How do you know whether your client is stressed?

Today we feature a 2019 article by Rook, Hellwig, Florent-Treacy, and Kets de Vries at INSEAD and Henly Business School, titled, “Workplace Stress in Senior Executives: Coaching The ‘Uncoachable.’” The authors introduce five areas in which stress may arise. Then they develop and test a protocol of inquiry that coaches can use to decode leaders’ stress. (Note, your IOC membership gives you access to other interesting work by IOC thought leader, Manfred Kets de Vries, in addition to many other resources)

What is stress?

The authors define stress sources as external - demands or features of the external environment - and internal - an individual’s psychological, behavioral, and physical response to environmental demands. (Note - this online book explores Lazarus’s seminal psychological model of stress.) The emergence of perceived stress happens in two steps – first is appraisal of environmental demands, and second is appraisal of resources available to deal effectively with the stressors. One study cited by the authors suggests that the pressures of lack of time and resources (internal and external) are a key source of stress for leaders.

As Harvard adult development psychologist and IOC thought leader Robert Kegan shares in his must-read book, In Over our Heads, stress happens when the demands of the moment exceed one’s perception of one’s capacities. We feel in over our heads.

Being stressed can be hard to admit for leaders

In certain cultures, admitting to being stressed may be perceived as a sign of weakness or inability to be successful in one’s role. Leaders may minimize or deny that stress is an issue, believing it applies only to others but not themselves, and worry that any signs of fatigue or stress may impact perceptions about their abilities or negatively impact their career advancement.

Although it may be hard to admit to experiencing stress, it is a growing concern for individuals, teams, and organizations. It is not uncommon to hear about leaders collapsing from exhaustion, health crises, or even dying prematurely from a heart attack or stroke.

High stress can manifest in various ways – ranging from antisocial and aggressive behavior at work or home, to sleep deprivation, excessive drinking or illness. Burnout of leaders can also occur, leading to a loss in connectedness and productivity characterized by exhaustion, cynicism, and inefficacy.

How to measure stress

Measuring stress is challenging as assessments are typically related to a moment in time or limited time period, and many stress evaluation tools are self-reported. In contrast to the widely used theories of stress and measuring stress, the authors use a theoretical framework informed by psychodynamic ideas. (Psychodynamics refers to the conscious and unconscious forces that determine human behavior and attitudes.) They propose using a psychodynamic approach to evaluating stress which helps to identify and address conscious and unconscious aspects of behavior, including emotional and relational issues.

Coaches can help their clients gather data in two ways:

1. Factual responses to questions and visual clues from the context of responses and appearance of the person
2. How a client responds/reacts to specific questions

The authors recognize the importance of using theory to drive interpretation of data. They apply RADIO indicators to assess a client’s responses to an inquiry on their stress (adapted from Otto Kernberg’s 1980 Comprehensive Textbook of Psychiatry). The RADIO framework enables the coach to make sense of the data collected in the interview through a psychodynamic lens rather than just considering the cognitive ‘facts.’

Reality testing: Is a person sufficiently in touch with what is happening around him or her?

Affect management: Does a person show stable and appropriate emotions when answering the various questions?

Defenses: What kind of defenses are used: primitive defenses (not accepting reality) or more mature defenses (accepting reality)?

Sense of Identity: Does a person know what he or she stands for?

Object relations: Does a person have a rich or deficient network of relations with others?

The authors then describe the Stress APGAR Protocol. This name was chosen to highlight similarity to what’s known in healthcare as the “APGAR assessment,” which is used by pediatricians to evaluate the health status of newborn babies just after delivery. In particular, the assessment aims to quantify the level of danger posed, if any, and whether there is need for immediate action. Similarly, a coach can use a coaching APGAR to gauge a client’s stress levels and what action might be needed.

In using this protocol, a coach’s questions and conversations with a leader can be particularly helpful in gathering relevant information. Understanding your client’s stress levels is not about asking specific questions on a list. Rather, it is about a coach’s ability to engage in effective communication, observation, and active listening, while speaking with the leader in his or her own language.

Appearance: Sleep patterns, eating habits/weight control, stimulants, exercise, nervous tapping, pacing or restlessness, digestion, energy levels, muscle tension, hypertension

Performance: Decisiveness, productivity, self-esteem, concentration and memory, innovation capability, generating new ideas

Growth and Self-development: Internal capacity and external support of learning, satisfaction with opportunities for personal growth and learning – too much? Not enough?

Affect Management: Ability to feel, understand, control and show emotions appropriately

Relationships: Perceived quantity and quality of relationships with life partner, family, friends and with professional peers and superior

The authors tested the use of the APGAR inquiry with a group of executive coaches (starting with instruction and then debriefing on the results). After the conversations about stress with clients, coaches evaluated client responses using the RADIO indicators above (Read the full article to access the full complement of APGAR questions).

You can think of this protocol as a psychodynamic lens in which a coach can help a client address stress through a non-threatening, non-judgmental, and compassionate conversation.

After all, stress is simply a messenger as Robert Kegan would say. The message? You are perceiving that you are in over your head in this moment. You have a choice: reduce the demands and accept your limitations or grow to access more of your internal resources and rise to the challenge of external demands. Stress is the signpost that growth is ahead. In other words, a moment of stress is the perfect opportunity for a coaching moment!

Takeaways for coaches

1. Keep your eyes open for stress signs: Explore questions from the APGAR assessment tool (download the article) to help clients understand the degree of stress as well as its sources and expressions.
2. Stress awareness is the first step: Help clients recognize that acknowledging stress is a healthy response, engaging self-awareness and self-compassion, a starting point for improvement and growth.
3. Help your clients normalize stress: Everyone experiences levels of stress that vary over time with changes in external and internal factors. All of us are “in over our heads” from time to time. It’s a good sign that there is an opportunity for growth.
4. Focus coaching on stress relief: Use coaching tools to identify habits of mind and body that can relieve stress, as well as areas for growth.

Apply these principles to yourself. Of course, coaches are not immune to stress. Ideally we are role models in self-coaching and seeking support in times of significant stress.

FEATURED ARTICLE: Rook, C., Hellwig, T., Florent-Treacy, E., & Kets de Vries, M. K. (2019). Workplace stress in senior executives: Coaching the “uncoachable.” International Coaching Psychology Review, 14(2), 7–23.

Other IOC Resources on Stress