Long Term Care (LTC) in Canada

In this position paper, we review the known root causes of this disaster, including: governance, structural relationships within the broad health care system, funding (public and private), and human resources, all necessary but not sufficient to repair the deficiencies. We will emphasize what we believe are the most challenging but fundamental requirements for change: leadership and culture.

Work Stress is not the Source of Lost Productivity; “Worry” is
Nov 29, 2017

Let’s start our discussion with a few simple questions, and please respond honestly (Y or N will suffice).

Do you:

  • spend more time then you should procrastinating over making decisions, even minor
  • feel reticent to express feelings and frequently suppress these (either positive and/or
  • feel compelled to check things over frequently?
  • pay close attention to physical symptoms, regardless of how minor these may be?
  • worry about the health of others, especially those closest to you?
  • find yourself incessantly reviewing the details of your day or planning the details of the next day?
  • dwell on errors you’ve made either recently or the distant past?
  • watch the clock carefully to ensure timeliness?
  • plan and re-plan, whether it’s a vacation, weekend, project…whatever?
  • wish you were better looking or more athletic or smarter or more prominent or richer or any of the above?
  • concern yourself with what others think of you?

If you answered in the affirmative to 4-5 of these questions, then in my personal view you are a worrier. Answer 6 or more of these questions in the affirmative and you are, in my professional opinion, a worrier.

Chances are, if you answered 6 or more of the “Pulvermacher Worry Quotient”, then chances are you are prone to:

– bouts of anxiety
– difficulty falling or staying asleep
– occasional palpitations or other nervous reactions
– people telling you to “stop worrying”, “make adecision”, and so on
– irritable bowel or loss of appetite
– need for tranquillizers, alcohol or smoking
– missing glorious opportunities
– periods of procrastination
– any combination of the above

The bottom line being that “worrisomeness” is a “dis-ease” which will undoubtedly undermine your effectiveness, satisfaction and happiness. In fact, it may cause those around you, whether friends, families or co-workers, to feel stressed around you as well.

Indeed, when we hear the statistics regarding the huge number of people taking sick days which they attribute to stress, I often ask myself what percentage of these people have selfinduced rather then work-induced stress. In my view, once a person has deferred control of their lives to what others may think, exaggerated the implications of events, such as making an error or not meeting a deadline, and fail to express perfectly reasonable and appropriate emotions due to their concern regarding how others might react, they are inevitably setting themselves up for periods of rumination, anxiety, and distress.

Where does the tendency to worry come from? Was it learned? Were you born with it? Chances are a bit of both. Regardless, blaming parents who themselves were worry-warts and analyzing root causes may prove interesting and provide people like me with lifetime employment, but it won’t change the “habit”…and indeed, worrying can become as habitual as brushing your teeth in the morning. This also implies that breaking the pattern of worrying is not easy, particularly for those of you who have been at it for a lot longer period of time then others.

Is it worth the effort to change the pattern? I ask the question because those of you who are worriers will have already have asked yourselves that question and likely a dozen more. “What if…” thinking is a hallmark of the worrier. ”What if I don’t succeed in breaking the habit”, “what if it gets worse if I focus on it”, and such other extraneous thoughts as “what if I don’t have all the answers”, “what if he/she doesn’t like me”, “what if this sore is a tumor”….and so on.

As I said earlier, “what if” questions are the hallmark of the worrier. Ironically, they rarely ask themselves the corollary question, “so, what if?” Now here is the paradox. Ask yourself, on a scale of 10, 10 being “always”, how often do the things you worry about actually come to fruition. And now ask yourself, if you didn’t worry about the potential occurrence of these events, and they actually did happen, would you have handled the situation any differently than if you hadn’t worried about it at all?

So, by now you have probably concluded that: A. Most things you worry about rarely happen–TRUE B. If they did happen, you’d have to handle these circumstances in the same way had you not worried about it at all—ALSO TRUE Lesson #1: you would handle those events you worry about, should they actually occur, in the same fashion regardless of whether you worry about them or not.

Lesson #2: worrying is a waste of time unless the worry leads to a specific plan of action which is realistic, implementable and that you are committed to. Apart from believing that anticipating a noxious event will allow you to manage it better should it occur, another dynamic related to intense worrying is the belief that if I worry about X, then I’m in control of X’s occurrence.

This fallacious assumption leads to such other beliefs as, I can totally control my wellness, I can control the behaviour of others, I can determine how people will feel about me, etc. That said, we can certainly engage in healthy behaviours and reduce risk factors, meet reasonable expectations of others, and so on.

Nonetheless, regardless of how hard you try, some people will think you are offensive, you will make the occasional mistake if you don’t check repeatedly, you won’t ever live up to everyone’s expectations….regardless of how much effort you put into it. Unfortunately, the worrier is reinforced in their worrying tendency even if that worry is reinforced on only one occasion. Consequently, they come to see worrying as an insurance policy against that which they worry about as happening or being better prepared to handle the situation if it were to indeed arise.

The paradox, of course is, that by worrying they actually increase the probability of bringing on the so-called disaster they are worrying about. So the worrier will forget words in a speech, undo a right answer and make it wrong, drive people crazy with their worrisome behaviour until they are rejected….and so on. Hence, the inevitable self-fulfilling prophecy.

Lesson #3: if you think you can control events or people, also try walking on water. Kidding aside, the way to avoid creating that which you worry about is, ironically, to stop worrying and/or take pre-emptive steps. Another very interesting phenomenon about worrying is that the tendency to worry is often a proxy for avoiding expressing feelings.

So, if you spend a great deal of time in your head worrying, noodling, dwelling, ruminating, and obsessing, you can thereby avoid spending equal and precious time in your gut….which euphemistically speaking is where your emotions lie (actually, emotions probably lie somewhere in the cortex of your brain, but don’t worry about it…it is of little or any consequence where emotions are located…they are simply felt). In my earlier days when I practiced as a Clinical Psychologist, a little trick I used to employ to help my patients quickly “get in touch with their feelings” rather than dwelling on their thoughts, was to ask them to wear a rubber band around their wrist, intentionally bring their worrisome thoughts to mind, flick the band with sufficient intensity so as to inflict minor discomfort, then take a deep breath and focus on their feelings (excluding the wrist pain, of course).

With several repetitions, patients would recognize the feelings they were trying so hard not to bring to awareness. Once surfaced, it’s those feelings, as well as those which subsequently emerged, which needed to be addressed. The nature of these feelings would often include fear, anger, regret, disappointment, and so on. Most of the feelings were directed towards others and the task now became to determine whether the feelings were justifiable leading to, if possible, some remedial action, or if the feelings were self-induced due to some irrational belief or expectation, e.g., everyone needs to love me if I’m to be a happy and successful person….in which case we needed to reframe the individuals unrealistic view of the world and how it operates.

Lesson #4: if you want to stop worrying figure out what the feelings are that these thoughts are obscuring and deal with the feelings constructively. My final point is that some people are beyond self-help strategies. Obsessive-Compulsive Disorder is an extreme form of worrying. If you are unable to gain control of the habit, my blunt advice is to seek professional help. Try not to worry about what others might think.

In fact, statistics now show that in NA, over 50% of people will seek out the help of a mental health professional. Therefore, if normalcy is defined as what most people do, then it is now abnormal not to seek the intervention of a counsellor. So, the next time you read or hear that NA American workers are less productive then they otherwise could be and it is due to excessive amounts of work-related stress, I would ask the question as to whether the stress is due to workplace demands or the tendency to intensify normal levels of stress through worry.

Remember, hundreds, if not thousands, of people may be confronted by the same workplace situation and not all of these people experience or report undue levels of stress. Remember too, some people are capable of taking a good situation and making it bad, and a difficult situation and making it worse.

Lesson #5: Do not be afraid to seek help should you feel that your worry tendencies are out of control or excessive. As always, feel free to send me your comments and reactions. Don’t worry….I won’t publish your messages.

In his initial professional iteration, Gerry practiced as a Clinical Psychologist. In that domain, he specialized in helping people learn to deal with and overcome phobias, anxiety-based disorders and psychosomatic problems in living, where stress was a known risk factor. Gerry then did post-doctoral training in Industrial/Organizational Psychology, which he has been practicing since the late ’70’s and still loves. Gerry works with publicly traded and private organizations, helping them formulate and implement business transformation strategies, either at the enterprise or business unit level.

He also works with senior-most executives, either individually and/or in teams, to assist them in aligning their leadership practices with the organization’s direction. Gerry has deep expertise in succession planning and implementation for senior-most executive positions and is a well-known executive coach.

Finally, Gerry sits on the Foundation Boards of Baycrest Hospital and Centre for the Aged (Toronto), Queensway-Carleton Hospital (Ottawa) and the Board of the Ottawa Jewish Community School. He previously sat on not-for-profit Boards in the New York City area. He doesn’t worry about being too busy and finds lots of time to spend with his family and friends….not all of whom like him. He doesn’t worry about it. Gerry practices both in Canada and the United States.

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