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Summary

This medical professional teaching session will discuss leadership and team dynamics and how they apply in the medical field. Consultant Doctor Alex Kermie will lead a discussion and interactive example-based talk including principles from the transactional analysis school of psychotherapy that can help us understand the dynamics between people and relationships. This session will offer the participants insights into understanding self mastery, vision, communication, trust, transparency, and win-win relationships.

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Description

This is the third session in the Mind The Bleep Psychiatry Series. In this Webinar Dr Alex Curmi of 'The Thinking Mind Podcast' will be discussing Leadership and Team Dynamics. We all experience different Leadership styles whilst working in our job, some of which we may feel are more effective than others. As we progress in our careers, whether that be as doctors, nurses, or other AHPs, we will likely take on more responsibility requiring us to utilise our own leadership qualities. In this session Alex will discuss the different styles of Leadership and their effects on team dynamics, provoking conversations around each team member's role in maintaining effective teamwork and maintaining our own well-being when in a team that may be less harmonious than it could be.

Learning objectives

  1. Recognise how self-mastery is an essential prerequisite for effective leadership.
  2. Understand the importance of demonstrating a personal vision rooted in values which others can be persuaded by.
  3. Appreciate the significance of communication on multiple levels and develop the ability to manage communication effectively.
  4. Develop an understanding of the power of trust and transparency in maintaining effective leadership.
  5. Become aware of the importance of win-win relationships and establish the skills for achieving such an outcome.
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The following transcript was generated automatically from the content and has not been checked or corrected manually.

Ok, evening everyone. I'm Izzy. I'm the minor bleep psychiatry lead. Uh And joining me this evening is um Doctor Alex Kermie, who will be talking through leadership and team dynamics. Uh This will be an interactive session. So um as I'm sure you'll say Alex, but just so that everyone knows that they can feel free to ask questions, give their own thoughts. Uh It's definitely a area that is applicable to different corners of medicine, surgery, psychiatry. So uh should be a really good, very useful talk. So thank you Alex for offering to do this one for us. Thanks for the invitation. Let me just make sure this works okay. Perfect. Yeah. So my name is Alex. Um I'm a psychiatrist. I'm gonna be a consultant in about four weeks assuming nothing catastrophic happens. And I've also done three years of psychotherapy training. And in addition to that, uh I've been leading a team to make a podcast about sort of psychiatry, psychology and psychotherapy for the past couple of years called the Thinking Mind podcast. And so I thought it would be really interesting to do a talk on the subject of leadership and team dynamics which maybe isn't to talk that's often given to doctors. But something I care about a lot is actually teaching doctors a lot of these soft skills, which are actually much more common in the business world. And I think it's important because you can really tell the difference between a doctor who has learned, taking the time to learn a lot of these skills and put themselves ahead of the curve and someone who hasn't, I noticed that in my first year, you know, my acquire one, whether there are some doctors who are technically very good, but because they didn't have good leadership skills, they didn't really understand people very well. They didn't understand teams, they didn't understand how to communicate. You could see very clearly how it was impairing them, impairing their career progress and things on those lines. So last time I did a talk on communication skills, which is still available on demand. And today I've talked a little bit about leadership and, you know, from what I've read and from my experience over the past 10 years, what I've learnt a little bit about leadership and I'll also be talking a little bit about theory from very specific school of psychotherapy, which is very interesting called transactional analysis. And what that can help us understand about dynamics between people, dynamics and social relationships. In addition to being useful in work, I think these skills are also very useful in one's personal life and they can help you with family and friends and romantic relationships or something we all have our struggles with. Yeah. So you make sure it's less. Yeah. So I'll talk a little bit about what constitutes good leadership. The first thing I want to mention before anything else is this idea of self mastery, which of course, doesn't involve other people. It just involves yourself. I think it's very difficult to function well, as a leader unless you have some control and some mastery over yourself. And the strange thing is you kind of are like a team and this is something that the school of psychoanalysis first brought to the public consciousness. And it's the idea that people aren't one entity. Exactly. But we're kind of a whole mix of different and conflicting drives and you know, this because anytime you've tried to accomplish something difficult, what you found when you've tried is that there have been different forces within you that conflict with one another. So, for example, you want to get in really good shape for summer and part of you wants to go to the gym and eat healthy. But part of you wants to sit on the couch and one Netflix part of you wants to eat ice cream, you have these different conflicting forces which you have to kind of figure out how to marshal and get working in the same direction. And that's what you would do with a team because the team as I'll discuss laters, compose of different people with different perspectives and different ways of thinking. And you need to get everyone growing in the same direction. It's very hard to do that. If you're not able to do that with yourself, if you're not able to get all the forces with yourself growing in the same direction, people are unlikely to take you seriously in a leadership role. If you're not able to demonstrate that by yourself, you can accomplish certain difficult long term goals. But if you can demonstrate that through different ways in your work and so on, people will be attracted to you and people who want to work with you. So I think self mastery is very important. I think vision is very important, but vision is a kind of afraid is a word that's thrown around a lot. So I'll define what I think vision is. I think vision is the ability to conceive of potential futures which aren't necessarily obvious, which not anyone else could see. And so vision to a degree is a function of the imagination. Again, as doctors were not taught to use our imagination very much. I think being a doctor used to be a much more created and evident is now now, medicine is very algorithmic and it's very much about repeating pre existing protocols. And obviously, there's value in that because it's very empirical and evidence based, but it leaves out something important, which is the exercise of the imagination in the business world. Vision is used to identify a gap in the market that other people might not be aware of. So really good example of this is Uber. For instance, people weren't necessarily complaining, that's those hard to get a taxi before Uber came. And yet when Uber arrives, people start to realize, oh, this is now this is a, this is a technology that makes it much, much easier. So people are hyper successful in the business world are often people who can, how can identify a need that other people aren't even aware of. And the same will likely be through medicine and healthcare, except rather than identifying needs, which people are necessarily aware of. It might be more about identifying potential solutions that other people can't even conceive of potential ways of treating problems. I think that part of the vision is an authentic expression of your values ultimately, which are the people resonate with because that's what you want. When you're leading a team, you want to be able to express a vision which other people are persuaded by and usually a vision that this persuade a bill is a vision that you actually care about. So I think it's very important in your part to becoming a leader to kind of interrogate yourself as you go through life and think what actually are your values? What actually do you care about because people are motivated by different things. So I think introspection is very important, uh experimenting with different types of work, exploring different ideas, meeting different people, figure out what really resonates with you and what doesn't can help you understand what your value structure is? Do you care more about people? Do you care more about ideas? Do you care more about success? Do you care more about financial success? What is it that resonates with you? And then when you figure that out, you can then take that using the power of your imagination, you can think about that in terms of the future. What is your vision based, given your particular value system and given the way you see the world as it is now? What could you conceive of as a better future that maybe the person next to you isn't able to conceive of? And then can you persuade people to come along with that vision with you? Obviously? Excellent communication is important. And as I said before, there is, I did a whole talk on communication. The main takeaway from that talk is that communication is happening, happening on many different levels simultaneously, some of which are more obvious and conscious and and some less so often the way people talk about communication is that it's the exchange of information in a clear way. But this is a very, very narrow way to look at communication. Communication is a transactional of emotions. It's a display of confidence or the opposite of that. It's the communication of all sorts of different phenomena including Fomina in our body. I think it was very long variable, etcetera. And communication is happening all these different levels. If you're not aware of the different levels of communication, you're going to be putting out things that you're not aware of and you're also gonna be receiving things which you're missing important things from patient's from colleagues. So communication is very important, trust and transparency is important. Two maintain leadership in the long term, essentially build trust by having repeated win win interactions over time. In, in business, people are successful, successful in business are able to be successful, not just in the short term, but in the long term. So they're able to establish relationships where both people benefit over a very long period of time. And that could be 10, 2030 40 50 years. And that's why I don't necessarily by the idea that people who are kind of psychopathic people who don't care about other people are the best business people because I think they might be very good business people in the short term. But what they tend to do is succeed very rapidly, but then have a kind of a fall from Greggs because they're not able to sustain a mutually beneficial relationship over time. So what you to establish trust, you establish a reputation as a person who basically delivers what they say they're going to deliver. Transparency is a very powerful tool which greatly reduces tension and social relationships. So what do I mean by transparency, transparency means being very honest about what you're trying to achieve in a given situation and how you're going to go about achieving it. And it's funny how even in interactions where it should be obvious what everyone's goals are just being very explicit can be very helpful. So for example, in a doctor, patient consultation where things are starting to get to the tense for one reason or another, even as a doctor saying something like my only goal here is to improve your quality of life as much as possible. Or my only goal here is to reduce your symptoms burden as much as possible, greatly, greatly reduce the tension in, in the room. It works because human beings have a very strong tendency when in the absence of information to make assumptions about what the other person wants and too often to make negative assumptions and those assumptions can lead to resentments. So being transparent with whoever you're working with telling them, you know what exactly you want, being honest about that and what exactly you're going to do to the best of your ability to try and achieve that goal is a really amazing tension reduce. Er, I want to talk more about win, win relationship so that when the concept of the win win relationship comes from the book is Seven Habits of Highly affected people, which is a very classic self. Help book. And it's again, talked about a lot. It's very much in the public consciousness, but I want to talk about it because I don't think it's always obvious. Many times people enter into lose, win relationships or win, lose relationships. Healthcare workers in particular, I find are very prone to falling into lose win relationships where they sacrifice themselves and what they want for the benefit of other people. Healthcare workers are often very high in a trade in a personality trait called the agreeableness. Personality trait. People are very agreeable. They want to maintain social harmony. They're highly empathic and attuned to other people's needs and they basically are much more, they have much more, have a tendency to sacrifice themselves for the benefit of other people. The opposite of being agreeable as being very disagreeable. So, uh someone who is a psycho psychopathic is usually very, very high and disagree ability, they're much more ready to prioritize themselves over someone else. Obviously, this is an extreme than general health care workers are often very high in agreeableness. And that's why they get into healthcare in the first place. As a result of all this, they can often enter into relation to shall lose, win, lose when relationships and when you lose relationships are not sustainable over time, it's really the win win relationship where both parties benefit. That is the only relationship that will see you through the decades. If as a healthcare worker, you're constantly getting into lose win relationships. The chances are that you're going to burn out and burn out is very, very common in, in healthcare workers when lose dynamics are much more common in, in the business world. And then people are a bit more psychopathic as I mentioned before. And uh as as I mentioned before, what it tends to lead to if you're engaging in win lose relationships with people as a meteoric rise, a lot of success very rapidly followed by a fall from graves. So if you think about some crime movies, some gangster movies like Goodfellas or Casino, that's what happens is because they're using criminality to, to achieve success. They have an immense amount of success very quickly. But then that's success and sustainability, it falls apart because it's simply not a sustainable way um of trying to move through the world. So what a win win relationship is explicitly is it's a very delicate bance of self respect and empathy. So whenever you're dealing with a person, be that a patient or a colleague or a junior or superior in a long term basis, you need to be thinking, am I getting what they need? Am I getting sorry? Am I even what I need from the situation long term? And you need to be thinking is the other party getting what they need long term? You can't be too extreme on one end or the other at the bottom. I I mentioned healthy conflict, a lot of healthy conflict and you don't necessarily think about conflict and leadership. In the same breath, I'll make the distinction in a bit between healthy conflict and unhealthy conflict. But what I want to stress is that healthy conflict isn't just something that you want to tolerate. But healthy conflict is often the one of the very important sources of progress because what healthy conflict is essentially is the exchange of different perspectives of conflicting information and of feedback about a particular person or a particular situation. The reason why teams are so valuable is because every person within that team is going to have a slightly different perspective on what is going on. And a team which doesn't have a culture of healthy conflict is not going to take advantage of all those different perspectives and allow all those different perspectives to be in a healthy dialogue. But instead what you usually have in an unhealthy situation is one person is kind of a tyrant or a couple of people shutting the rest of the team down and that can lead to delays in progress and bad outcomes. So if for example, literally a doctor is too, too, too terrified to tell their consultant, that's a particular test is not available because they know the consultants going to fly off the handle, it's gonna delay progress for that patient and ultimately lead to a bad outcome for that patient. So whenever you're in charge of creating the culture of a team, you want to create a culture where there's a lot of healthy conflict, where people are free to express themselves in a respect for the way to exchange, like I said before, information and perspectives and then feedback as well, feedback to other colleagues in a, in a calm way and in a way that's relatively unrestricted. So in terms of feedback, specifically, we can look at the difference between healthy conflict and unhealthy conflict. So if someone is not doing something correctly. So for example, someone overall this investigation's when dealing with a patient, healthy conflict tends to be very specific and it tends to be very compassionate criticism and sharing of that information and feedback. So you're telling the person in a very specific sense, this is what's going wrong in this situation. This is what you can do to improve it. And you're not globally denigrating the person, an unhealthy conflict. Usually there's an irrational global denigration of the person and normally there's a lot of unconscious forces that play. Often people might be taking out a lot of aggression that they, that they enter the situation with on the person. So global, so unhealthy conflict would sound like saying telling someone, for example, you're a terrible doctor, you know, you overall all the test, therefore, you're a terrible doctor. So it escalates into this kind of irrational global denigration of the person you're dealing with. And that's what you want to with. So these are a few more ideas which I think going to leadership, it's very uh as I've kind of already talked around previously, you need to understand that people are wired very differently. And here personality theory can help us. So the personality model I use the most is the big five model of personality. The reason i it's a whole talk by itself. But the reason why I use this model is because it's the most empirical, most evidence based model. And what it tells us is that basically everyone has a unique personality and what the personality is is, it's not just behaviors, most people associate personality behavior, personality is a behavior. It's a mindset. It's a way of seeing the world. It will include your passions and your drives. It will include your values. Personality is a very important force within us. And you need to understand that everyone has a different personality. So everyone's gonna view situations differently. Everyone's gonna be motivated differently. Everyone's going to have different goals in a particular situation. If you're leading a team, we need to understand this because if you don't, you won't be able to do those, win, win relationships that I uh mentioned before because a win for one person might be very different to a win for another person. Some people might be medicine because they love working with people. Uh Some people work in healthcare because they're driven by the idea of getting status or financial success, whoever you're working with you to understand what is this person's motivation? You know, why aren't, why are they on in this job? Why are they in this training program? And what that allows you to do is give them what they want, establish what the win is for them. And obviously, understanding your personality will help you understand what the win is for you to help you choose and design your career accordingly. You need to understand that delegation is obviously very important. Talked about a lot when you're talking about leadership. But the art of delegation I think is a bit miss misunderstood, you need to feel calm and comfortable delegating. But at the same time, you need to make it clear that you're not necessarily above doing any one particular task. So you need to make it clear on some level with your team that you're not doing a particular task, not because you're above it, but simply because there are, there are certain tasks that only you can do and what you learn as you progress through your career over the years is that time, energy and focus is the most important currency in your work. It's everything, especially as you get into your registrar like years and your consultant ears. So the reason why you can't do certain low level tasks that you might ask might other might otherwise ask other people do is because of the opportunity cost, you're simply not able to fill that time doing those tasks because there are other tasks that need to be done with only you're in a position to do. Um So delegating should be a, you know, a normal part of your, of your role and something that should be done routinely. But being care to demonstrate that you're not about doing any one particular house, understanding emotions is probably the most complex single point in this talk. Again, that could be, it could be a talk by itself. Part of being a leader is learning how to leverage positive and negative emotions, not necessarily in a deceptive way or a manipulative way, but just in order to motivate people to do what needs to be done. And this ties in with having a vision which I mentioned earlier. So for example, if you're waking up with a patient and you want to have them stop smoking, how could you leverage positive or negative emotions to have them stop smoking? You could get them to get them to imagine a future 10 years down the line where they stop smoking and that would be using positive emotions. So you can get them to imagine playing with their kids or their grandkids or still being able to work being generally healthy. And that's a positive vision of the future, that's them positively motivate them to stop smoking. And then afterwards you get them to envision a future where they don't stop smoking. So 10 years down the line, what happens if they don't stop smoking and they might have a chronic illness, they might have a very serious illness. They're less healthy, they're less functional. They might not be able to work, they might not be able to play with their family, etcetera. So you're marshalling both positive and negative emotions to get them to achieve a different, a very difficult long term goal. And I talked about self mastery before. This is very much how you achieve self mastery as well. That mastery is all about mastering emotions. Because really anything that's particularly difficult to accomplish tends to be difficult because you need to sustain it over time. Like anyone can go on a successful diet that lasts for 24 hours. What makes dieting hard is the fact that you have to do it for days, weeks, months and the the challenge in maintaining that and sustaining that is really about mastering emotions. So you need to be aware that the motions are very important. Teams are often structured to help people with their emotions. So I used to work in a community mental health team that had very risky patient's through themselves, presented in very volatile ways. And a lot of the patient's were seen by, by key workers, community nurses and they'd be very affected by the patient's. They were seeing all the time. We're very high risk. And what I learned very quickly is when they had difficulties with the patient and they came to talk to me as the registrar. Dr often, what was help was not me necessarily providing a specific solution, although sometimes I did that, but often what was helpful was let me just inviting them in to my office, getting them to sit down, allowing them to talk about it, allowing them to simply emotionally process that they, the different patient's they've seen and even investing five or 10 minutes doing that such that they can then leave my office a lot calmer, a lot more relaxed feeling like they've offloaded some of the responsibility and some of the risk on to me, which is unfortunately part of the part of the role of being a doctor. Um It's very, very useful and then you learn that that teams are globally structured like that. So then I can offload to my consultant. My consultant can offload the consultant, supervisors of teams are often structured, tell pass process, difficult emotions, surpass process anxiety and, and anger and burn out and all the different things that happens in healthcare. So it's helpful to be conscious of this. I think it's important to understand the difference between leadership and management. Although generally, if you're in a position of authority, you're going to be doing a mixture of leadership and management. But it's helpful to understand the distinction if you need to. I think leadership is mostly about designing and building systems, especially in the business world. And in medicine, it's a lot about solving problems which are dynamic. So for example, in a intensive care unit, that's leadership where the goal isn't always preset, you need to come up with the goal sometimes or where the goal is very elusive and you need to solve the problem in a very dynamic way. Management is mostly about running an existing system, optimizing that system, making that system more efficient and meeting pre established goals and targets trying to solve pre established problems. It's useful to understand this distinction because some people are better at leadership and some people are better at management. So going back to the big five personality trait model for a moment, there's a trait called openness to experience and people who are very high in openness, they love ideas, they love novelty, they love exploring new territory and that's like exploring physical new territory, but exploring new territory psychologically as well. So entrepreneurs, people start new businesses tend to be very high in openness and they tend to be very good leaders, people who are very low in openness, who are a bit more skeptical of novelty of new ideas and a bit more frightened minority. And I'm not saying one is better by the way, these are just different ways of me. Um managers tend to be lower in openness and they tend to be really good that once an entrepreneur has set up a new system, a manager is really good at running it and optimizing it and make it better so often, really successful duos or teams are made up of mixtures of leaders and managers. And as I said before, you will be part leader and part manager, but it's useful to interrogate yourself. I think, you know, what am I am? I more suited leadership or management because that can help you design your career. You know, do you want to build systems or do you want to optimize systems? That's a good way of thinking about it. So those are some ideas which I think are important and putting to leadership. Um Now I'm going to talk about something and it's a bit different. So I'm going to talk about team dynamics and I'm going to talk about it through the lens of transactional analysis, which I mentioned before. So ta is a really specific school of psychotherapy that was started, I believe in the fifties by a psychiatrist in America called Eric Burn. And Eric Burdon was a psychoanalyst. So he trained and trained in a kind of Freud in psychoanalytic style. And then he came up with a series of the're ease under the umbrella, transactional analysis was all about social relationships, how people interact with each other very much on the micro level, how people interact with each other in a way that's functional and helpful and leads to good outcomes and how do people interact with each other in a way that's unhelpful more dysfunctional and tends to lead to bad outcomes. And I'd like to just discuss a couple of the more interesting ideas from Ta, which I think pertain a lot to working in a team environment. So one idea from T A is this idea of ego states. So this is the idea that at any one time, we're kind of either in a adult ego state, which is where we're kind of in the mental state. We have the behaviors, thoughts and feelings very much in the here and now. And we're quite in our rational minds and we're kind of quite mature. That's the adult Diego state. The parent ego state is more demented state of a parent and very much the kind of things we inherit from. Our primary caregivers are parents were growing up and the parent ego state is often either very critical. So wants things to be different or very nurturing, very caring and compassionate. And the last ego state is the child ego state, which is the previous thoughts and feelings you tend to have from as a child. And the child ego state is often divided item to the free child, to the child that's playful, exploring, having fun, spontaneous or the compliant child child, that's kind of following orders that's submitting to rules. And you can see how those the compliant child and the free child kind of corresponds to the critical parents or the nurturing parent. Now, it's important to understand we can be in any of these ego states at any time, you know, during the day. And often when people get triggered, often they're going from an adult ego state, either to a parent ego state or a child ego state. And it's really important to understand that good problem solving generally is going to be done in an adult ego state. So when you're interacting with people, you can often tell when people might be more of a parent ego state, child ago state or an adult ego state. So if you think about you go into a coffee shop, you ask how much the price of a cappuccino is. They tell you the price, you give them the money, you leave with the cappuccino, that's an adult to adult interaction. But say you're interacting with your supervisor at work on the surface, the interaction might appear to be adult adult and certainly it would be appropriate that adult adult, but often if you look at the interaction below the surface, it could be more parent to child. So for example, the supervisor gets very triggered and all of a sudden becomes very critical and he starts to display those aspects of unhealthy conflict. Like I said earlier, uh soft to denigrate his trainee and overly criticize them. What you find very often is that if someone approaches you in a more parent ego state, say they approach you in a critical parent ego state, what you notice is a part of yourself tends to respond or the natural tendency unless you have very good boundaries, would be to respond in a kind of compliant child legal state or maybe a rebellious child legal state if you're more rebellious, so the supervisor might be highly critical and the trainee might break down in tears and say, even though the supervisors are being very unreasonable trainee might break down in tears and say, you know, they're very sorry and they're making to make sure things don't happen to get and happen again. And they're going to very much submit themselves to an irrational degree to the supervisors authority. So these kinds of things are often happening in the workplace and the more you can be aware of them, the more you can avoid them. Or if you find that someone, for example, is coming at you with an ego state that's kind of inappropriate and you can see they're triggered, you can cut the interaction short by responding back in an adult ego state. So for example, the supervisor is very harsh and critical and as the trainee and this is difficult to do, I'm not saying it's easy, but you can respond by saying, you know, I get some of these criticisms, but some of these criticisms seem unfair to me and this is the action plan I'll make based on the criticisms which I feel are legitimate, but based on these other criticisms, these I think there are better rational and maybe we can revisit them in the future is that will be an adult way of responding as opposed to responding in a more child legal state way. So the the founder of transactions, as I said, when he came out with the first popular psychology book for games people playing. So we all, we talk about this in the lexicon and we say, you know, if someone's not being a straight shooter, we say they're playing games. And he was the first person I believed to bring this into the public consciousness. So we talked about games and he had actually a technical definition of a game, which was really interesting. So I read about the, so in tier theory, a game is a repetitive and predictable pattern of interactions between individuals that often involves hidden agendas, ulterior motives and unproductive outcomes. Games are typically characterized by a series of scripted behaviors, often driven by unconscious psychological processes and often towards maintaining, often aim towards maintaining the status quo. So, and you see this all the time if you look so a really common example of a game that Eric Ben talked about as a game he called. Why don't you? Yes. But so that's when I imagine you have person, am person be personally, is talking about feeling very overwhelmed as work and person be offers a solution and personally says, yes, I see that solution, but it's not gonna work for this reason. Person be offers another solution and personally says, yes, I see that solution, but it's not going to work for this reason. And this continues on and on. What you realize when you, you know, look beneath the surface of these kinds of interactions, is these, there are these ulterior motives as I mentioned definition. So even though person a might on the surface want to be less over in that work, he's clear, not showing a willingness to respond to any meaningful eat any of the solutions that person be is proposing. And what he realizes that person is his primary motivation is not actually to solve this problem or to improve the situation. But his primary motivation is to feel like to express his victimhood, for example, might be one of his primary motivation or to express that he's in a vulnerable position or to get person be to rescue him and to take all the responsibility. So that person A doesn't have to do any of the work. So these things are happening all the time and it's very important to be to be aware of them. After Eric Berne founded the school of uh transactional analysis, one of his students, Eric Cartman came up with a really useful concept and it's kind of based on this idea of Games and Niego states and that's called Coppens drama trying uh and the drama triangle is this idea that very often in toxic situations between multiple people, you'll find that one person tends to occupy a victim role. And the victim roll means you're putting yourself in a down position. You're very much absorbing yourself of responsibility to, to, to fix the situation at home. You're very much saying that you're powerless. One person tends to or he by the prosecutor role where they're very denigrating and very harsh, irrationally harsh. So the person, you will have a lot of unhealthy conflict. Another, the third person might occupy the rescuer roll, which on the surface seems like a good thing. Like rescuing is a good thing. But the problem with being a rescuer is rescuers totally sacrifice their own well being for the well being of the victim. And often it doesn't work out just like in that game, I just mentioned, just like in the lose win relationships that I mentioned, rescuers often have to sacrifice themselves for the victim and not only do they sacrifice themselves, but ultimately, it doesn't work. And the problem perpetuated serve and the status quo remains now people can switch roles. So you might have three people and the victim, one person might be the victim in one instances and that might change. And one person might flip from being the rescuer to the persecutor. Often victims can split teams. So I don't know if you guys have had the phenomenon of the phenomenon called splitting in psychiatry. It happens a lot, particularly with people with a diagnosis of personality disorder where they'll often occupy a victim role, a sense of powerlessness. And what you find is half the team, I really want to save them and do anything to help them. And half the team are very skeptical of them that's called splitting. And what it really highlights is that half the team have become rescuers and half the team have become persecutors. So that's the situation where it's very dysfunctional. What's the antidote? So in 1990 a guy named Troy came along and he came up with the Winners Triangle, which is the opposite of the drama triangle. And what you see is the drama triangle is kind of the dark side of the winners triangle. So being assertive, being forthright about what you think and being boundary died is kind of a is the good side of being a persecutor. Being caring is the positive aspect of being a rescuer and being vulnerables, positive aspect of being a victim. So being vulnerable doesn't mean you're a victim, being vulnerable. This means you're honest about where your weaknesses might be and actually being vulnerable can be very powerful. Being assertive is very important as I said before because certain this is the essence of good boundaries and assertiveness, for example, leads to healthy conflict and healthy disagreement. And obviously being caring is important because often people are in vulnerable positions and they need care as healthcare workers, we need to be especially responsive to this. So when you find yourself in that kind of dysfunctional place of drama where there's a persecutor victim and a rescuer. What you need to think is how can I respond in a more adult way? How can I be assertive or how can I be caring without falling into the trap of being a rescuer or how can I be vulnerable without falling into the trap of being a victim? So these are some take home messages from the whole talk. Uh I think it's very important that if you're going to be in a position of authority or leadership that you learn to lead yourself first, I think understanding people and others, understanding psychology to the extent that you can is very essential to leadership. And I think things are rapidly changing, you know, in a world where AI is developing very rapidly, I think the role of the doctor is probably gonna change very rapidly. So the more different skill sets you can acquire to make yourself a more dynamic professional. I think the better off you're going to be in a future, which looks pretty unpredictable and rapidly changing at the moment. I think it's important to understand that even though we have this illusion that we're kind of very rational beings because we have smartphones and different technologies, human beings are not just rational information processes were very complex, emotional beings. We all have our own goals and motivations. A lot of our goals and motivations as the psychoanalysts and the transactional analysts tell us our unconscious and you need to understand that when you're working with yourself and then when you're working with other people, and then the last thing is of course, that your team and your business and your department, wherever you're working, success is going to be built on repeated win, win situations all the time. So it's important to establish what's the win for you and what's the win for everyone you're talking about and how, you know what that is, is dependent on all of these different complexities that we mentioned. Um I'd like to give you some resources so maybe I can put these in the chat if you have any particular questions, you can start putting in the chat now. Um So I'll give you guys a few podcasts that I made. One is about personality theory. One is about conflict and the difference in healthy and on health, healthy conflict. And one is about emotions, the function of different emotions and emotional intelligence. And these are some books I read, which basically helped me come to the understandings that come to. One is games people play the book written by the founder of transactions analysis. One is The Laws of Human Nature, an excellent book about Psychology by Robert Green. One is the seven habits of highly effective people have had classic and the last one is Principles. This is a business book really written by Ray Dario who's one of the most successful investors of all the time. And he wrote this book about the different principles he used in his business. So, yeah, that's what I'd like to talk to you about if you guys have any particular questions. Uh I'm happy to answer you, answer them, we could discuss them. I'll just put the podcast I mentioned in the chair. So Zoe says, thank you, as you made me realize some of my team teams dynamic. And I can see right now, I also have the book games people play, so need to dust all the Chevy. It's a really good book. Can't thank you enough. Really have no problem Brink. Who says, thanks. Uh Yeah, I just put those links in the chat. So pfizer says, hi, big fan of the podcast. What advice do you have for a junior interested in a future in leadership? I guess it depends in, in what context the leadership is. I guess what this depends on is as I mentioned, area, really, what, what your value system is, what you care about because that would dictate, you know, what problems you want to solve. So, for example, I started my podcast because I, I, I felt like there wasn't a resource for doing a psychiatrist to access a lot of online discussion about psychiatry and psychology. So that was something I cared about and that was a problem I want to solve. So, uh leadership isn't really a goal in and of itself. But leadership is a way to accomplish a particular goal, goal to solve a particular problem. So the question you have to ask yourself is what do you care about and what's the problem you want to solve? And then from that point, I would just go about acquiring as much skill experience and knowledge on that problem as possible. So there should be a kind of an inhalation phase where you kind of are an apprentice and you're taking loads of information around that problem area and then start becoming more active, start producing things or start working in there and gain as much experience as possible. And then I think leadership is basically a natural consequence of taking responsibility for that problem in different ways. And you take responsibility for it in small ways, taking a volunteer position than taking a paid position and so on and so forth. And as you accrue more responsibility and expertise, people will start to naturally see you more and more as a leader. So I think becoming a leader often is more of a byproduct of, of investing a lot of time and energy in a particular problem more than a goal and of itself. So I, I hope that answers your question. Any other questions? Just put them in the chest. Um I think that might be all of the questions, Alex. Um Yeah, thank you very much problem giving them talk. Um It was really interesting, I think from starting coming to the end of F one you do through all the rotations, the experience, a lot of different leadership styles and more cohesive teams, excuse of teams. So this provides a very good overview. Um And obviously all of us will move through becoming leaders ourselves. So it's really good to have sign posting of where to learn more and hopefully not repeat the sort of the same leadership styles which we've probably experienced that aren't very cohesive. Yeah, it's a big, it's a big, it's a question you want to ask early as possible, you know, what kind of when I'm in a leadership position, what kind of leader do I want to be? Because I think if you don't ask those questions, it's very easy to fall into the track of them going with your impulses. You know, I think if you don't examine your own psychology, it's very easy to, to go down a more dysfunctional part because so human, you know, such a human thing to do. I think also with the current strains on the system of being a realistic leader in an environment where you, you can't perhaps go to your full potential, giving constraints of your own workload and those sorts of things. Um And coming up with ways of, yeah, being not losing yourself, I think in the kind of heat of all of the dysfunction that you might have in terms of like the work of those things because I, I've seen that quite a lot this year where people who are normally very good leaders because of certain circumstances, it's become derailed. And I think having the awareness of when that can happen and ways to kind of combat becoming very reactive, um I think is kind of more critical than ever. Yeah, 100%. Yeah, I couldn't agree more. Um I think, yeah, so I've sent the feedback link for everyone. Um Just to say that we've got one more session in the collaboration coming up which um Rebecca is doing on psychotropic medications. So this will be very, very useful even if you don't have a psychiatry job. Uh They lots and lots of patient's are on them here. You will experience in surgical medical rotations a any. So it's good just to have a bit of a baseline knowledge. Um And also just being able to ask any questions about these drugs because I think they're often an area of hesitancy, great mystery and great mystery and anxiety. Yeah. Um And always come up in exam questions from someone who's providing for post grad exam. So, yeah. Um So, yeah, that will be on and I've obviously forgotten the day. So just go and check out the minor bleep age and you'll find it. I think it's the 17th, but I can't remember. Um But yeah, thank you very much, Alex. Um Yeah, really, really good to look. Thanks. For the invitation. Uh huh.