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Preventing and managing fear
MGen Andrew Downes, OMM, CD, QHP, MD, Surgeon General
BGen Marc Bilodeau, CD, MD, Deputy Surgeon General, Canadian Armed Forces
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Fear is a powerful emotion that can arise in response to a real or perceived danger or threat. It induces a physiological response and can trigger fight, flight, or freeze behaviour. The threat may be to oneself or others and may include multiple dimensions, such as health, safety, finances, and reputation.
The degree of fear felt in the face of a given threat varies among individuals and can also fluctuate over time with such changing factors as their resilience and stress level, understanding of the threat, experience, confidence in leadership, and support from colleagues.
Fear is part of the human condition, but it can negatively impact and even disable individual and team performance. Further, fear can be contagious. Therefore, it is important that leaders at all levels of an organization, especially during a crisis, be vigilant and consider how they can prevent and manage fear on their team.
Managing fear with understanding and compassion
About 10 years ago, while deployed in Afghanistan, a medical technician (med tech) was overcome with fear when tasked one day to be medic on a convoy to one of the forward operating bases.
The med tech had been on convoys before without incident, and the level of risk was no higher this time, so what had changed? It turned out that their child’s birthday was that day, and the fear revolved around the risk of dying on that special day.
We managed this situation with understanding and compassion, and we were very cautious to not label the person negatively. We established a principle that, where possible, we would not send med techs out on their “special days,” as long as they still did their share of convoy duty. The med tech was excused that day, but went out two days later.
This case is instructive for leaders of people who are in harm’s way. The risk of dying was probably the same for any convoy, but the emotion of fear was higher on the special day. This highlights the possibility of unexplored opportunities available to leaders to help manage fear, beyond just reducing personal danger.
The leader’s responsibility
Preventing and managing fear requires the leader to apply skills in two LEADS domains: Lead self and Engage others.
Lead self
Before leading people out of their fear, leaders must first assess and manage themselves. Leaders are not immune from fear and, in fact, may face the same threat as everyone else and then have the additional burden of leadership responsibility. People expect their leader to be calm and reassuring and to be able to make the right decisions in a timely fashion. This can be difficult, especially as the level of fear increases.
Engage others
In the LEADS framework, Engaging others is about getting down to business and leading people. It is about building teams and culture, communicating, and facilitating collaboration and cooperation. Fear among team members can be difficult to prevent and manage in crisis situations, but leaders may find the following points useful.
— they are rested and not cognitively overburdened
— they have a sense of purpose and duty
— they are part of a highly functional and supportive team
— they feel confident in their own abilities (requires preparation and training)
— they feel supported by the organization, its leaders, and their colleagues
— they worry less about impact on what they value most, e.g. health, family, etc.
— they have some level of control or influence over the situation
— they are recognized for their courage, even informally
The Canadian Armed Forces’ Mental Health Continuum Model
The Mental Health Continuum Model (Figure 1) is a helpful self-assessment tool for gauging the impact of stress on mental health and, by extension, on work performance. During times of stress, it is common for people to move toward the right on the scale. People who find themselves toward the right side of the continuum could benefit from help from a peer, a supervisor, or a professional (Figure 2).
MGen Andrew Downes, OMM, CD, QHP, MD, Surgeon General
BGen Marc Bilodeau, CD, MD, Deputy Surgeon General, Canadian Armed Forces