships with clients because income is limited. People only have so much expendable income for rehab. They've maybe spent a lot on the medical process and maybe they don't have quite as much for the rehab. And so you really are trying to juggle and you're only getting so much out of your paying clients, only getting so much out of your potential staff members. And it does make sustainability very challenging.
H: What do you also think you brought to the mix because of your giftedness, because of your ADHD, maybe even because you grew up in an entrepreneurial family, and you've always been an achiever. So how do you think you added to that, strain, added to that difficulty, added to the challenge of that just because of who you are and how you perceive things?
G: Yeah. I think I've just sort of always perceived that if I work unbelievably hard, if you just work hard, it's going to happen. And so I had this perspective of but just keep on working, just keep on working, it's gonna happen. And I think I also then honestly set a fairly bad example to my team. Always behind on admin, always on the back foot, not taking care of myself, not prioritizing sleep. How must they manage themselves if I can't manage myself? And that is still something I'm definitely working on.
But I think I've just had this perspective of work hard, keep on working. I'll show you how to work hard now, you work hard too. And I don't necessarily think that was the most, yeah, I suppose work smart, not hard, that I was just working hard. It wasn't strategic and it wasn't serving my team or me or my clients because then you're not following through on certain things. You're behind on admin, accuracy goes out the window. Communication isn't as effective and so, yep, I think there needed to be big strategic changes that needed to happen to be more effective for all of us.
H: I think that was probably one of the most transformational things during our time together is really, really recognizing that no matter how much you might inspire people, inspiration and example doesn't necessarily translate to motivating them to work better or faster or differently. Let's talk about that a little bit more because I think that was that was a tough part of the work together is and I think you're very idealistic as am I. We realize we have a lot of traits in common, and that was something I had to learn too as a manager, as a leader, as somebody who is doing the same work as everyone else and kind of thinking, well, just lead by example and they're gonna rise to the occasion. And when they didn't, I got frustrated. I doubled down. I tried to be more inspiring, more motivating. It still didn't work, then I got angry. Let's talk about your experience.
G: Yeah. And I think what add just before I get into that, what adds to the kind of nurturing nature is that I am also working in a specialist field of OT. And so there's nobody that I employ in my practice who just knows how to do vocational OT, return to work OT. And so I also assume the role of teacher when they join me and that also comes in with that nurturing. It's okay to mess up. I also learned this the hard way. Why don't we try this you know? And so I really think I did just adopt this, yeah, this nurturing role, and I'll never forget it was that day that I missed our session.
I got the time wrong, and you very, very kindly accommodated me despite me being in a complete panic about it. And I'll never forget that we kind of settled, we got into the session and you said to me, so you think if you just keep on working hard and setting that example that they're gonna learn to do the same. And I'm like, yes and I could never remember you were like, well, that can't happen. I can't remember what exactly a wording was, but it was such a harsh sentence that I remember just, like, just took my breath away for a moment. Like, but that was my whole strategy, Diann, what are you saying?
H: Now what am I gonna do?
G: Yeah. But I think that it was so valuable and I always come back to what you say about, you know, we kind of any, manager or boss is going to mirror somebody else's authority. Well, not necessarily the authority issues, but, you know, their natural relationship dynamics. Did you wanna jump in there?
H: Oh, yeah, you're such a good listener. You see the thought forming in my mind and trying to come out my lips. It's, realizing that, yeah, you were setting an example, and you thought that would be enough. But I think it's largely because you didn't fully, until that time, appreciate that the mindset of someone in your profession who starts a business is very different from someone who comes to work for that person. It's not a matter of they're gonna grow into that if you just model it for them, if you just inspire them and motivate them and show them it's possible. Because if they had that mindset, they would have a business instead of work for you.
G: And that maybe people aren't gonna care as much about quality as me, you know, in that exact same session. That's where I had that realization I've just been like, but we're professionals. And there's a standard we wanna uphold and we want to help people. And why wouldn't you want to offer good quality? Why wouldn't you want to do well at this job? You know? And it was that same session where you kind of said, but no. Not everyone who gets into a profession is truly this passionate or truly that fussed about quality, you know, and that was also challenging. I think I was leading with a mindset of we all have a similar mindset and let's all do this together. And there's now been a shift to actually why I need to understand myself, and I need to understand these individuals, and I need to understand the goal of this business and try and connect those.
H: Yep. One of the things you said to me, when we were wrapping up, and I have this process of requesting client feedback, you said that you didn't really realize until we work together how much your ADHD shows up in your business and how you approach your business and how you approach solving problems and all of the things. And one of the things you're speaking to right now, Kirsten, is that I think we tend to gravitate towards roles that allow us to leverage our passion and our purpose.
In fact, I think it's an absolute requirement if we are going to do something and we're gonna do it well, especially when it involves emotional labor, we have to feel really passionate about it. And we have to believe this is my purpose in the world, and I it's hard, and it's demanding, and I wish I had more free time and made more money, and people are a pain in the butt. But I really feel I'm fulfilling my purpose in the world, and I'm using my gifts in service to others, which is very, very satisfying to me. When we have that, we just assume, doesn't everybody?
And I remember because I was breaking it down for you, and you were like, I feel like you just ripped my idealism in half, thanks for nothing. And because I'm also very idealistic too, and I've had to learn this myself, it's like, okay, here's the thing. You're very passionate. Purpose is really important to you. And you're also a leader and so it's like, well, wait a minute. If I am able to just initiate, if I am able to push through when I'm tired or bored, can't everybody? And I think it was you said, I didn't really realize, like, how my ADHD really affects me as a business owner, how it shows up in my business.
And I think you also hadn't really, you knew you were smart, but you weren't really recognizing that you're actually gifted. And the combination of giftedness and ADHD, especially as a leader, we double down, triple down, quadruple down, and continue to beat our heads against the wall thinking, if I just do my best and everyone else sees what my best looks like, they're gonna wanna be doing the same thing and doing their best. No, and it was almost like kind of almost like a grief and loss. I went to go through the five stages of grief and loss, because you're like, but wait. Like, then how do you get people to honor like, why didn't they just get a job? You have to get so much education to be an OT. It's very demanding work. Why do this if you don't strive to be your best? And I think you had to go through a period of disillusionment.
G: Absolutely. You rained on my parade so many times.
H: You're like, that I'm paying for this?
G: I remember I had prepped for one of the meetings and one of the my to dos was, you know, what do I want out of my team? And on my list was intrinsic motivation. And again, you rained on my parade and you're like, well, guess what? You can't create that in someone and I was like, what? But it makes sense, you know, and it makes you so much more strategic in the way that you think and you manage people.
H: And also recognizing that's what's important to you. And what you may I say, what makes your chili cook? What gets you up in the morning? What makes you proud? What you're willing to do even when it's hard is not necessarily the same thing as the people who work for you, who may honestly feel just as identified with the profession. They may, in their own way, feel like they care about quality just as much as you do. But your ability to be really single-minded and determined in the way that you are, I think that's exceptional. And I think that's something that we may be able to show people. And we may think we're modeling or mentoring, but if they don't have that aspiration, I say if they don't aspire and desire to have that and to be that, all of that energy was actually wasted and probably frustrated them as much as it frustrated you. They just weren't about to say anything.
G: Yeah. It makes you less relatable. I mean, okay she's gonna motor on and she's gonna do all the things. She's a superhero.
H: Motor on. That was the expression I was trying to remember.
G: And, you know, what about the rest of us? I can't wake up at 4AM like she does and get all that admin done before a full day of patients. So, you know, that's it's actually not a realistic standard that I was setting and I had not realized that. I had it had never been spoken about my intelligence. It was, I think, our second session when I was like, so what is this twice exceptional thing that you're on about? I was diagnosed late with ADHD, and for a long time, I was in a bit of denial around it. And so I know you kind of are often of the frame of reference of you don't need the diagnosis to really act on it. But for me, it was quite important to accept. Okay, so I am allowed to have some of these problems that these people have, and I am allowed to try some of these strategies that work for these other people.
It's not their strategies. It's not safe for the people who really need it you know? I can take on this identity and then also realizing then that I am an intelligent person and I've kind of lived my life where if I encounter an obstacle, I figure it out? And it's quite hard when you're managing people. And I can be quite blunt, you know, and it was so relatable when I found out through working with you that there are other people that are like this, where if they're struggling with something and I'm like, well, just try harder. Like, it's so hard to empathize and be compassionate with that, but I didn't actually realize that was my intelligence and my problem solving abilities being different to those around me. Not better, but I wasn't relating to them.
H: So we don't really realize that we are actually holding ourselves back because we need better boundaries. We need to actually get more realistic about our expectations of ourselves and others. We need to recognize when we should actually be doing less, when the way you and I are wired, more is always better. Like, if a little is good, then more is better right? And you're like, well, actually, when you're doing so much, what that signals to the people around you is the opposite of what you want them to see. What they see is must be nice for her. Like you say, being not being relatable Must be nice to be her or, well, good for her. That's not me and meanwhile, you keep you're doing all these things. You're putting all these terrific programs and in services and all the trying to create all these, you know, motivations and incentives. And they just keep thinking, wow she just keeps knocking herself out, nice for her.
Now one of the tangibles that I do feel really good about, and this took a little bit of work too, because it was it was shifting your perspective, Kirsten, from being a practice owner to being a business owner. And for you to recognize, actually, myself and the business and my professional identity as an OT were kind of fused. And what you needed to do was recognize that your clients have needs, your team has needs, you as the business owner has needs, and your business as a separate entity has needs. And I think some really interesting things and changes were able to happen with that perspective, including you recognizing, I need to have a day outside the office where I'm not the beck and call girl. Let's touch on that a little bit.
G: Yeah. And I still use your word, the owner days. I can't say I've started referring to it like that with my team yet. But, yeah, absolutely, I've needed time for me and time for the business, and I don't think that I've been able to see that. I haven't had that perspective. Like you say, the identity was completely blurred, and I can just see such a crazy shift in how I'm making decisions. Because when you're making decisions for the people right now, they are the immediate decisions.
It's the grabbing the chocolate out of the sweetie cupboard. And it's not the decision that's right for the long term. Well, you know what? Long term, I really am wanting to get fitter and healthier. I'm going to hold myself back from this chocolate right now. I'm gonna hold myself back from giving into this leave request or giving into whatever this thing is that my team might be disappointed about in this moment. Because if I make this decision for us in the long term, make the decision for the business, it's going to serve all of us in the long term. And I was making the decisions in the right now, in all of our experience. I was so caught up in my own emotion. And I think that that was then knocking onto my team. And it wasn't serving any of us.
H: You're not initiating. It's not initiating energy. It's responding, which is easier for our brain because it takes a whole hell of a lot less executive functioning. And that's why we realized you need to have an owner day every week where you get the hell out of that office and you limit their access to you and limit your own compulsive checking to make sure everybody else is okay. Because otherwise, the executive functioning that we actually need to think big picture, to think about our vision, to think about our long term strategy, our long term planning, changes that we wanna make in the business so it's not only sustainable, but profitable and vibrant over time.
There's no way you're going to be able to do that when you're constantly getting requests. Hey, got a minute you know? Hey, can you take a look at this? Hey, I got to run this thing by you. Plus the inbox, plus things, you know, referrals and all that. Your attention span is literally being sliced and diced. And but it's so easy to give into because we get a little squirted dopamine every time we solve someone else's problem. Every time we pay attention to someone else's priority, it's less effortful for us and it feels good. Like, it feels good because we're helpers. That's why we went into the fields that we went into. We like to help people. So being able to separate yourself from just the immediate gratification aspect of that. Plus, it's harder to think about priorities and to think strategically and to plan. It's so much easier to just whack a mole and put out fires.
G: Absolutely. And it just plays into that whole mommy dynamic where you just constantly need it. And, yes, it does feel good, but it feels even better to feel in control of your business and your time. And so I think that it's scary to give that up, you know, and I've now appointed someone into a managerial position, which was in the works in our time together. And it was actually today that there was a moment where I hadn't had a question for quite a while, and there was a problem on the group that was resolved and there was a moment of like, oh, okay.
Like, do am I needed? Do I fit? And then I was I had to remind myself, Kirsten, this is exactly what you've been working towards. I got to get my own work done this morning. It was a cracker of a morning but it actually was uncomfortable, you know. So, yeah, it's fascinating how our own needs and our own emotions. And I think especially with the ADHD, like you mentioned, we thrive on that purpose and that passion. And so much of our own identity and our own satisfaction out of life does come out of this. And so it's hard to step away from the emotions, but it's absolutely necessary.
H: I almost think of it like weaning yourself off of I don't wanna put it on the level of an addiction. I think that's too pathological. But as I often say, all human behavior is habit forming. And when your brain, has challenges with executive functioning, anytime you initiate something, anytime you're the one who has to come up with the plan, who has to come up with the priorities, who has to come up with the sequence, all of that just consumes a lot of executive functioning. So without realizing it, we just kind of unconsciously say, well, I just need to take care of a few things. I just need to answer a few emails. I just need to check-in with the team and make sure everybody's good. And then I'm gonna go focus on the bigger picture stuff.
You're gonna focus on the big picture stuff with what energy? What energy are you gonna have left after you do? And it's so because it feels so rewarding in the moment. And we do get that dopamine, and we're feeling purposeful, and we're feeling important, and we're feeling necessary. You're feeling needed, all of which is very gratifying. Nothing abnormal. Nothing pathological about that. But then when we put our own priority work last, we're attempting to do it not only with our already diminished executive functioning, but now we have diminished energy. Because even doing things for others and getting the dopamine and getting the satisfaction, you're still getting depleted at the same time.
G: Absolutely. And you're setting a bad example. It's not good leadership. You know, I think there's that that sense of importance and sense of authority that comes with coming in and fixing it for you. And, you know, in the short term, that feels like, well, maybe this will get me the respect I need to lead a successful team but the reality is it doesn't. Being in control, being able to delegate, being strategic with your time, not always being on the back foot. Those are the things that are actually gonna gain you respect, long term respect from your team. But, yeah, it's hard to see that at the time.
H: It was one of the first things you wrote in your getting started questionnaire, which sets the frame for my work with a client. What are the most important goals? What are the most important achievements? What do you wanna walk away from this six months together with? And one of your top priorities was, I want more control of my time. So we've been talking about a lot of ways that you have created that and recognize the need for it, even though I had to come in like a wrecking ball and destroy many of your cherished fantasies and idealistic beliefs. What are some other examples about how this has continued to play out for you?
Because it's typical, a lot of people think I'm only gonna make these changes while we're in the work, in my experience. And why I usually wait several months after the engagement to have one of these interviews is because almost without exception, the work continues after we're officially done because you've learned the things that you need to do, the things you need to change, the different ways you need to think, the things you need to pull yourself back from, and how to make that happen. So what are some of the ways that you have continued to shape the business to better serve your long term goals after we finish working together?
G: Sure. Diann, how much time do you have?
H: We got about five more minutes.
G: No. I must say I could never have expected the process to have been as transformational as what it was. I don't think it's really measurable or that there's really a list of bullet points I could go through with you. It is every decision that I make, I am making for the business. I am no longer the business. We are now making decisions for a business. And the way that I think about hiring, the way I think about retention, the way I think about teaching, the way I think about being needed, the way I think about delegation and investing in maybe administrative resources or, you know, financial support resources or coaching resources, you know, those things we invest into the business, and then we all benefits in the long term.
So I suppose to be specific, I could say, yes, hiring someone in a managerial role, delegating more, solving less problems for my team, and being drastically more specific about what I expect from my team and who I'm gonna hire and what I expect from them at the hiring point. I think those are the specifics, but I really like I said, it's so hard because it's just been a complete shift in my mindset and in such a freeing and exciting way. It's there was always this fear of getting stuck in the mundane of the business. It did feel like a lot of my days were similar, and this is different. This allows me to tap into the creative and the aspirational and the idealistic. I had never realized how idealistic I was until we worked together. And you were like, you know, but that's kind of a dreamland. And I just thought we all lived there. And so it's an entire mindset shift. I cannot speak highly enough of the process and what it's done for me.
H: I think it was really helpful that we met every other week, which has now become my norm. I used to work with people every week, and I think you were one of the first clients that we talked about meeting every other week because you are so busy. But I think it was also necessary for you, not only because of your busy schedule, but to actually have time to really, really process some of the things I was challenging you with.
G: Absolutely.
H: Some of the new ways of thinking and feeling and working and giving you time to really observe your patterns and say, oh, shit, she's actually right and what do I wanna do about this? And so I think it's now become my standard that I meet with people every other week because I really realized most of us really do need to kind of process things and noodle them. And sometimes we need to bounce back and forth and verbally process on Voxer, and we need to create experiments in our business. But I think one of the things that I've also know that you recently adopted a puppy. And I'm pretty sure you because you're a person who's single, you don't have kids, you don't intend to have kids. I've been pretty sure, this may be an assumption on my part, that you wouldn't have felt that you could have a puppy with as much as you were working before. So I also see this as, like, a declaration of staking a claim on the freedom and the time flexibility that you wanted so that the other parts of your life can be just as robust as your business.
G: Absolutely, Diann. I mean, it's the dream for me. I adore animals, and Lemon is going to be trained as a therapy dog, as a service dog in practice. And I think that that's also just, you know, it's bringing me back to the dream, why I got into this. I like to help people. I like to share with people. I want to share Lemon with people. And for me to be able to say, hey this is a priority, I'm not waking up at 5AM to get my admin done. I'm waking up at 5AM so I can get ready so we can go to the park. And for us to I mean, for me to commit the amount of time that I have to her, you know, I really have committed a lot of time to teaching her, and it's been so exciting.
And, yeah, like you say, a reflection of the transformation, in the process. There is one other thing as well that I was just thinking while you were talking. Is I do also think with the time span that we had, it also gave me time to learn more to thrive on some of the resources that you sent me, and that it excites me, the learning. And it also made it a not just a me problem. It got me out of the me because I actually learned that a lot of the issues, like, you had said to me, no, I've worked with other OT practitioners and I was like, okay, yeah but she hasn't worked with me.
H: But they're not me.
G: Yeah. Exactly. Like, who's to say that the problems they're experiencing are the same. And so much of that extra material that I went through was like, okay. But there are other people out there like me. The experiences I am having are I'm not alone, and that there are solutions to this. And so I think it also made it a bigger world and a bigger problem than just me and, oh my gosh, this is so hard and I'm so tired and I think the distance between us probably also contributed to that. You know, so I really think that that was another part that helped me solidify and make the change in that time that I had between sessions.
H: You know what you're making me realize as we're wrapping up, Kirsten, is that it seems like you both learned how different you are and how similar you are like exactly. As a as an OT and we're on opposite sides of the globe right? I'm in the US, you're in South Africa. Your profession is the way it operates is a little bit different over there, but not so different. And I've worked with a number of other group practice owners who are also OTs. I just think there's something about being socially conditioned as a female, being a person who drives a lot of satisfaction from helping others and solving problems, being a person who's ambitious and driven and independent, and doesn't I mean, you're much younger than many of my clients.
And you knew that you wanted to have a business right away. Most people kind of come to that later after they get more seasoned. So I just think that you learned and came to really accept and embrace and, and really work with the ways that you're different. You're twice exceptionality and the ways that, no, it's not just me. I'm not just an outlier. I'm not just a weirdo. This is part of my profession. It's part of being a helping professional. It's part of being a group practice owner. And I think that helps you make decisions that really feel concrete and not like, well, let's just see what happens you know, like, let's just wing it. It really helps you think more strategically and know what's possible and what isn't.
G: And accept yourself. You know, there's so much rejection and being different and so much that comes with the neurodivergence. And I think just the acceptance and embracing this is who I am, I know that and, yeah, it's an exciting place to be.
