The 'F' Word, Uncertainty and Other Musings
I recently had the pleasure of delivering a seminar to the senior leadership at West Suffolk Foundation Trust, and I thought I’d share some of my musings. Fear of uncertainty has been something we’ve all had to come to grips with recently. I hope this is helpful.
WARNING - This is a very rough transcript of what I said, so all my comms professional friends reading this - please don’t judge the less than standard writing style!
“Don’t worry now, this isn’t a session exclusively on my ambiguous gender identity. You’ll be pleased to know I have other much more boring strings to my bow which I am also delighted to be harping on about to you today. However, being non-binary has taught me a lot about the thing that I’ll be talking about today – uncertainty. As a species, we love certainty – a nice codified way of living where we all neatly fit into boxes and categories. Turns out life isn’t really that easy. Why would it be?! My experience of falling outside one of the most pervasive and problematic binaries (and I’m half Irish!) has taught me some very important lessons about acceptance of uncertainty.
I make a terrible woman. Whatever woman actually means. I mean gender here – surely the last thing you need to hear before supper is about anybody’s bits and pieces. That’s the more technical term for ‘sex’ by the way. Any docs on the call feel free to use that term.
‘Woman’ gender means all sorts of things. Society tells us we can be strong and pink and not pink and also weak and sexy but not too sexy and emotional but NOT IN THE WORKPLACE and religious but not IF IT OPRESSESSES US and we can like boys sports like rugby, but you’re probably a lesbian.
‘Man’ gender means not having to be strong all the time, but strong in the gym but not to take steroids too much and having a good beard, but making sure we oil it and be stoic and self-confident and manspreading on the tube, but not transgressing sexual boundaries, being sexist but only if there aren’t any women around so other boys like me (don’t let your wife hear!). You can like girly things like makeup but you’re probably gay.
Exhausting, huh?
As I said I can’t do any of these things very well. I like rugby and musical theatre. So I’m both a lesbian and a gay man. But I’m not because who I sleep with is none of your damn business. I dress in a masculine way but I love the way femininity softens and opens people up. I love strength and picking heavy things up. I am in a high-risk category for sexual violence, but I do not get catcalled in the street.
I don’t think I’m the only one to fall outside of gender the binary. Into something less certain. Perhaps it’s always been less than certain. We’re just desperate to feel part of a club or a team. It feels safe and in our comfort zones. It’s what we’ve always been taught. And if we don’t fit perfectly, we change ourselves, hide part of ourselves or accept that other people will see us as weird or a misfit.
Accepting myself as non-binary, unwilling to hide or change myself has been tricky at times. It’s taught me not to take things for granted, to be open to others, and to listen. But it’s also taught me that there can be a whole lot of freedom in not knowing all the answers, all of the time.
It’s important to note I think at this point, in your line of work, uncertainty is terrifying. Probably more than any other industry. Well, perhaps other than a nuclear power station operator or one of those magicians that throw knives at his wife on stage for a living.
It doesn’t surprise me that a lot of work goes into making sure you are certain about as much as humanly possible. As leaders, it’s up to you to make sure that you have enough beds, that the doctors have enough sleep and that you’ve got enough of those little fruit jelly desserts for everyone on the wards.
Certainty is your bag, I get it. Prediction and perfection are your goals.
Today I’m going to suggest a few ways improv can teach us about managing uncertainty:
1. Sometimes the thing you least expect is the most interesting/useful thing
2. Accept and build
3. Creating a trusting ensemble that looks after each other (and can get you out of any sticky situations)
THE F WORD
What scares you?
Aside from being a professional nonbinary I also teach and perform an improvised comedy – the art of making things up for an audience before their very eyes and making them laugh for a living.
Hands up who’s seen Whose Line Is It Anyway?
It is a lot of fun. But there’s one thing that it’s packed full of – uncertainty. We simply have no idea what the audience is going to make us do on any given night. We have some rules that we try and stay broadly within, but we are simply responding in real-time to anything that happens. And trying not to panic.
In improv there a few main ‘fears’. For people doing it for the first time, for established performers too. If you’re stuck as a performer it is worth checking these as – I’m almost certain it can be boiled down to that fear thing:
Fear of failing at it
Fear of other people thinking you’re an idiot – for failing at it
Fear of trying something new – because you have established some stuff that you know doesn’t make you look like an idiot – we are very good at just doing things we are very good at – live your strength train your weakness – that’s a Crossfit quote – if you think you couldn’t find me any more annoying.
Fearing pushing your limits until you do actually risk fail – stepping out of comfort zone – this is a stressful thing – always being in that learning zone and not being very good all the time can be bad for you too – impacts self-esteem
The bad news is folks, that the number four thing is where the magic happens. In improv, we call the funniest thing/interesting thing that happens in a scene ‘the game’. We constantly ask ourselves ‘what is the game here’? Once we find it then we get to metaphorically throw it about and explore it and exaggerate it until the audience is howling with laughter.
I am not saying we should do this with things we know work. Going back to the nature of your roles. I know that when I do certain things on stage they work. People laugh. I’m not going to muck around with that too much because it’s important to have these in your repertoire. I mean if an appendicectomy works going through those little holes in the abdomen, I’m not suggesting you try going in through the ear hole in the name of challenging uncertainty.
But staying in this comfort zone can be limiting. My audience will get to see a very limited range of characters. And I’m assuming the NHS has one appendicectomy limit per patient right? And that procedure sure ain’t gonna fix my dodgy knee.
In a world of uncertainty – when we are faced with a new problem – how can we create solutions that are not limited by our own individual experiences? How can we use some of the principles of improv to see uncertainty as an open door?
It took me a long time to realise that usually, the most interesting thing that ever happens is the thing you got wrong, went in an unexpected direction or came from a part of your brain you were desperate to keep locked up, in order to fit in or not be seen as an idiot.
It’s actually when something doesn’t get the laugh that I need to look at the fears above. I can ignore it and hope it will magically get better on its own or just pray that audience tastes will change. Or I take a bit of a risk and start innovating, listening to others’ ideas, and playing with what I do.
In improv, we give each other an offer to start a scene. This could be an actual thing – a book, or a cigar, or onion. That’s the thing we play within the scene – we toy with it, experiment with it, bend it, stretch it. It’s the agreement between the players – the playfulness.
Sometimes the offer is a question or a problem that needs to be solved.
In that case, we don’t tell the person who’s offered that to sod off in the scene. Otherwise, the scene would just stop. Whatever we are presented with we accept. Otherwise, there’s no scene. If we don’t like what’s offered or it wasn’t what we were thinking of, we are still obliged to hear it out. It’s up to us to work together to sort co-create and justify what’s happening without blocking, and still searching for a resolution.
I genuinely believe that this is the perfect way to approach uncertainty. We greet whatever comes our way – we don’t deny or dismiss it, we don’t try and punch it in the face and hide under the bed. We say hello, how are you doing, sit down and let me make you a cup of tea.
The interesting thing that improv has taught me is the only thing we actually ever have control over are our own actions and behaviours. Everything else is a mysterious and chaotic whirlwind. We simply do not know what is going to happen next. In improv, we have a solution to this terrifying problem. It’s called Accept and Build. It will get you out of all scrapes and scenarios.
Accept and build is about meeting things in a bold way – always adding value, rather than blocking an idea or ‘offer’. Suddenly all conversations become a sort of opportunity to play a little.
Some overly enthusiastic F1 comes to you and says they have an idea about how to improve bed management in a ward that’s really struggling at the moment. You roll your eyes because folks, YOU HAVE HEARD IT ALL BEFORE. They say something vaguely about discharge rates and thresholds. You scream silently in your mind. You tell them you’ve tried those things, and thanks, but it won’t work.
They walk away.
What would happen though if you’d said, yes and? Yes, and how would you get around the fact that we are understaffed and there’s a pandemic? By adding value here you give that person the parameters in which to build their solution, rather than just shutting them down.
Is a quest for perfection limiting your choices? Are you scared of failure?
Quest for perfection
I bet, however, that that quest for perfection has permeated absolutely every aspect of what you do as an organisation. I bet its crept into places that perhaps the stakes aren’t quite as high as other places in healthcare. Perhaps, it means that your quest for perfection in some places is actually preventing you from trying something new, exploring a new idea or risking that horrifying f word . . . . not that one. Failure.
The key, I have found for uncertainty, or rather the risk of something not turning out exactly how you planned, does not lie with the individual. I’m not going to stand here and say – ‘Embrace ambiguity! Don’t be scared!’
Be scared. You will be scared. It is scary.
Taking risks is scary. So it’s all well and good me encouraging you to take more but there is one critical component to making that work. You need to create the right ensemble.
What I do as a facilitator is create an environment where everyone is able to take that risk knowing that everyone is on their side, that they have their back, and that they can be trusted with your vulnerability. And they are there to help you avoid things going very wrong, bring you back if you start drifting off somewhere, and keep you grounded and focused on the game.
Can you trust your colleagues with your vulnerability? Or would you rather simply tell them what they want to hear, do what is safe, simply to avoid exposing it? If your team is scared of uncertainty then I would guess that you haven’t made it safe for them to embrace it, get it wrong. That means they are also too scared to innovate, challenge, or try something new.
I need to able to trust the people around me. I cannot control them. I only have control over my own actions and behaviours. I have to rely on others to do the same. This is why trust is critical to managing uncertainty - I have to be certain I can trust my team, even if I’m uncertain as to what will happen or what the solution is.
How do you build trust? Role model the behaviours that you want to see – accept and build. Debrief on where things don’t go wrong – get your team to share their experiences without judgment and as a team discuss what we can learn/avoid for the future. Encourage and reward experimentation and above all else – honesty. Having a team that is unafraid to bring their whole selves to work will work harder and in a way that means they aren’t afraid of ‘doing it wrong’ thus ‘looking like an idiot’ and therefore ‘not leaving their comfort zone’. Watching each other fail, then picking each other up will create the groundwork for playful, productive innovation.
So what if you happen to chance about a trans or non-binary person. Which I brought up, obviously. Try a bit of what I’ve talked about today. Uncertainty might worry you at first. But try and avoid avoidance for fear of ‘doing it wrong’ and simply accept and build. Get to know them. You might just find you have more in common with them than you thought.”
Ali Hannon, 23 June 2020