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Stress at Work: From Hospital to Hospitable

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We all get stressed... In this blog post, Noah Heldman talks about his personal experience with stress at work, and the tools he has used to significantly reduce and effectively manage it, with a focus on the benefits we get from stress (yes, you read that right), and the costs.


I’m not an expert on the psychological or medical aspects of stress. I’ve just dealt with a lot of it and have come up with some tools that have helped me deal with it better. If that helps you too, great!


I’ve gone to the emergency room four times over the last 15 years with severe chest pains. You know, the kind where you might be dying, so they see you right away, before the people who have been waiting there for three hours? After a battery of tests (heart stress test, Holter monitor, ECG, echocardiogram, etc.), each of those four visits ended with the same diagnosis: “your heart looks fantastic… you’re just really stressed.”

The last time this happened was over four years ago, and it was my wake-up call (yes, I was stubborn, or just locked in old habits). I knew I needed to make a fundamental change, and it wasn’t going to be as simple as lowering my salt intake, or even exercising more. Those are positive steps, but what I needed was to fundamentally change my relationship to stress. And to do that, I needed to understand what that relationship was.

My Relationship to Stress

People experience stress differently. For some, it may manifest in physical symptoms like headaches, stomachaches, or (for me) chest pains. For others, it may show up as mental or emotional symptoms (mind racing, inability to focus, depression). Or you might have physical and emotional symptoms, which is no fun at all. In all cases, your body is trying to tell you something is not right.

In my case, the early signs of stress were not obvious or detrimental enough to change my behavior. My body would just start raising more red flags until I noticed… and I only noticed when it was time to go to the ER. It took severe chest pains to knock me out of my pattern, because while my stress was slowly ratcheting up, I was actually benefiting from the stress.

The Benefits of Stress 

What could possibly be the benefit of being stressed? It took me a long time to figure it out for myself, but a few years ago I recognized that it was really important for me to look like I was working really hard. I needed my coworkers to know that I was busting my butt every day because it meant I was valuable and important. If I couldn’t show all those coworkers the output of my work, I had to get them to notice me somehow… so without realizing it, I took on stress. I did it to look busy. To look important. It gave me a short-term adrenalin boost. And the perceived benefit outweighed the cost at first, because the early symptoms of stress are manageable: take a walk for a few minutes, do some deep breathing, have a glass of wine. But at least in my case, stress was cumulative, and the small release valves were not enough to ease the pressure over time, so eventually things “blew up” in the form of hospital visits.

One of the unintended consequences of my “be stressed to look busy” approach was that my coworkers found me to be much less approachable (“I don’t want to bother him, he’s way too busy and stressed.”) Not only was I perpetuating my own stress, I was alienating my coworkers! I knew I needed to change something, but it wasn’t as easy as “stop being stressed.”

Stop Being Stressed

Okay, in a way, it actually was as easy as “stop being stressed.” But I needed to take that apart to figure out how. One of the most useful tools I’ve ever used in software development is to break a problem down into smaller problems until they aren’t overwhelming. I tried applying that to stress, and it started to click:

  • What is stress?
    • Emotional strain resulting from very demanding circumstances.
  • What demanding circumstance am I experiencing?
    • My client told me he would lose his job if I didn’t deliver his application on time.
  • What emotional strain am I experiencing as a result?
    • I feel I am personally responsible for my client keeping his job, which is scary and overwhelming.
  • Does my emotional response help my client?
    • Possibly, because if he sees how stressed I am, he’ll know how seriously I am taking the responsibility, and I am empathizing with his stress (see, there’s that “benefit” of stress…).
    • But in reality, it makes me less focused, and may lead to physical symptoms so severe that I have to miss work, in which case there’s no way I can deliver the application on time.
  • Is there a more beneficial interpretation of the situation that may reduce the emotional response?
    • Make the outcome important, but not meaningful.

Important but Not Meaningful

As humans, we attach meaning to everything: the way people look at us, the words they say, the actions they take. All of our interactions are colored by the filters of our previous experiences, and we decide what those interactions mean. Have you ever been in a conversation with someone who furrows his/her brow, tilts his/her head, and maybe frowns a little when you’re talking? That has happened to me a few times, and I used to interpret it to mean that I wasn’t communicating clearly, which quickly spiraled to meaning that I wasn’t a good communicator at all, and maybe had no business leading client meetings. I once asked a client if what I was saying made sense, because I was worried she was confused, and she said “You made perfect sense! I just do that with my face when I’m concentrating.” In my mind, I had made all kinds of negative leaps to the land of self-doubt (which leads to stress), when in reality, I was doing fine.

So, I shifted my thinking. The way someone else reacts to or interprets a situation is beyond my control. I only control how I behave, and how I react. Now, instead of assigning meaning to someone else’s reaction, I determine its importance and react appropriately. Back to the example of my client who might lose his job, I was wrapped up in the meaning of not delivering on time, when I should have been focusing on the importance of delivering on time. With my new mindset, I made it important to meet my client’s goal, and I communicated that importance to him, but I didn’t get sucked into the emotional whirlwind, or the “what ifs” of not delivering.

There are so many things we can’t control that are not worth the mental energy to try to manage. If we focus on the things we can control, and make those important, but not meaningful, they don’t have emotional power over us. Another way to think about it is to consider the difference between a promise and a commitment. It’s subtle, but for me at least, a promise implies meaning, subjectivity, and emotional distress if that promise is broken. A commitment is more objective, and while it’s clearly important to the committer, the committee understands that there are valid reasons why the commitment might not be fulfilled. Because of this distinction, I tend not to make promises so I don’t get bogged down by what it would mean to break the promise. Instead, I make commitments that I take very seriously, but that don’t carry the same emotional weight.

My client didn’t lose his job, even though we didn’t deliver the application on time. In that case, it turned out there were circumstances well beyond either of our control that prevented on-time delivery. If I had focused on what it meant to miss that deadline instead of doing my best to meet it (by making it important), I bet I would have been right back in the hospital.

Stress: Your Choice

The “important but not meaningful” tool has been tremendously helpful, but it doesn’t eliminate stress. I use other tools to try to keep the upper hand so I don’t suffer the sneaky cumulative effects of stress over time. One of those tools is recognizing that stress is a choice. (More accurately, we have a choice in how we respond to stress.) People often say “you’re stressing me out,” putting the blame for creating stress on someone else. While the other person may be communicating something most people would interpret as stressful (“I need you to get this done by the end of the day or we’ll lose millions”), it’s entirely your choice how much you let that perceived stress affect you. Remember, you are not responsible for how other people react. You can only manage how you react. Don’t get me wrong. It’s not easy to separate the reality of the situation from our interpretation of it; in fact, it’s difficult, and it takes a lot of practice.

Our body produces stress hormones in these kinds of situations, and we can’t realistically control that. But we have the capacity to control how to respond to that stress. When we’re not in the middle of a stressful situation, we can logically conclude that we will be more effective getting something done on a tight deadline if we don’t have stress clouding our minds and shaking our confidence. And yet, some elements of stress (e.g. adrenalin) may make us more effective in the short term, so we fall back into that pattern. In many ways, we are built for instant gratification, and the adrenalin we get in these instances may give us a little push, but it costs us a lot in the long run. By repeatedly catching yourself in those situations where you feel yourself tensing up with stress, you can analyze the payoff you’re getting from the stress (short-term energy boost, appearance of being emotionally invested), and weight it against what it’s costing you (long-term physical and mental health).

As I’m writing this, I’m realizing that my job is nowhere near as stressful as many other people’s jobs. A trauma surgeon deals with an entirely different amount—and kind—of stress, and it’s often a life or death situation. Even so, the same tools apply. If the surgeon lets the emotion of stress in, she simply can’t perform her job as well. We talk about the “steady hand” of a surgeon, but it starts from a “steady mind.” With my client who might have lost his job, I let the stress in, and I thought it made me look more empathetic, but I was less effective as a result. Imagine if the surgeon took that approach, and the surgery was impacted: the family of the trauma patient would choose a successful surgery over an empathetic, emotionally-connected surgeon every time. Thankfully, I didn’t need that surgeon’s skills for my chest pains…


My life is not without stress. I still get stressed regularly, but I recognize it so quickly now that I can decide what to do about it before it builds up. And I usually choose to let it go, and focus on what’s important, not on “what it means.” I know most of my filters, my preconceptions and pre-decisions that would normally cut off productive interactions, and I do my best to set those aside. I still use the daily stress reduction tools: deep breathing, meditation, walking, banging on the drums, etc. And despite my best efforts, sometimes stress still builds up, and that’s okay. If that happens, I’ll do what I call “safe venting,” where I tell my wife the stress is getting to me, and that I just need to get it all out without judgment. All of these tools have helped. My coworkers say I’m much more approachable at work. I’m happier and healthier for it, and I haven’t had chest pains in a long time…

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