Stressed-Out Baboons

If work is so good, how come they have to pay us to do it?

—Mike Royko

Sylvia's conditions are increasing her mortality. Probably yours too, if you are getting six or fewer hours of sleep each night. The problem is in large part structural. She works for a pecking-order company and has little autonomy to fix the problems on her team. The pecking order also creates a stratified entitlement culture: stress collects in the middle and toward the bottom of the organization.

Robert Sapolsky, the American professor, neuroendocrinologist, and author, has studied the social habits of animals in the wild for over 30 years. His research on stress-related disease in baboon culture reveals similar parallels to the workplace:

The reason baboons are such good models is, like us, they don't have real stressors…If you live in a baboon troop in the Serengeti, you only have to work three hours a day for your calories, and predators don't mess with you much. What that means is you've got nine hours of free time every day to devote to generating psychological stress toward other animals in your troop. They're just like us: They're not getting done in by predators and famines, they're getting done in by each other.

Up until 15 years ago, the most striking thing we found was that, if you're a baboon, you don't want to be low ranking, because your health is going to be lousy. But what has become far clearer, and probably took a decade's worth of data, is the recognition that protection from stress-related disease is most powerfully grounded in social connectedness, and that's far more important than rank.¹

In the National Geographic documentary Stress, Portrait of a Killer,² Sapolsky tells the story of a baboon tribe that followed the model. The lower-ranking baboons carrying stress-induced obesity (belly fat), were more susceptible to all the symptoms of metabolic syndrome. When the tribe found rotted meat in a garbage dump, the alpha males took the prize while the females and lower-ranking males sat at the perimeter.

The toxic meat killed the entire clan of alpha males. That placed the females in charge. When the females took over, the tribe morphed away from a hierarchical command into a grooming culture. The tribal time that was once spent intimidating, defending, or staying on alert changed over to caring, connection, and nurturing.

Primates in the Workplace

The Whitehall studies, conducted over several decades beginning in 1967, tracked 18,000 male employees in the British civil service, and over 10,000 civil servants, both male and female. The studies asked how the workplace affected health and mortality. The results represent the human version of Sapolsky's work.

The first Whitehall study found that those at the lower end of the pecking orders experienced more severe adverse symptoms of metabolic syndrome. “After controlling for these risk factors, the lowest grade still had a relative risk of 2.1 for cardiovascular disease mortality compared to the highest grade.”³

Please Help Me!

“My body hurts. I feel exhausted. I feel emotionally numb. I can't move as fast as I want to. Please help me.” Mina Mori, 26, left this note just before she committed suicide in 2008. The investigation revealed that she worked “in excess of 140 overtime hours a month.” The Japanese have a specific word for death from overwork—karōshi.⁴

According to Jeffrey Pfeffer, “It's even worse than that.” In the research for his new book,⁵ he discovered that deaths related to overwork are the fifth leading cause of death in the United States. He also told me: “We understand that people's minds affect their bodies. Why are we surprised at the numbers? Life's demands, financial insecurity, lack of control, overwork and stress—it's killing us.” Using the epidemiological studies that have been around for decades and aggregating them to develop cost projections and business implications, his team estimates that deaths due to overwork in America conservatively total 130,000 a year.

He also wrote in Fortune magazine:

The 10 workplace conditions included some that affected people's level of stress, such as work–family conflict, economic insecurity ( fearing for one's job and income), shift work, long working hours, low levels of organizational justice ( fairness), an absence of control over one's work, and high job demands—and one factor, whether the employer-provided health insurance, that, particularly prior to the passage of the Affordable Care Act, affected people's access to health care.⁶

Your Body Under Chronic Stress

Cortisol is the gas pedal that accelerates your heart and releases energy (glucose). It gets us up in the morning, energizes us for peak needs, and is then supposed to turn off at night. But stress pushes the same pedal. If your body is not in survival mode (like fighting a tiger), but stress insists that it is fighting to survive, serious complications become dangerous to your health:

1. Blood sugar falls out of balance.
2. Arteries produce a waxy substance to cushion the vessels from increased pressure. The wax hardens into plaque, which narrows artery walls and raises blood pressure.
3. The brain also instructs the body, “Hold on to those calories.” Guess where they go? Right to the abdomen.
4. Suddenly, we must cope with cascading factors of chronic stress: weight gain, high blood pressure, diabetes, immune system suppression, and cardiovascular disease. It also shuts off your parasympathetic nervous system (your recovery mechanism).

These symptoms are called metabolic syndrome. It is the number one cause of chronic disease.⁷

Loneliness also contributes to stress. Most people are friendly and have friends. The problem is energy or time. Research reveals a growing number of depleted and lonely people. The more people are exhausted, the lonelier they feel. “Research by Sarah Pressman, of the University of California, Irvine…demonstrates that while obesity reduces longevity by 20%, drinking by 30%, and smoking by 50%, loneliness reduces it by a whopping 70%.”⁸

Well-Being Before Wellness

I am the amateur in every group and with everyone I interview. However, all this evidence about the primacy of stress seemed overwhelming, obvious, and intuitive to me. So, I just kept asking, “Why is the focus of wellness aimed at physical health when stress is clearly the driver behind most of the problems that wellness efforts are trying to solve?”

I learned from Dr. Roizen and others that in the beginning of the wellness surge, no one saw stress as a factor. But then, like a fluorescent light turning on, the role of stress began to slowly dawn on everyone. So, in many ways, it was all backward. Wellness leaders started with physical health and then finally discovered stress as the largest driver of unwellness.

The real cost of poor employee health and well-being is not medical or pharmaceutical costs. It's not even the associated absenteeism. It's the toll that poor health takes on a person's productivity while they are at work—something that researchers and managers have labeled presenteeism.⁹

—Kate Lister

In other words, well-being comes before wellness (we explore that in more detail in Chapter 10).

That one perspective—well-being before wellness—changed everything for me. And it should change the details and direction of wellness efforts. It should send every human resource manager, corporate executive, policy expert, wellness program designer, and architect back to the drawing board. It seems that everyone leaned the ladder against the wrong wall. An entire industry has spent billions trying to solve symptoms—obesity, heart disease, diabetes, strokes, and other physical breakdowns. But stress is the serial killer behind all those mortal afflictions.

Well-Being Requires a Mind Shift—Not a New Program

A recent article in a prominent HR journal announced that employers are taking wellness to a higher level. Well, let's hear the drum roll, trumpets, and popping champagne corks. It seems, according to the article, that after a half-century of inadequate or failed efforts to improve health outcomes or reduce costs, the HR industry is “now very confident” that its next version will satisfy corporate criticism and pressure to deliver on a 50-year promissory note to improve employee health and well-being.

The article highlights stories from rich companies who pay a premium for talent; they are spending more on fitness centers, meditation rooms, and services to help people better manage their finances and other key stress points of life. Except for adding the words “holistic,” “individualizing,” and “sustainable,” the wellness industry is offering the same old programmatic approaches to addressing their employees' life challenges. But the source of most employee stress is the very structure and culture of the workplace. For example, sending Sylvia to a stress management class would not reduce her stress. Getting rid of two toxic employees would.¹⁰

Leaders, me included, mean well. When we see a problem, we reach for our bag of tricks or call in outside experts with their bags of tricks. But, when we do that, we operate with a diminished capacity to care. Part of the reason is that by the time we have climbed the ladder and reached positions as master problem solvers, our emotional intelligence has precipitously dropped.¹¹ We become numb to the ripple effect of our decisions on people. That mirror neuron installed at birth as a means of empathizing with others can (without continued cultivation) become tone deaf. (The TV show Undercover Boss is built on the premise of tone-deaf bosses discovering the impact of their decisions.) As a consequence, we seldom take the time to fully explore what a meaningful, practical, and caring response might look like. True care is personal, a gift to another. So, instead of actually caring, we busy leaders try to delegate care to an efficient delivery system that assembles the components of care. But that system does not, cannot, include the human touch. Too often the solutions we parachute into various areas of need are imposed; done “to,” not done “for” or “with.”

Tom Emerick told me a story from Walmart of how the benefits world, his world, was so often a grand adventure in missing the point:

I met a bunch of cashiers in the store. They were all overweight. And I, the Very Helpful One from Corporate, said, “What if we gave you free gym memberships?”

And one woman answered, “The only way I can come back here and do this all day long is I go home and soak my feet in Epsom salts every night. My feet hurt so bad at the end of my shift that I can barely walk. Don't ask me to get on a treadmill, or I won't be able to come back to work. If you want to do something to improve our lives, gives us shoes, or a mat that will keep our feet from aching an hour after we get here.”

Another lady said, “You know, I drive a 14-year-old car. I buy my furniture at garage sales. I've never had a vacation because I don't get paid enough money here. And a couple times a week I get a large pizza and a six-pack of beer and just go home. That's the only recreation I have all week long. Don't tell me I can't have that.”

And, you know what; she was right. I got to thinking, how arrogant am I to not have any idea what these people's lives are like?

That is the threshold that only care can cross—knowing the sights, touches, textures, sounds, smells, and nuances of what people's lives are like. The mammoth delivery system that we often call “care” does not have (and will not allow) room for a human touch. The metrics measure participation and health cost, not care and connection. Organizations like the Mayo Clinic and Cleveland Clinic and companies like Barry-Wehmiller, Next Jump, W.L. Gore, Cummins, and GoDaddy have created different structures more aligned with grooming cultures than traditional pecking orders. They provide leadership that cares, clear cultures and ecosystems of support, and environments that continually reinforce why and how employees are valued.

When Well-Being Becomes the New Norm

Perhaps the real problem is stress seems so normal. I do complain about stress with peers at the end of the day over a beer. We can all articulate the activities, demands, and curveballs that complicate our lives, but in fact we regard them as badges of honor. You and I know people who jokingly say, “There are two kinds of people, those who get stressed and those who give stress.” But his knowing smile implies that the speaker is the latter. Stress is our modern-day Faustian bargain. We have willingly handed over our well-being in exchange for the promise of financial security, recognition, or feeling valued. It is another python.

As Bob Chapman told me, “Don't complain about the cost of healthcare. 84% of all illnesses are chronic. The largest cause of chronic illness is stress. The biggest cause of stress is work. Guys, you are the problem. Okay? You can beat up insurance companies. The dumb things we do to manipulate insurance companies and doctors and hospitals. Why don't we just reduce demand?”

Chronic disease is the steamroller that threatens corporate survival. When I share the statistics and stories with business leaders, I see true surprise, even alarm. I see a growing and universal acknowledgment that stress represents an existential crisis. But wellness efforts have had no effect against chronic disease, largely because organizations and companies have learned helplessness. They have acquired the reflex of throwing up their hands no matter how shocking or dramatic the numbers and details. They also keep aiming at the wrong target. Stress is the target! It drives the steamroller that disables and kills so many.

Increasingly, it seems that many leaders are starting to feel this. They are moving beyond cerebral acceptance to gripping it personally. It is no longer abstract, but painfully visceral. That is why I have hope. Many of the examples of cultures of care came through painful lessons, crossroads, and turnabouts. The road from reducing stress to achieving happiness is a road everyone wants to take and can take! The workplace can become a place of meaningful achievement, relationships, personal growth, and a sense of accomplishment.

Getting the Horse Back in Front of the Cart

According to Bob Chapman, “The person you report to at work is more important to your health than your doctor! And there is a 20% increase in heart attacks on Monday mornings. Furthermore, we know for a fact that the way we treat people at work affects the way they go home and treat their spouse and their children.”

With 160 million workers in America, Bob Chapman's research shows they can and will have great influence on the health of the rest of America when they go home after work. So, what does it mean that work is baking stress into the workforce and that work is the fifth leading cause of death in America? That fact is a major contributing factor to everything else we will address. We must put the well-being horse back in front of the wellness cart. Our research found that well-being costs less in both the short and the long run—but it must come first.

Google is considered one of the best places to work. But they saw their culture was burning out too many people, and turnover was too high. So, they launched two efforts to understand performance and resiliency better. After studying 180 teams over two years, they concluded that psychological safety was the number one factor in high performance. So, reducing the friction of work, as David Radcliffe says, or creating a safe place to work are not just nice soft skills for cushy workplaces. They are keys to survival for this new era of work.