I zeroed in on the sharp angle of Pam's jaw, which barely moved as she told her story. From her point of view, however, she wasn't storytelling. As a leader of an organization, she was accustomed to announcing progress, showing "deliverables" against goals and objectives, and reporting "measurable results ...advances along timelines." The topic today was her headaches, and they were as sharp as her mandible.
First, the patient's history: She began relating it from the time she took the job. For a short moment, her eagle eyes defocused. She looked up, briefly allowing white space in a mind filled with points. She searched her memory for a point, found one, then looked directly at me and spoke.
"Actually, the headaches began a few months after taking this job," she said.
She then recounted, in detail, the litany of failed medical interventions and disappointing diagnostic procedures she had undergone for her headaches. She regretted wasting her precious time on previous endeavors she hoped would end her pain.
"Can you tell me more about your job?" I asked.
"What, specifically, do you want to know?" she answered.
I watched her even more carefully as I continued to question her. I didn't have a standard set of prepared questions, as would have been her wish. Instead, I sought answers to the question I cannot ask my clients directly: "What's causing your pain?" (Leaders don't want to focus on pain, even if it affects their lives.)
Nonetheless, I flurried along with a list: "What was happening at work at the time your headaches started? Are they worse at any time during the day? Does anything at work, or not at work, make them better or worse? Is there anything about your working condition that affects them?" My questions flew out in rapid succession.
Pam nodded slowly, looked up again, took a deep breath, then spoke. This time, her body, jaw, upright posture and eyes relaxed a little. She crossed her long, lean legs gracefully and tucked them under her chair. Her words came out haltingly, yet steadily and quietly. She sat back a bit on her chair, but was careful to adjust the folds of her perfectly tailored white suit. I suspected that for her, relaxation never occurred in the presence of others.
Years ago, she entered the top ranks of this prestigious financial institution as its chief operating officer, the first female in such a role in the company's 45-year history. She arrived during the golden years of growth, when her boss, Alan, was off buying companies and making deals.
"Alan knew I'd handle everything, and I did for a while. As time went on, he was away for weeks, or even months, and I was doing his job." She grimaced when she said this and rubbed one side of her head.
"How does your head feel now?" I asked.
"Funny you should ask," she continued. "Just at that moment, I felt a headache come on."
"Can you tell me how it feels to you when you do work that you think is really your boss's job?"
That did it. The cork popped.
She let loose and railed for at least five minutes about how-guys-just-never-get-it - how-people-need-them-and-why-should-this-particular-guy-be-any-different-from- any-of-the others-who-are-after-all-clueless-about-anyone-else's-needs-and-she'd-actually-be pissed-off-about-it-all-if-it-weren't-so-predictable-but-that's-the-state-of-the- American-workplace - and didn't I agree?
The words were spit with venom.
"Have you been in this position before, where you did the work for a man who got the credit?"
She muffled a burp. My question made her queasy.
"Did I tell you that I also get nauseous when the headaches come?" she asked.
We continued with a long talk about her views of her work, concentrating on how splits between responsibility and authority can create not only a double bind for the people involved, but can affect your health. On our first day together, she didn't want to believe that these utterly debilitating headaches were "psychosomatic." After about six months of coaching, however, she learned that they were symptoms of her frustration. Our long-term goal was to improve her ability to use her frustration to her advantage. Thus, on that first day, we started a marathon of subtle, yet important negotiations about her work.
In the early months, we created a large chart on which we listed the key responsibilities in both her and her boss's jobs. We then tracked who had authority for decisions compared to who had responsibility, and we found a significant number of tasks in which Pam had a lot of responsibility, but little positional authority. She liked the graphic that made her dilemma so visually discernable and focused. It gave her the plan to guide her actions.
I was reminded of quotes from the Nei Jing, the Yellow Emperor's Classic of Internal Medicine: "The Liver Official excels at strategic planning ... and ... The Gall Bladder Official stands upright to make wise judgments and to see clear decisions... ." Would the court of the ancient Chinese emperor ever have imagined that these terms applied to a modern American, female business leader? And would Pam ever imagine that classical Chinese medicine would get her a better job?
Over 18 months, by phone, we clarified Pam's understanding of her responsibilities. Gradually, we discovered strategies with other people that led to her having the authority she needed. We also invented a set of coping mechanisms to help her manage her stress. These included: planning exercises immediately after meetings with Alan to let off steam (and constrained wood chi); altering her diet to reduce the strain on her liver (to this day, she does not drink coffee or alcohol); and being aware when her calendar was too crowded and the work pressure mounted.
I also prescribed a low dose of bupleurem sedative. I mentioned to her that another brand name for this compound is "Relaxed Wanderer," and suggested she allow a few minutes of unstructured "wandering time" per day. Within the first three months, her headaches and indigestion were gone, and she was engaged in a healing process that would change both her career and health.
Now, even as her industry has taken hits from the stock market, scandals and wars, Pam has quietly risen. She gradually received compensation, and authority, for all of her work.
This year, the company's board of directors celebrated the ascent of its first ever-female CEO, whose sharp jaw opened into a broad, bright, round smile when she was awarded the job.
Click here for previous articles by Nancy Post, MAc, PhD.