Why You Need a Pre-Performance Routine

on December 12, 2017

Just after 8 a.m., Mark McLaughlin is sprawled on a ratty armchair in a hospital locker room in central New Jersey. In a few moments, the neurosurgeon will make a six-inch incision into the back of a patient whose arthritis is threatening his ability to walk. McLaughlin will be drilling, chipping, and cutting amid vital nerves, just inches from the patient’s aorta. McLaughlin needs to be focused.

Clad in green surgical scrubs, McLaughlin lays his feet out on a low table and reclines. His eyes are closed. His iPhone sits on his chest, playing a Bach cantata at low volume. For a few minutes, he sits in silence. When the patient is anesthetized, McLaughlin—who is fifty-one, wears glasses, has graying hair and retains the broad, muscled back of a former college wrestler—walks briskly toward the operating room.

Most surgeons work very differently than McLaughlin does. In the moments before an operation, they chat and joke with nurses and colleagues. They check e-mail, do paperwork, and make phone calls. They are relaxed and nonchalant, treating surgery as just an ordinary part of their workday.

McLaughlin doesn’t banter. If a colleague tries to talk to him while he scrubs, McLaughlin replies a bit rudely: “Not now.” He’s engaged in his presurgical routine, which he developed in the wrestling room of a New Jersey prep school, an hour’s drive from the hospital where he now operates.

McLaughlin began wrestling in sixth grade, and although he immediately showed a talent for the sport, his physical skills only took him so far. “Physically, I was completely prepared,” he says. “Mentally, I wasn’t.”

So McLaughlin began working with a sports psychologist, who helped him create a highly choreographed routine of mental preparation. Before matches McLaughlin would visualize a Greatest Hits reel of his best wrestling moments, reinforcing his confidence. “We focused the preliminary routine on trying to get me into that autopilot mode and let my body fall into that groove,” he says.

After he began using this pre match routine, McLaughlin’s experience on the mat changed. He no longer heard the crowd. The worries, self-doubts, and negative thoughts decreased dramatically. And he began winning most of his matches.

McLaughlin went on to wrestle at William & Mary. Then he attended medical school, eventually specializing in neurosurgery.

A few years later, as a surgical fellow, McLaughlin began to recognize similarities between the stresses of wrestling and the pressures of surgery. Both activities require hyperfocus and both result in clear wins or losses.

So before every operation, he began utilizing the techniques he’d used in wrestling, by going through a systematic, ritualized process to put his mind in the optimal state.

As he moves toward the OR, McLaughlin is running through a precise series of thoughts and visualizations, which he calls the Five Ps. First is a Pause: He tries to forget what’s happened earlier in the day and focus only on the present. Next, he thinks deeply about the Patient. “This is a seventy-three-year-old man, and we need him to come out of this pain-free and able to walk more easily,” he says to himself. He reviews his Plan, mentally rehearsing the surgery step-by-step. Then he offers some Positive thoughts: “You were put on this Earth to do this operation,” he says. Finally, as he steps toward the table, he says a quick Prayer. “It’s very ritualistic, and I’m very focused,” he says.

Before a routine elective procedure like this one, McLaughlin doesn’t say much to his surgical team. But in certain situations, McLaughlin gives his colleagues a pep talk. “Listen, we have to pull together,” he will say. “This patient is dying. We have ten minutes. Let’s be a team. Help one another. Stay focused.” If he gave these talks before every case, they would probably lose their power, so he gives pep talks sparingly—but when he does, he believes they have an effect.

Like most surgeons, McLaughlin plays music before and during an operation. Most of his playlists consist of country music. During especially stressful operations, he turns on a classical mix, which calms him. When a patient is bleeding excessively, he’ll ask to hear George Strait. And when a surgery gets particularly challenging, he plays John Hiatt’s inspirational country song “Through Your Hands.” “It sounds crazy, but when I’m struggling, it helps me get through,” he says. The song is so meaningful that McLaughlin hired Hiatt to play at his fiftieth birthday party.

Some parts of McLaughlin’s presurgical ritual don’t make much sense unless you know their significance. For instance, in a surgical tray nearby, he keeps a set of microsurgical tools called Jannetta instruments, named after the renowned neurosurgeon Peter Jannetta, who was McLaughlin’s mentor. The tools are obsolete now—McLaughlin rarely uses them—but he finds their presence comforting in a superstitious sort of way. “It’s kind of like having Dr. Jannetta in the room with me when I do hard cases,” he says. “When they aren’t there, I get anxious.”

There are downsides to McLaughlin’s regimen. By multitasking right up until the moment they make the first incision, other surgeons can be more productive, attending to administrative duties. And because McLaughlin is so silent and focused before he begins his work, the atmosphere in his operating room feels slightly tense; if I was a nurse, I might prefer working in an OR where coworkers chat about last night’s TV show or discuss plans for the coming weekend.

There is no easy way to test whether McLaughlin’s routine increases his performance. But he believes it boosts his focus and concentration when it matters most, reducing the odds he’ll make a mistake. And even if the atmosphere is serious, he thinks colleagues appreciate the fact that his work habits are steady and predictable. “I can’t produce any evidence,” he says. “I think my routine helps, but I don’t really know.”

Unlike Mark McLaughlin, I was a mediocre high school athlete—a benchwarmer on the football and basketball teams. Scrawny and slow, I was a second-string offensive lineman on the football team. In basketball, after some success in ninth and tenth grades, everyone else got taller and I didn’t. By the time I reached the varsity level in both sports, I served a function similar to that of legendary Celtics’ coach Red Auerbach’s cigar: If I entered the game, it signaled my coach felt victory was safely in hand.

Still, high school sports gave me a window into the psychological techniques coaches used to prepare us (and the players used to prepare themselves) in the final moments before a game. Like most teams, ours relied on specific music to rev us up; when I hear those songs thirty years later, my pulse still quickens. Our teams had ritualistic pregame prayers and routines. The coaches worked to kindle a sense of hostility toward key rivals. We spent hours listening to pep talks aimed at instilling a sense of purpose.

I came away with a lifelong fascination with how people get psyched up before important events. When I watch the Olympics, I’m as interested in what the athletes do before a race as I am in the race itself. I’m drawn to political photography that captures candidates just before they walk onto a debate stage or give a make-or-break speech. How do they stay calm? What tools boost their confidence? What mental tricks optimize their performance?

As an adult, my job couldn’t be less athletic. As an editor at Harvard Business Review, I spend my days reading academic research and helping professors, consultants, and executives write articles that aim to “improve the practice of management”—our company’s mission. It’s a great job, but not one that inspires high-fiving or dumping Gatorade on the boss’s head.

Yet as I sift through research, I am surprised by how frequently I come across experiments involving variations of the practices I experienced in the high school locker room—studies examining how people use self-talk and pep talks, rituals and superstition, mental tricks and other gambits to prepare for the high-pressure tasks of a white-collar professional. In many cases, evidence shows that these routines really do help people perform better.

Some of these ideas, such as Harvard Professor Amy Cuddy’s celebrated (and controversial) work on “power posing,” have made their way into the mainstream. But much of this research remains obscure. That’s too bad because many professional would benefit from learning these techniques.

In the years since Malcolm Gladwell published Outliers, we’ve become a society obsessed with practice, with systematically grinding our way to the magical 10,000 hours required for proficiency. Practice is vital to any high performer, of course, but eventually, you run out of rehearsal time. The audience is seated and the orchestra is warmed up, or the patient is anesthetized and the nurse is handing you the scalpel.

Whether the performance takes place in a courtroom, a classroom, or a boardroom, and whether it involves a presentation, a negotiation, a sales pitch, or a job interview, we have just a few moments to collect our thoughts and prepare our minds. There’s no room for more practice. We need quick-hit tactics and life hacks. In fact, there’s a growing body of research on how best to spend those crucial moments. But most of us ignore these techniques and just jump in.

In my new book, Psyched Up, I argue that the practice of getting mentally prepared before make-or-break events shouldn’t be limited to professional athletes. As the nature of work has changed, many professionals’ success or failure is now less dependent on repetitive daily tasks and instead based on a thin slice of evaluative moments. Working on projects involves more crucial first impressions, followed by more final presentations. The “gigs” and “side hustles” of modern life require people to interview for jobs or sell their services more frequently. Think of it as the “Shark Tank economy,” in which we have more riding on the ability to deliver a pitch under pressure.

Back in the operating room, it’s nearing lunchtime as Mark McLaughlin finishes tying a long series of internal stitches and hands the surgical needle to his assistant, who will finish closing. He heads back to the locker room, changes into khakis and a polo shirt, and walks to the waiting area. “Everything went really well,” he tells the patient’s wife, adding the odds look very good that he’ll walk without pain.

Another surgeon—one who was tweeting or joking around before picking up the scalpel—may well have obtained a similar outcome. But if it was your loved one on the table, wouldn’t it be reassuring to know that in the final moments before the doctor performed, he was doing everything he could to increase the odds?

So as you think about advancing your career, try to emulate Mark McLaughlin. Come up with your own pre-performance routine—one that will help you deal with the flood of adrenaline, increase focus, boost confidence, and otherwise optimize our emotions before taking the stage.

That routine may include a special song or playlist. It might consist of visualizing your Greatest Hits, drawing on techniques taught to cadets and athletes at West Point. It may involve superstitious rituals, which have been proven to increase effectiveness in a variety of settings. The routine may involve special techniques to reduce anxiety, such as those taught to musicians at Juilliard to increase their odds of success during high-stakes auditions.

Even if no life hangs in the balance during your workday, it’s worth investing the time to create your own pre-performance routine—one that puts you in the right state of mind to boost your chance of success.

 Daniel McGinn is a senior editor at Harvard Business Review and the author of Psyched Up: How the Science of Mental Preparation Can Help You Succeed (Portfolio, 2017), from which this article is adapted.

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