4

Courage Takes Trust

As we start to really get to know others, as we begin to listen to each other’s stories, things begin to change. We begin the movement from exclusion to inclusion, from fear to trust, from closedness to openness, from judgment and prejudice to forgiveness and understanding. It is a movement of the heart.

—Jean Vanier

A physician named Lynne Fiscus was offered a once- in-a-generation opportunity to lead the endeavor to build a new clinic that would consolidate more than thirty individual clinic locations into a single space. She knew the project would be challenging. Although the new building was designed for a more modern and flexible practice, having to build it during the recession meant more clinics in fewer rooms. It would also mean being open longer hours for better patient access. Nobody had a choice about moving. Clinicians and staff were angry, complaining, “Here I am in the academic world where I’m expected to teach and do research and do clinic. Now you’re telling me that sometimes I have to have clinic ’til seven o’clock at night!”

On top of all that, Lynne had to deal with three organizations that did not have a history of alignment: the university, the hospital, and the physician practice organization. She had to find a way to bring together people who had been mistrustful of each other. In her first few weeks of being in the position, she held one-on-one meetings with medical directors, clinic managers, and faculty stakeholders and attended many clinical meetings. Her intention in entering these meetings was to hear how these people felt she could be successful. Lynne found herself in many raw conversations about disappointment, anger, and hurt.

“It was really clear to me that my role was not to figure out the optimal room utilization resources at three-thirty in the afternoon of pulmonary clinic. I needed to be the person who could give capacity to people to stay in this work.”

Lynne had attended several Courage-based leadership and resilience retreats that her employer had offered for professional development. Lynne also had the mentoring support of another physician. “That really helped me focus on what I wanted to do and actually set me up to be able to take on this large role that I have today.” Lynne brought some Courage practices she had learned into the way she led this new building endeavor. One was giving groups a common focal point to begin discussing difficult topics and problems.

“I started each of my monthly meetings with medical directors and clinic managers by introducing poetry. The first few months, people would say, ‘What? Someone brought a poem to start off their meeting?’ For months I continued to get head scratching and equivocal looks.”

“I’ve been very intentional about how I run meetings. I brought in poems and intentionally reflective activities, Circle of Trust touchstones, examining not just the ‘what’ of leading but connecting to who we are and how we lead. Doing so made it clear that this wasn’t just the same old, same old. I wanted to make sure it felt different than what had happened before. It helped us get out of some of the old patterns of being and patterns of relation we had gotten used to with one another.”

One day, Lynne was inspired to use a video in her next meeting about the new building initiative. This meeting was a large one, with seventy people, including medical directors and clinic managers. Lynne introduced the topic of transitions and posed a few questions. Then they all watched a YouTube video called “The Parable of the Trapeze” that includes a voiceover of Danaan Parry’s words: “I see another trapeze bar swinging toward me. It’s empty and I know, in that place in me that knows, that this new trapeze bar has my name on it. It is my next step, my growth, my aliveness coming to get me.”¹

Lynne explained: “It was just this great metaphor for everything. You know, we’re leaving physical space and flying through the air, and it feels out of control. What are our opportunities for learning, for growth?”

The conversation that followed was productive, and completely different from what would have been possible nine months earlier. After the video, Lynne asked the leaders assembled: “If the trapeze artists take risks with the security of a safety net below, where do you find security in the work that seems often over-whelming?” One answer was that they were piloting new things before moving into the new building. Another safety net was that the basic work of caring for patients wasn’t changing, especially the human connection of comforting patients in distress.

Afterwards, one of Lynne’s colleagues said privately to her, “I didn’t want to say this in front of the room, but one of the things I feel like makes trapeze artists so successful is they just have ultimate trust in one another. That’s part of what’s really hard about this work, is that we’ve still got a big deficit in trust organizationally.” This lack of trust had been named in earlier leadership sessions discussing a potential merger in the midst of this project.

Lynne used the same video and reflective process a few more times with different groups. The conversations continued to be generative.

When it came time to open the new building months later, it was decided to control some of the chaos by moving only half the clinics the first week and using reduced patient schedules. Even so, it was rough. A new environmental services vendor hadn’t delivered enough trash cans to the building due to a shipping delay. Automatic hand-sanitizer dispensers weren’t working due to missing batteries. Individual clinic areas were missing the appropriate sharps containers to dispose of needles, posing a safety risk to patients and employees. The leadership team was meeting twice a day to stay apprised.

After hearing those concerns for two days, Lynne made a tough leadership call. She told her team, “We’re not going to open our doors tomorrow until we’ve gone through and made sure every single room where we’re sticking a needle in somebody, we’ve got somewhere safe to put that needle when we’re done with it.”

Lynne, along with senior executives from the environmental services company, the construction company team, and the infection prevention team, went room to room making sure there was a sharps container in each one. By midnight, they finally all agreed that it would be safe to take care of patients the next morning.

But then, midafternoon on day three, there was a complete IT network failure. For four hours there were no electronic health records. The land lines didn’t work, only cell phones. But the biggest problem was that because it was a brand-new building, every patient needed guidance.

“It was such a dark period of time,” said Lynne, “specifically for our leadership team. We were frenzied, harried, running around. I kept thinking, is anything ever going to work in this building again?”

It was supposed to be exciting, this third day of opening a brand-new clinic, but it was not, at least not in a positive way. Amazingly, the staff and patients were fine. Nothing bad happened to any patients when the network was down. Lynne spent the afternoon walking around checking on things, handing out gift cards to patients and chocolate to staff. She was worn out, wondering how she was going to come back for day four.

On top of her leadership role and practice as a primary care doctor a few days a week, Lynne is also a mother of two young children. She had missed multiple nights at home during the clinic’s opening days. And she had to fly out of town for business the next day. Her colleagues encouraged Lynne to go home so she could have dinner with her kids. Later, hearing that the IT network was back online, she didn’t need to return that night. Alone with her thoughts after putting her kids to bed, she found herself asking, What is my role as a leader in this time of excitement, chaos, and disappointment?

Despite how hard she and her team had been working, she realized that she needed to reframe this situation for her team in a way that helped them. “If I’m wondering how I can go back tomorrow, I know every single person on our leadership team, who’s been so invested in this project for so many years, is probably feeling the same thing.”

It felt like climbing back up the proverbial trapeze ladder. Lynne went to bed, but couldn’t sleep. At five in the morning, she got up and wrote an e-mail to the members of the team who were working in the new building that week:

Team,

As I have been reflecting on the events of the last 3 days, I continue to come back to the “Parable of the Trapeze.” We had a discussion months ago what were our safety nets as we “let go” of the old care model, old habits, and old building to fling ourselves forward into our future.

We talked about the safety nets of our staff knowing what to do, how to care for patients, we talked about practicing (your staffs clearly had) and we talked about trust in one another.

We can certainly say that yesterday was a day we needed all of our safety nets.

Trapeze artists don’t allow themselves to believe that the use of the net constitutes failure. They must, as we must this morning, climb back up that tall ladder and prepare to do it all again after they fall. Nerves and butterflies are natural, but it is our work. It is what we do. It is who we are.

The trust we have in one another is not that our partners will never disappoint us, will never let us slip, never make mistakes. Nor do we expect that our partners believe that we will get things right 100% of the time. The trust is that ourselves and our partners are as committed to the success of this trapeze endeavor as we are. I have seen that commitment from our physicians, staff, and internal and external partners this week all across the building, and out into the arrival plazas and beyond across all hours of day and night.

We have already heard from our patients what a beautiful thing our care model is when it is working well. Let’s dust ourselves off and start climbing that ladder again this morning.

Please know how deeply grateful I am for all of you and couldn’t imagine flinging into the future with a better group of partners.

For trapeze artist inspiration, the link is here: https://m.youtube.com/watch?v=HWvV5N4hOGc

Take care and please remember to be good to yourselves and one another.

—Lynne

A month later, Lynne sent out a similar message to the larger group of employees, medical directors, and clinic managers. “I expressed my gratitude to them for their part and explained how we’re changing how we lead this organization. Had they not been so honest in our earlier conversation as a group six months earlier, we wouldn’t be at this place where we are today, able to help each other through these things. We wouldn’t have had the language; we wouldn’t have had the trust; we wouldn’t have had the conversation. It was, for me, a great moment to be able to step back and say how far we’ve come from fifteen months ago when I started. I think back to how crazy, crazy those first few days were and how we were able to respond to one another with kindness and understanding in a way that, I hope, will set the tone for how we’re going to be in relation to each other in the future.”

No one can change the world by a new plan, project or idea. We cannot even change other people by our convictions, stories, advice and proposals, but we can offer a space and ourselves where people are encouraged to disarm themselves, lay aside their occupations and preoccupations, and listen with attention and care to the voices speaking in their own center.

—Henri J. M. Nouwen, theologian

Creating Relational Trust

Developing courage as a leader boils down to trust: trusting yourself, trusting other people, and developing an ability to trust in the balance of life overall. Trust takes time to create, and at the heart of trust is a leader’s own self-awareness and social-emotional intelligence. Trust requires listening to one’s inner life, which can translate into greater empathy and willingness to invite reflection among colleagues, which can in turn inform a sense of shared purpose and optimism.

Relational trust is a specific form of trust that arises from interpersonal relationships—or social exchanges—between people in an organization, community, or network. Contractual trust, however, may be enhanced by good social relationships but it explicitly defines work, products, or services to be delivered with legal ramifications for failure to do so. Most businesses operate on contractual trust without recognizing that relational trust within the corporate culture itself may be the make-or-break key to success.

Many workplaces today function as a social system, or a community, working together around a shared purpose. At their best, there is rapport, cooperation, and belonging, forming a cycle of healthy and productive relationships. Complex problems, competing priorities, family dynamics, and stress-filled, siloed work are just a few factors that contribute to a breakdown in trust.

Relational trust at first glance is simply about trust between people: Do I trust you to do your job so that our shared endeavor moves forward? We depend on each other to fulfill the obligations and expectations defined for our roles. That leaves us vulnerable to power asymmetries, to misunderstandings, to breakdowns in communication, to all sorts of tensions that can wreak havoc not only on relationships but also on our individual capacity to handle stress. In fact, relational trust comes from our inner perceptions and interpretations of others’ behavior and motives. This inner territory is full of potholes and shadows that demand we tend to our own self-awareness.

Tested in Schools

Our framework on relational trust came out of the Center’s roots in education. During the same decade that educators and physicians were beginning to experience reflection in community through our Courage to Teach and Courage to Lead retreats, parallel but unrelated research affirmed and advanced the importance of the inner lives of educators. Researchers Anthony Bryk, Barbara Schneider, and colleagues named relational trust “key to advancing improvement in urban public school communities.”² Even when variables such as poverty, racial isolation, and student transience were factored in, the strong correlation remained between relational trust and student improvement in standardized test scores in reading and mathematics. In schools where trust between teachers was strong, students’ test scores improved. But schools whose staffs reported low levels of trust both in 1994 and 1997 had “virtually no chance of showing improvement in either reading or mathematics.”³

Informed by Bryk and Schneider’s research and other more recent studies, in 2012 the Center for Courage & Renewal with researchers from the University of Virginia came together to develop and pilot a program called Leading Together: Building Adult Community in Schools.⁴ In schools where Leading Together protocols became integrated into school meetings and culture, the study showed improvements not only in relational trust but also in professional capacity. Teachers reported feeling more inclined to learn and innovate, a greater loyalty and commitment to their school, and a sense of collective responsibility to keep improving their school. All that added to an increased sense of optimism and collective efficacy.⁵

Four Lenses of Relational Trust

Relational trust involves discerning the intentions of others. We observe and interpret the behavior of others through the dynamic interplay of four lenses, often applied unconsciously and simultaneously in default snap judgments. These four lenses, as named by Bryk and Schneider, are respect, regard, competence, and integrity.⁶ A severe deficiency in any one can undermine trust. When trust goes missing, we’re often unaware of more than a gut feeling. This framework can help us pin down not only what’s missing but also what can be done to repair it.

Respect

Respect involves honoring the important role each person plays in the workplace and the mutual dependencies among team members. The quality of conversation, including genuine listening, makes a difference. It’s one thing to follow procedures to ensure that each person is heard; it’s another to make sure all feel that their opinions are not only heard but valued and will be considered in future actions.

The touchstones are ground rules that increase relational trust because they create a commitment to respectful, nonjudgmental, and meaningful conversations. Whether they are read out loud as a meeting begins, or whether the practices become internalized, the protocols for deeper listening create an intentional way to interact. In our Leading Together pilot study, school teams collectively created their own touchstones or adult community guidelines to provide shared norms that hold the adult community to high standards of professional practice.

The way Lynne held cross-departmental meetings helped people recognize themselves as part of a bigger whole. That set the stage for people to get to know one another beyond their job functions. This latter point weaves in with the next lens, personal regard.

Personal Regard

We often work in a complex web of roles and relationships where power dynamics can’t help but exist, leaving people in subordinate positions often feeling vulnerable. When the more “powerful” person makes a conscious commitment to relieve uncertainty or unease, it can create a sense of being cared about. This might entail leaders expressing kind concern about some-one’s personal life, creating professional development opportunities, or otherwise extending themselves beyond what their leadership role might formally require. In other words, if you make me feel safe in being vulnerable, I’ll return the favor.

When Lynne expressed her dismay at missing another dinner with her young kids, her fellow leaders responded by encouraging her to go home. On another day, Lynne was on the other side of the equation. An employee abruptly left a conference call that ran late into the evening. Soon after, he texted Lynne and another physician to apologize: “So sorry. I had to pick up my kids at day care.” She texted him right back and said, “Don’t apologize. You’re talking to two physician moms. Multitasking is our superpower.”

Lynne reflected on that interaction: “That’s not something people should ever feel like they need to apologize for. It’s the reality of our lives these days, and we’ve got to be able to figure out a way that we can help people do both work and personal life.”

Lynne’s values around wholeness and work-life balance show up in her personal regard for her team, and that contributes to relational trust in the long run.

Competence

This lens of relational trust involves how people measure leaders’ and coworkers’ job performance or the value of their contributions. We’re not talking about annual performance evaluations between supervisor and employee. In the context of relational trust, we’re talking about the many informal observations and judgments—positive and negative—that we make day-to-day about people’s apparent capacity to maintain order, to wield fair discipline, or to maintain calm under pressure, for example.

Lynne recalls what went well during those hard days, especially during the network outage. At the infusion clinic, the competent nurses were unfazed. They simply walked across the street to the hospital to print out consent forms.

“They were all in problem-solving mode, focusing on the right work in a way to be able to completely care for our patients. It got me thinking about our safety nets. Because they had practice, they knew what to do. They’ve been through system outages before in the old building. Not that it happened all the time, but it was just like, ‘Oh yeah. Okay. We’ll just figure this out.’” Lynne and her leadership team, by contrast, were distressed because there was very little they could do. While IT was working on the technical solutions and care teams were serving patients, the leadership team felt useless.

On the surface, the idea of competence seems to refer to an objective process of assessing roles, responsibilities, obligations, and expectations, but in terms of relational trust, our own shadows affect how we perceive competence. We often judge others without knowing the whole story. Sometimes we feel blame or shame and project our own darkness onto others. We wonder if anyone knows that we don’t have a clue what to do next with all this complexity. Senior leaders interviewed in the report Thinking the Unthinkable gave voice to fears of feeling like imposters because of their inability to perform despite being highly paid.⁷

Integrity

When there is consistency between what people say and do, we call that integrity. We say they “walk their talk” or “keep their word.” We sense integrity when a person’s work appears to be guided by a deeper moral-ethical commitment.

For relational trust to develop and be sustained, Bryk and Schneider note, leaders and followers must be able to make sense of their work together in terms of what they understand as the primary collective purpose: Why are we really here?⁸ To what higher purpose do we answer besides the obvious bottom lines?

In schools, teachers or principals demonstrate integrity when they act with the best interests of children at heart, especially when they must make tough decisions. Integrity is seen when teachers take a risk in using new instructional methods for the sake of improved student learning or when principals speak out against a central office policy they believe won’t help children. Such behaviors affirm that upholding the shared values of the school community comes first.⁹

In health care, integrity translates into making the health, safety, and well-being of patients one’s highest priority. Lynne did this when she insisted on the placement of sharps containers in every clinic room necessary. Her leadership team did this by stepping in to ensure that patients were guided throughout the facility when it first opened.

What might integrity look like in business? It’s not only the opposite of the immoral and unethical behavior most often reported in the news. Look for circumstances where someone goes the extra mile or goes against the grain. Integrity often requires us to stretch and be stronger than normal. Integrity demands an extra measure of responsibility and resolve to do the right thing. Integrity is refusing to participate in unfair business practices. Resisting pressure to meet quotas that cause harm. Relinquishing a sale or a competition for the sake of winning long-term loyalty. Retracting misinformation.

Integrity requires a shared understanding of your organization’s purpose and values, and being committed to living them out. It requires reflecting on how you prioritize decisions for all the bottom lines—people, planet, profit, and purpose— and then clarifying which people you are talking about: your shareholders and board, your employees and their families, your customers? Integrity means releasing a scarcity mindset and redefining short- and long-term value.

Building and maintaining relational trust are daily and lifelong practices that take hard work and heart. With the four lenses of this trust-building framework, leaders of all kinds can become more aware of their own blind spots and see where they can take responsibility for ensuring improvement. Leadership is an opportunity and an obligation to create the conditions in which trust can arise. Courage practices contribute to fortifying trust within, between, and among people.

You need only claim the events of your life to make yourself yours. When you truly possess all you have been and done . . . you are fierce with reality.

—Florida Scott-Maxwell, playwright and psychologist

The Inner Life of Trust

Trust isn’t found or formed in one day, one meeting, one conversation, one e-mail, or one video shared and discussed. It’s how we stay in the conversation that matters, especially the difficult ones. Can we let the tensions between us stretch our hearts and minds open? Can we move along the Möbius strip, recognizing how our inner perceptions affect our outer relationships and decisions? Can we make the time, space, and effort to get to know each other without judging? As you’ll see in the next chapter, reflecting—alone and together—on the big questions we face can shift the possibilities toward trust. And with trust comes more courage to stay engaged and to lead.