Episode 81: Alex Auerbach, PhD, on Building a Niche for Performance

We basically know it's almost impossible to predict who's going to be, you know, great as a professional athlete, right? We have some indicators. Obviously scouts and front office people are highly trained, highly skilled people who are good at projecting, identifying talent and all that stuff. But you've got sort of the gimmes of the world like the LeBron James is, right? And then you've got the misses of the world like the Tom Brady's and how do you know who's going to be what? And the answer is like, you don't really, right? Some of it's luck, some of it's skill, and a lot of it is the environment that they're put in.

Hi folks, I'm Dan Dworkus and this is the Emergency Mind Podcast, a space where we bring together lessons from the emergency department and beyond about performance when it matters the most, and applying knowledge under pressure. Our guest this episode is Dr. Alex Auerbach. Alex is the Director of Wellness and Development for the Toronto Raptors. Now prior to that he was Director of Clinical and Sports Psychology for the University of Arizona and he's worked extensively with Multiple NCAA Division 1 schools all across the United States. Alex holds a doctoral degree in Counseling Psychology with a specialization in Sport and Performance Psychology from the University of North Texas and an MBA from Salve Regina University. He's also a Certified Mental Performance Consultant, a licensed psychologist, and a member of the United States Olympic Committee Sport Psychology Registry. In our conversation together in this episode, we dig into the role that predictability plays in driving performance, even in the context of unpredictable environments. We talk about the massive impact of the team environment on individual performance. And we explore Alex's performance Matrix, which is both fascinatingly similar to and different from the IHO matrix that we often talk about on the podcast before we get started. A quick reminder if you want to join individuals and teams around the world who are working to perform better during times of crisis and emergency. There are so many ways to get involved with the Emergency Mind Project community and we would love to have you. The easiest way to get started, and this is a new way actually, is to try out our new Personal Crisis Skills Test, which you can find@emergencymind.com just click on the Crisis Skills button to explore how your personal habits stack up with those from some of the top performers under pressure across multiple domains. Our episode today is brought to you in part by the folks at EM Coach. So at a high level overview, EM Coach is a really excellent Emergency Medicine Board review program. It's one that I use personally to study emergency medicine and it's one that I've seen my residents enjoy as well. It has great features for both students and learners, things like on demand lectures and the ability to track your learner's progress through assigned question sets. There's a ton there and if you work in emergency medicine, you should definitely check them out. You can find them@emcoach.org that's E M C O A C H.org and for us, for the Emergency Mind community, they are offering a substantial discount if you use the code Emergency Mind at checkout. That's emergency mind all one word. So check them out at emcoach.org use the discount code Emergency Mind and get in there and enjoy. Okay, all that said, let's jump right into this episode with Alex Auerbach. I hope you enjoy.

All right, Alex, thank you so much for coming on the podcast and joining me. It's been awesome to talk to you on Twitter and this is one of those great sort of like from the social media world to the real life world. And I'm, I'm psyched to have you on the podcast to to talk all this great stuff.

I'm psyched to be here too. And indeed this is a cool extension of the Internet, so I'm happy to be here spending some time with you.

Brave, brave new world stuff. Alex, for folks that don't know you, can you give everybody just a brief overview of sort of who you are, what you do and then we'll drill in and stuff from there? Sure.

So by way of training, I'm a performance psychologist and a counseling psychologist. Got my doctorate at University of North Texas. Currently working full time as the sports psychologist overseeing mental health, mental performance and off court player development for the NBA's Toronto Raptors. Before I was here, I was overseeing the mental health and mental performance services at the University of Arizona where I did my undergrad and have been spending the last few years serving this wonderful organization here in Canada and have had some cool opportunities to extend my work into other places. Whether it's been some work at Fort Bragg with Special Forces and other high performers, it's been really pretty cool.

This is amazing.

You are the second guest in the last small chunk of time that has done graduate level training at University of North Texas. This is a very small world, considerably considering that I grew up in Dallas, in Northern Dallas. Oh, nice connection to that community. It's a weird small world. But in any case, let's start with the Raptors. Tell me about your work there and what got you into that?

Yeah. So my background, actually, before I became a sports psychologist, I was a college football coach. And I, I had set out for myself, you know, at a pretty young age, around 16. Like, what I really wanted to do was be a head football coach. It was a lot about leadership and development and more of the soft sides of coaching, if you will. Though I hate the term soft. And then I found once I got my first full time coaching job that what I was gravitating toward was really the off field stuff with the players. It was dealing with things like coursework and classes and picking a major and understanding what they wanted to do professionally. But it was also things like, hey, you know, I'm. I'm out a little bit past when I should be. Can you help me get home? And I had the opportunity to just build some really unique relationships with players that have continued now well beyond my time coaching them, you know, now a decade plus actually, which is really pretty cool. So when I sort of found that that was what I was passionate about, I started to reimagine what my career might look like and was fortunate enough to have, someone suggests to me, sports psychology. And I was like, oh, that sounds kind of interesting. You know, it's an opportunity to build relationships with people, help them perform better, think about the sides of performance that are, you know, not as visible in sport, but we know, make a massive impact on how people actually perform. And I just immediately kind of latched onto it and so did a little bit of an internship and then went through grad training and all that good stuff. And then I joined the Raptors about 11 days before the NBA season shut down in March 2020. So I was sort of immediately thrown into the emergency, if you will, of COVID And I think in, in many ways that shaped a lot of the work that I've done since I've been here. I mean, it put me in a unique position where I was onboarding in a remote world with a very high touch, hands on group of people. I hadn't built any relationships face to face, really. You know, I was just starting, I'm supposed to be like learning and transitioning in and kind of getting a feel for things. And then the world was turned upside down. And so I had a really cool opportunity to, you know, do kind of a company wide workshop and start to think about how we manage the pandemic. And since then it's really been about creating an organizational culture that supports health and high performance. So that's working at the organizational level, thinking about things like how we structure our days or the ways we travel. That's the team level. Thinking about how people are working together, performing well, how we build familiarity with each other, how we come to understand what helps someone else perform well and how that can help me perform well, how we regulate each other, those sorts of things. And then of course, the individual level, right? Thinking about one on one, addressing performance challenges, whether that's, you know, difficulty transitioning into or out of a game, performance anxiety, you know, runs the. Runs the gamut for players based on their careers and where they are and what they're trying to accomplish. And the same is true for coaches and staff.

It's so interesting to think about, like.

You know, we often.

What's the right way to say this? I guess a simplistic way to think about performance is that it's all an individual skill set, right? You are a person and you have tools, you use those tools, you use them better or worse. And there's so many examples that have come up recently, both on the podcast and Emergency Mind project in general, about how very limited of a view that is. And there's this whole sort of other counterpoint that thinks performance almost as an emergent property of teams and systems. And the question is, how do you build a system in an organization that. That creates the opportunity for high performance to arise? And there's this fascinating parallel on there, sort of on the safety side of the world between the older school, like humans screw up and cause accidents kind of point of view, and the more human factors, safety two sort of mindset that says actually safety is an emergent property of a system and a team. So we're sort of exploring over the last several podcasts this interesting parallel track that's causing us to zoom out and think about this deeply. So super psyched to get into that with you. Let me ask this. When did you first start thinking about performance from that lens as opposed to more of an individual lens?

I would say maybe in the last three to four years for me. You know, I think my grad training was really about individual performance. I mean, that was what the focus was on. And still in many ways is what sports psychology from a scientific standpoint is really focused on. How do we help each individual learn the skills to optimize their performance and reach their full potential? And that's certainly like an interesting way to look at solving the problems of performance. But you know, to your point, I think it's maybe a bit narrow in scope. And so I was fortunate enough to sort of blindly stumble into the work of a guy named Christopher Henriksen out in Denmark who has done a lot of work on the holistic ecological approach to sport, which is the idea that you want to get, you know, all the stakeholders involved in an athlete's success communicating aligned on the same page, talking about what they're working on. The same way we think about teamwork, kind of across different domains, just applied to the development specifically of athletes. And I really stumbled into that because I was starting to look at the idea of talent identification and talent selection. And at least from a psychological perspective, we basically know it's almost impossible to predict who's going to be, you know, great as a professional athlete. Right. We have some indicators. Obviously, scouts and front office people are highly trained, highly skilled people who are good at projecting, identifying talent and all that stuff. But you've got sort of the gimmes of the world like the LeBron James is, right? And then you've got the misses of the world like the Tom Brady's. And how do you know who's going to be what? And the answer is, like, you don't really. Right? Some of it's luck, some of it's skill, and a lot of it is the environment that they're put in. And so when you think about Tom Brady's emergence, obviously he's a highly dedicated, really professional, incredible athlete, very gifted. Like, it's not taking anything away from who he is as a performer, of course, but he was also put in a system with a coach who thinks really critically about how to help his players succeed and is well known for taking teams of basically nobodies, quote, unquote, nobodies, and winning super bowl after Super Bowl. And that's kind of a unique combination where we might say it's the two of them together has done something kind of unique and dynamic. And so as I was starting to think about that from some of the work I do and helping with draft processes and things like that over the last seven to ten years or so, I got into. I was sort of dissatisfied with the individual performance explanation and started to look at what else might contribute. I landed on the role of the environment and subsequently the role of the team too. Right. So I think both of them now, in my thinking, you know, both of them play a huge, huge role in facilitating high performance and things that, you know, we might take for granted I think are really good examples. So a really simple one is like the environment often dictates the schedule of things, and yet, you know, if you're in an environment that's unscheduled, unpredictable, your performance is going to suffer. It's just the way that humans work. And so you can think about someone who might reach one level in a totally unstructured, unguided environment, who with just a little bit of structure is now able to reach a totally different level. Well, that's an environmental intervention. That's not an individual skill based thing that we're trying to develop. And so now I'm starting to see how the pieces fit together more dynamically and that informs a lot of what I do.

So as we're building together this model of performance, we have a couple of factors that are coming into. We have the individual component which I do want to drill into your brain.

A little bit about that.

For sure. We have the team dynamic. We've sort of set out a second idea which is you mentioned this kind of dyad between the coach and the player. Right. Which is maybe that's the same as the team. Maybe that's separate. I thought on that. And then you have the environment which is sort of the built structure around it. Things like systems and schedules and other demands. And is there another piece that's like the culture of the club or the whole organization or I guess to ask that more broadly, what else would you throw into that model on whatever. I guess it's the right side of the model that we're looking at.

You've got all the pieces starting to come together. Yeah, I'd add culture in there. Culture is a tricky one, but I'd add it in there. So I think it's individual factors. I think it's within and between team member factors. I think it's coach athlete factors, coach team plus coach athlete team factors, culture factors, environment factors.

All right, all right. Terms in there I'm thinking about, sorry, model. This is perfect. This is actually good. So one of the. Just to, to like ultra nerd out about this for a second, like you apply certain physics standpoint or a parsimonious modeling idea and you try to put the most important terms first and get rid of some of the rest of them. So when you're looking at performance, maybe this is an impossible question to ask, but how do you weight these different things? What do you think? If I, if I made you pick three to like give you 80% of the ability to predict the performance of the person, what would you pick?

Oh man, that's a really hard question. I'm. I'm going to give you. I, I guess I'm going to give you Two answers. So the way I've simplified this, this down for myself when I'm thinking about interventions or the work I'm doing is this is my model is sort of a simple three by three matrix. It's organization, team, individual on one axis, it's prevention, intervention, postvention on another axis. With my goal being to spend as much time in organizational prevention as possible. Because the more work that we're doing preventing problems from emerging, the more we can just allow performance to emerge for the people who are really, really good at what they do. And so then you can think about like a team intervention might be what people think of like traditional team building. You might have an individual postvention when someone's gone through something more difficult or traumatic and they need to process. Like there's all these ways that you can move within the matrix to sort of understand what might be most relevant at any given point. But for me philosophically, I believe an ounce of prevention is worth a pound of cure kind of thing. To answer the question about like what factors do I think matter most for people performing well, I think I would maybe give you two or three factors. So one, the data supports this idea of self regulation is probably the single best predictor for individuals of their performance. So a simple way to think about that is the ability to manage and direct your thinking, feeling and physiology, manage and direct your behavior and optimize your own learning, right? Which means setting goals, monitoring your progress, evaluating your progress, seeking feedback and adjusting your goals and just going through a cycle repeatedly. And if you can sort of do that full self regulation package, the data suggests you're more likely to do things like make a national team appearance for your soccer team, you know, which obviously like, you know, European soccer for example, is like incredibly gifted athletes and yet those higher and self regulated learning are more likely to go from that elite level to the national team level, which is like one step above right? It's the collection of the world's best all combined in one, one space. So I would say that's one factor. I would say the second thing I would be looking about or thinking about is sort of the general culture of the team. This is where it gets a little less scientific and a little more feel or loosey goosey if you will. But to me this is like one of those things. You know it when you feel it, right? There's no like core set of values that makes for a good team culture. There's right way to do culture. But in general I'm looking for things like predictability cohesion, open communication, ability to tolerate discomfort, willingness to have conflict, things that sort of signal a willingness to work toward a common goal and an understanding of the other people that are part of the group. Which I think would be sort of like the two underlying factors of good teamwork. Right. And then I think about the environment, which is sort of like all these structural things that could be in place to support people performing well, you know, and that's why I think like the Olympics for example, make such an interesting case study because there's so much difference in funding for the different sports. There's difference in funding across governments and that's like a real environmental factor that matters. I mean if you ask elite athletes the things that are most impactful on their performance, like right up there is organizational stress and right up there is like financial stress related to how the operation is going to function so that I can get to the Olympics, right? I got one shot in four years. Like how is this place going to support me? And so it makes total sense that these environmental things would be really big in terms of how athletes feel and perform.

So interesting. I mean it's very similar. We, we use a model that's like a three by two matrix, the same, same rows, the organization, team and individual. And then the colon press are on or off the axis being like are you in an emergency or out of the emergency?

Cool.

Has the same sort of structure behind it in terms of like splitting the universe into things you're doing when your head's down and things you're doing when your head's up is another way to say it that's interesting. Like the idea of splitting out the pre and post. It's interesting for us because there's not always the same clear cut definition of pre and post in the emergency world. Like you might be post one particular resuscitation, honestly moving from one room right into the next one. So maybe you're pre that other thing, but that's it. But I love that you're using a similar structure about that, a lot of power and splitting your, your vision like that. In part because it, it allows at least us in the emergency my project to talk about it better to explain a little bit more about what we're doing. And I wonder when you're thinking about this stuff, how explicit are you with the team about what you're doing? Are you being like, guys, this today our, our goal is to work on the, you know, team based post session and this is how we're going to practice it or something like that I'm.

Not quite that explicit. Yeah, I think it's sort of my internal working model of how I think about things. And it's part of it shapes the language for how I frame things, like the value proposition of a particular activity or intervention. Because I do think it's. It's somewhat intuitive. Right. Like the idea that it's just helpful to prevent problems. As many problems for as many people as we can is something people like generally resonate with. So it helps frame that up. But I'm very rarely like, you know, this is the bucket we're in today. And it's more for me, helps me figure out what bucket do I need to be filling right now. Because you can't always live in the top left organizational prevention quadrants. Just not realistic. And so, you know, what, what's needed.

When that makes a ton of sense. I'm really fascinated by this focus on environment. Stop me if this gets into trade secret sort of stuff. But what have you been doing with Raptors to modify the environment that you are playing? What does that look like?

Logistically, I can't get too deep into trade secrets here, but I think, of course, yeah, I mean, I can give you broad strokes of things I'd be thinking about. Right. So I think for me, you know, to get to like a real neuroscientific level for a minute here, I'm in love with Lisa Feldman Baird's work and the work around predictive processing. And so in general, when I'm thinking about building a high performance environment, the thing that I'm thinking about most is predictability. And the second thing I'm thinking about is how is the environment facilitating people, basically managing allostatic load? Well. Right. Like what are we doing that is making this place easy for people to walk into. Right. So the more predictable you are to me and I am to you, the easier it's going to be for the two of us to interact. It's going to be less taxing mentally and emotionally. We're both going to feel better going through the process. And the environment should facilitate that. Right. So whether that's doing things like building a shared set of values, which is very common for organizations, like the function of the value should be to guide the behavior so that the people in the environment are more predictable. It shouldn't be to just pull some values up on a wall and sort of leave them there.

Right.

Which is unfortunately what happens a lot of times. And so that's sort of like the first principle, I guess I would say of what an environmental intervention looks like. For me, it's all about easing the work of coming into the environment, and in many ways is thinking about how you can use the environment to remove barriers to peak performance. Right. So, for example, one of the barriers in the NBA for all 30 teams to peak performance is the travel schedule. Everyone's getting in at 3amWe're playing a game the same night at 7pm like, how do you build in rest and recovery? What does that look like? You can leave that up to an individual and that's fine. Or you could come up with systems wide environment wide ways to think about how we bake recovery into the schedule. So that's to the allostatic load bucket. And then like I gave you the scheduling example earlier. Right. That's a predictability bucket. So those are some of the things I'm thinking about when I'm trying to figure out how do we optimize the environment? Because ideally, these two things are putting an individual performer in the position for their best performance to emerge. It's not a guarantee, but we don't want the environment blocking it. And that's. That's what the goal is.

Sure. I'm reflecting as we're talking about this about, you know, like a recent string of night shifts or shifts where I get off work at three in the morning and, you know, trying to, like, operate a system like that. It's obviously a little different because, like, there has to be emergency medical teams on the line 24 hours a day, 600 days a year. So you have to have some people that are operating in environments that are unfavorable. And depending on, you know, who's listening to this podcast, they might be operating in environments that are anywhere from the minimum unfavorable all the way out to directly antagonistic or unsafe when people are actively trying to kill them while they're doing their job. And so there's a lot of systems that we don't have any control over. But I'm really fascinated by this question of how do we tweak the environment around us as much as we do have control over. Because I think there's a very fatalistic sense that takes over certainly what I had when I was younger and starting in this, which is like, well, I don't control big stuff, so I don't control anything. So, no, screw it, I'm gonna come home and like, not do the things I need to do to prepare myself for tomorrow. And getting away from that is a challenge. And has individual components, also has cultural Components that everybody else around you is doing what the team is doing. How are you interacting with your players around these high level concepts like this? Are you guys doing it more sort of like didactically, paternalistically, like everybody goes to bed at this time, or is it more like, hey, we want you to understand this and army with these things and then you're going to create your systems and you know.

Yeah, I think it's our responsibility to help everyone, not just players, everyone in the organization individually optimize the environment for themselves. Right. So we have some like, best practices, some good recommendations, right? Like it's helpful to get seven to eight hours of sleep, but you know, there's only so much we can do, so we can make some suggestions, right? Like, hey, it might be helpful to leave yourself 10 hours of time to sleep versus five hours because you're never going to get seven hours if you only leave five hours. Right. Little things like that go. Go a surprisingly long way. But really I see my responsibility is to help each individual performer optimize the system for themselves. And I love what you're describing about your change in your mindset because this is something I talk about a lot. In fact, when I give a presentation on how I help people sort of work toward high performance, the first step in my model is curate your niche, which is sort of an extension of the environment literature and some of the more interesting stuff around ways animals shape the world around them. But like humans do this from an incredibly young age and then we just kind of like give up, right? You know, so I have a five month old daughter and she started this process of niche construction, like when she was born, right. She would cry, she would determine whether or not I would respond or not, or my wife would respond and then that would shape her behavior for the future. And then somewhere along the way we just kind of like give this process up. I don't know if it's school, I don't know what it is. I haven't figured it out yet. Right. But we, we sort of like relinquish the impact that we can actually have, right? And this manifests all these places. Like I'm thinking about even the medical world, right, where you think about all the historical research on nurses having difficulty speaking up to doctors and how that led to, you know, some tragic and unfortunate outcomes. And then just having one person speak up makes a difference. Well, like giving that feedback is shaping your environment. And so ultimately maybe that's too in the weeds, but that gives it like some hopefully color to What I'm describing when I think about individualized performance and shaping your environment is like, give the feedback that you need to give. Let's think about the structural, systemic things, but also tell people what you need. Help us figure out how to give you what you need. Like, this is a bidirectional process where you can shape the environment a little bit to better support you. And the environment should be responsive, to facilitate you being the best version of yourself.

Yeah.

Wow.

Cause those are like, two very important directions in that.

Right.

Give the feedback, ask for the things that you think you need, and then you have an environment that supports you and listens to you about that. It's certainly not always how the medical committee has been a version status in particular, the one that I know the best, but I do think we're getting a lot better at that. And to me, that gets to, like, one of the most interesting places for leverage and intervention is the coaching level. Right. Where you're not necessarily the one doing all the things. You're also not, you know, 20,000ft away, looking at the whole field. You're in the middle, you're guiding, sometimes you're participating, sometimes you're just guiding about stuff. And you also set so much of the tone for the culture. So I don't know, how do you work with coaches? I think that's the thing that I'm. That I'm asking a lot of people across all different domains right now is how do you work with the folks that are sort of.

I love that you're asking this because this is where I've been spending a lot of time and attention recently. And certainly what some of my own work and writing has been about, and something I'm thinking a lot about. And similar to my thinking around individual performance, my thinking around coaches or leader performance broadly has. Has also changed. So I would say I used to think, you know, especially as a sports psychologist, this is some of how I was trained, was like, oh, we'll just teach the coaches the skills. The coaches will then teach the athletes those skills. And it's like, that's a really interesting idea. What I have found out in real life, and I'm sure this is similar in the medical community, I know this is true in management and business and other places, is these leaders have so little support, so little training, formal education, whatever, to actually facilitate the way I think it's going to work, that it's just a matter of trying to, like, establish a foundation and help them feel better, perform better, take care of themselves. All those Things before we can even get to the really complicated intervention by transitive property for the sports psychologist, right? So now I would say my thinking is really about how do we help coaches see themselves as performers and treat themselves as a result the same way the athletes treat themselves. So I grew up in the coaching community a little bit, right? I had a coach who I'm still friends with today, pulling for him right now in the NFL playoffs, who looked at me when I was a young ga and I was like, oh man, I'm tired. Cause I've been going to bed at whatever midnight, waking up at 4:30am he goes, oh Alex, you'll sleep and you're dead. And I'm like, this is such a. And now as an adult, like much older adult, I'm like, this is absolutely ridiculous. Like I'm. There's no way I'm going to be the best version of myself as a result. There's no way the athletes are getting the best out of me or getting the best coaching they can get. And ultimately that's what it's about. And so my lens now is how do we help coaches take advantage of the things the athletes have? Nutrition, exercise, sleep, hydration, mental skills, mental health, right? All these things that go into being your healthiest, highest performing self, not so that we can then teach you sports psychology skills that you can teach other people so that you can deliver your work with the best possible quality, knowing that the best you is gonna be the best you for the athletes. Right? There's no, there's no exemption to that. The same thing would be true in medicine, right? The highest performing peak performance physician, the best version of that person is the best doctor for the patient, the best doctor for the team. Not even close. And that's what I'm after now because all the coaches I've been fortunate to work with across the levels, they all know their sport super well. They all know kind of how to motivate athletes or push. What they don't really know is how do I do this whole peak performance thing for myself? And so that's where I think, where I hope to see it kind of continue to evolve. And of course there's more we can do about facilitating good leadership and communication. All those things are certainly important, but they all come from a place of someone being grounded, being able to tolerate some of the new skill, learning, all those other things.

Yeah, that one really hits close to home. I'm just again struck by this thought that like there are externalities that are outside of your control when You're. When you're operating in emergencies, whether that's in an emergency department doing medicine or somewhere else doing something else. Right. Like, there's. There's definitely things that you can't control, but it's so easy to make mistake, and that means you don't control anything. And so hard to take a step back and be like, all right, well, I'm going to really throw myself into pieces that I can manipulate and to make the best version of myself available. Because I think that's true. If you ask anybody on any of the teams that I work with, do you want to bring the best version of yourself to bear today or a subpar version of yourself? Right. Nobody's going to be like, you know what? I'd really like to bring the worst version of your. My soft bear. Actually, like 60% Dan. That's who I want to show up today to run this cardiac arrest, like Hill. Right. But am I doing the things that bring 60% Dan to the table? Or even if you account for the fact that, like, maybe I'm not going to hit a hundred of what I would hit anywhere else, you know, because I'm overnight and it's four in the morning and whatever, can I bring the best possible version of myself that exists in those circumstances to bear? That's a cool version of that question that. I'm not sure I phrased that one before, but I really like it. So thank you for that.

Thank you. I think we're. We're barking up the same tree. That's exactly how I think of it.

Yeah. So, all right, if we think about environment and culture as a space where individual and team performance emerges from or has an opportunity to emerge from, how do we scale that up a level and create an organization that has the capabilities for coaches, leaders of teams to have this performance emerge in the same way? Is it the same set of stuff? Are you looking at the same matrix or is it sort of a different version?

Yeah, I think it's the same matrix with a different set of problems to me, you know, so in working with athletes, you're thinking about primarily physical performance and how that can emerge. And then, of course, mental performance is. Is a part of peak performance in sport, too. But a lot of what we're thinking about is things like skill acquisition and how do we help them learn the playbook and those kinds of things and even put them in a position to be 90% consistently, you know, versus 60% consistently. I think those things are really important. I think the same thing is true for coaches, it's just the currency of performances now. Things like decision making, quality relationships, being able to engage in healthy dialogue. Right. All these things matter for the coach's performance. And so same matrix, but maybe a different set of tools and a different set of problems to solve for.

I think that when in some worlds like sport, there's such a very clear cut delineation between you are a player or you're a coach, in a lot of the other worlds, for a lot of folks that are listening to this podcast, you're part of the emergency mind community that doesn't necessarily exist the same way. Like it's more of a spectrum. There are moments when you are the cutting edge of the knife and you're in moments where you're aiming the knife and you're sort of moving back and forth between those sometimes that's because we're, we're operating as part of a team that has a dynamic focus and leadership where, you know, we're working together on a problem set. And I'm like, okay, I'm heads down on this allergy, take over the field. I'm going to concentrate here. We go back and forth to each other. I love what you're describing because it gives the sense that we can create a system that allows excellence to emerge no matter where you are on that spectrum. And really seeing yourself on that spectrum becomes a positive as opposed to sort of a while I'm only really thinking about performance when I'm on the left side or the right side. That is really cool. I'm wondering, you know, in the same way that we're talking about, while people fall in this trap necessarily thinking leaders as performers, we're not necessarily thinking leaders as people that also need to concentrate on their own performance. What other traps are you seeing now? Where are you seeing people go, go awry and getting stuck?

So I think you raised one, which was the idea that we can't really do anything to shape our environment. I think that's, I think that's a trap. I think the second trap you just mentioned, the kind of coaches seeing themselves as performers or not is sort of like, in my view, I'm just making this connection now, but I think it's sort of like a misapplication of the idea of servant leadership. Right. It's like I just exist to help everybody else. It's like, yeah, but you know when a plane's going down and they, you lose cabin pressure and they tell you to put your own mask on first. Like that's sort of what we're after here, you know, you can still help other people. Right. But it's a lot harder to help people when you're passed out in the aisle way. And so I think that that's a fallacy. I think a third one for performance in particular is the idea that more effort will always lead to the outcome that you want. I find this is particularly over applied when people fail or make mistakes. But you know, in fact the data sort of points to the opposite. Right. Like kind of ease up and slow down and recalibrate. What else do I think is a misapplied model of performance? I'm sure I can, can think of several others if I, if I had more time. Yeah.

Looking at it from a different vantage point, holes become more obvious. Right. And it's easier to see what you're stumbling into or you have sort of like a, a higher level advantage on everything sometimes hard to tell when you're in a hole. That effort not equal to success thing, I think is a great example of that. We were working on that with a case yesterday and we had a situation where we're trying to put a breathing tube in and it wasn't working. My incredibly skilled counterpart was trying incredibly hard to get the tube in, get the tube in, get the tube in. And understandably losing a little bit of sight of the rest of the room.

Right.

Sometimes pushing more is not necessarily the answer in there, but it takes an interesting type of mindset to remember to look up when you're not exactly succeeding at that individual task. Learning how to train that and how to help people do that. I think that's an interesting skill set, but I actually want to turn it a little bit less turn here. A lot of what you've been describing about making things predictable, managing allostatic load and creating an environment that is optimized for emergent success works really, really well on intact teams. Right. Folks that are selected together, trained together, play together, continue to operate together. A lot of the people that sounds like you and I both work with in a lot of ways that aren't on that work in more of a swarm team environment. Right. Where they come together to solve a problem, set ad hoc and then they sort of dissipate back out into the universe. Very different universe. What do we take from everything you're learning and teaching that work in the Intax team and port over to help swarm teams work better than we do?

This is a super dynamic question. I may or may not have anything super profound to offer here.

We think about this all the time in emergency medicine. Because some days we're more like swarm teams and some days we're more like intact teams. And a lot of the groups we work with, just like there's not a clear cut donation between player and coach, there's not always a clear cut delineation between intact team and swarm team. We're having to learn what the best practices are and sort of build the plane as we're flying.

Yeah, I think that's fascinating. I'll be curious. What do you guys find and what you learn? You have to keep me posted as you go. I think, you know, you're sort of alluding to it now. The first thing that comes to my mind is role clarity. It's helping people. To me, role clarity is about making the world predictable.

Right.

It's like, what do you expect of me and what should I expect of you? So to me, that seems like the natural starting point when a group is coming together is to understand what role everyone feels they can best play. And do we have all the roles that we need to be successful here. The second thing that comes to mind is like, how do you drastically speed up some form of familiarity building? I don't have a clear answer to this, but, you know, one of the things that helps people just is time around each other. And in this swarm team, you don't have that opportunity really to just sit around and exchange ideas and drink tea and relax and get to know each other. But is there a way that you can help people more quickly express who they are and what they need, even if it just takes five seconds a person? Maybe you don't even have that much time in some of these situations. Right. But, you know, a simple way to. To help people kind of improve that familiarity, I think would be really interesting. And then I think the other thing that I would maybe pull in here would be, and this probably has to come from the larger environment again, but what are the expectations and standards of behavior here? Because I think if everyone's on the same page, it's like a little different, a layer down from culture. But if everyone's on the same page of what the expectations are, what the standards are, I think you at least get a sense of what I should expect here. Those would be the things that would be maximally useful so that the rest of your time and attention and energy can be spent dealing with whatever crisis is on hand. Because that's likely to be an incredibly taxing event.

I think you've identified a lot of the things that we do Think about when we talk about role clarity and building whatever little bit of predictability, environmental control we have into these dynamic situations. And really we're sort of getting at this idea here. I want to go back to like some of the pitfalls of not catastrophizing. Right. Things are really bad, but they don't have to be worse than they are. And there's a tendency to make things worse than they are. Like, oh, we don't have any time to talk, you don't have any time to establish rules. You don't have anything. And sometimes you truly don't.

Right.

But you walk in and the person is in cardiac arrest and people are already doing chest compressions and everything's going. But a lot of times you do have that extra second. And Aaron, how do you leverage that as best as possible to make this as smooth a possible transition? The other thing that we spend a lot of time talking about is this idea of low clarity. And in your matrix this would sort of fall in sort of like organizational or T level pre stuff. Right.

What can you do ahead of time?

So that maybe Dan and Alex have never met together before, but there's somebody in the Dan role who has met somebody at the Alex role before and they understand a little bit about what generally how Dan's and Alex has talked to each other about stuff. And you're able to sort of predefine what some of those things look like to make that as smooth as possible.

But yeah, no, I appreciate the question actually to jump in real quick. I love where you ended. And so it makes me wonder about, you know, are there ways these organizations that are dealing with swarm teams can in non swarm circumstances put people who would otherwise not be in touch in touch so that when the swarm happens, there's an increased likelihood that we've at least met each other or been exposed to each other in, in some way. Right. So I think that comes to me from the first point you raised, which is like, I think you're absolutely right. People just immediately jump to how this situation will not work. Right. We all, we can't do anything with role clarity because Johnny's dying on the table over here. And like, sure. And maybe that's 10% of your cases. Right. It might be like high number, but there's also then 90% of the times like you probably do something. And I think that's what high performance and high performing teams is, is about. It's about not getting something 100% of the time. It's about getting as much of what you can done to improve your odds of success. I mean, all performances are odds based events. You should be doing everything you can to tip the odds into your favor. And so rather than black and white, kind of like, oh, we just can't do that. It's too extreme here. It's like, well, look for ways that you can creatively introduce some of this stuff because it is going to help you. And it's not good enough to just say like, well, in these one instance it wouldn't work. Like, okay, sure, but that's not a high performer to me. Right. That's sort of taking the lazy, easy way out. And I recognize these are incredibly difficult situations that we all want to get right. And so it behooves us all to figure out how we optimize those things.

Could not agree with you more on that. Right. Like 1% difference over time is going to make an enormous, enormous impact when you aggregate all of that. I think that's, that's absolutely huge. One of the ways that you do try to do that is maybe you can't get everybody together ahead of time, but the importance of post processing an event once you are cleared, once the patient is stable or not stable or whatever happens next. And you disband this swarm tea and always encourage my folks to go back or to spend a few minutes afterwards and be like, hey, how did that go? What do you think? Who are you? Nice to meet you.

Right.

And create that culture, even if you're only creating it on the ending side of it. Because you might, then either you or somebody else in your role is going to inherit the benefit of that when you go back up to that same space to run it back again. In any case, we're drifting into some interesting territory here, but I want to be super mindful of our time before we close out. Give you a chance to issue a challenge to everybody listening to this. What do you want them to do differently? What do you want them to take away from this? And if they can change one thing over their next couple shifts or next couple of games or next couple practices or whatever, what do you want it to be?

Thank you for giving me this power. This feels like a tremendous responsibility. Yeah. I think my challenge would be to find the thing in the environment that you can change that will make you a bit better. It's very on theme with what we've been discussing, but I think it would be easy to sort of say something like meditate more, you know, which would, would also be valuable. But I think really it's you know, pushing yourself a little bit more to figure out how do you shape your world to get the best out of you. And if you can do that, that's going to make a huge difference in your overall health, your overall performance, and that's what we're after here.

Love it. Alex, thank you so much for coming on the podcast. Ned, honored to have you. And I really thank you.

Thank you so much for having me. It's been fun.

All right, folks, that brings us to the end of this episode. I hope you learned something and I hope you enjoyed. As always on this podcast, our goal is to dive deep into what it takes to perform under pressure. Nothing that we discuss here should be construed as medical advice. And all of the opinions that we discuss are our own and are not necessarily representative of any organization with which we were affiliated or for whom we work. If you want to go even deeper and get more involved, don't forget to check out our book. It's called the emergency wiring your brain for performance under pressure, and you can find it@emergencymind.com book all right, good luck out there.