The Art of Manliness - How to Achieve Cognitive Dominance

00:00:00.000 I'm Brett McKay here, and welcome to another edition of the Art of Manliness podcast.

00:00:10.740 Now, when it comes to high-stakes endeavors, few are as fraught as brain surgery.

00:00:14.280 One false move, and you can forever alter someone's life.

00:00:17.100 That's why my guest has spent his life studying how to master fear and enhance performance

00:00:20.400 and gain insights that can help anyone do likewise in every area of their life.

00:00:24.200 His name is Dr. Mark McLaughlin, and he's a wrestling coach, a lecturer at West Point,

00:00:27.400 and a practicing neurosurgeon, as well as the author of Cognitive Dominance,

00:00:30.900 A Brain Surgeon's Quest to Out-Think Fear.

00:00:33.020 Today on the show, Mark and I discuss how fear manifests itself in a range from mild discomfort

00:00:37.180 to full-blown paralysis, and how you can get a handle on it by developing cognitive dominance.

00:00:41.360 Mark then unpacks what cognitive dominance is, and how it involves being able to overcome

00:00:44.760 our visceral reaction to unexpected events, and respond to elements outside our control

00:00:48.760 with poise and composure.

00:00:50.360 We then talk about how to gain that kind of composure by breaking things down into objects,

00:00:54.060 which are things that exist independently of us with features everyone can agree on,

00:00:58.060 and subjects, things that are specific to you and encompass the sphere within which

00:01:02.060 you can personally act.

00:01:03.440 Mark walks us through how the objective and subjective can form an X and Y axis, and how

00:01:07.340 you can map the things that happen to you into the four quadrants they form in order to figure

00:01:10.660 out how to respond.

00:01:11.960 We enter a conversation with how to deal with the known unknowns in life by making a two-column

00:01:15.980 list of who you do and don't want to be and focusing on the former.

00:01:19.800 After the show's over, check out our show notes at aom.is slash cognitive dominance.

00:01:24.060 All right, Dr. Mark McLaughlin, welcome to the show.

00:01:37.220 It's my pleasure to be here.

00:01:38.540 Thanks, Brett.

00:01:39.200 So you are a neurosurgeon, a brain surgeon, and you're also an author.

00:01:42.620 You wrote a book called Cognitive Dominance, and in this book, you explore extreme fear

00:01:48.020 and how to overcome it.

00:01:49.200 So how did a neurosurgeon end up exploring the topic of extreme fear?

00:01:54.060 Well, I think we all have episodes in our life of extreme fear, and I guess each of us perceive

00:02:02.460 it and experience it in a different way.

00:02:05.080 For me, I think it came as I was a young neurosurgeon because I care a lot about my patients, and that's

00:02:17.320 something that's very hard to balance because in order to be a good doctor and a good surgeon, you have to be objective, and you can't lose your objectivity,

00:02:27.960 certainly when you're in the operating room and you're in dangerous situations.

00:02:32.020 And so it's a very hard thing to balance.

00:02:36.620 I think, you know, obviously caring a lot makes a great doctor, but it can also get in the way of you making important decisions and, you know, dealing with emergency situations.

00:02:48.360 So for me, that's kind of where it started.

00:02:52.060 I kept struggling with how can I really, really care about this person and yet dispassionately make the decisions that I need to make as things unfold and particularly when things might potentially go wrong.

00:03:06.160 And that's really when I started thinking a lot about fear and how I could put it in its appropriate place because you need a certain amount of it to perform, but too much is paralyzing and too little doesn't get you to rise to the occasion.

00:03:24.020 Well, yeah, you call this paralyzing, like thinking about being freaked out.

00:03:28.280 You call it the fear of freak out, and you kind of break down what are the elements of the fear of freak out.

00:03:33.000 But for you, what are those elements when you, you know, you're about to do a surgery that's a real big deal.

00:03:38.860 For you, it was doing surgery on kids.

00:03:40.820 That's the thing that kind of sort of triggered it.

00:03:42.860 So what are those elements of the fear of freak out?

00:03:45.980 So if you are experiencing or you're practicing avoidance behaviors, escapism behaviors, if you're engaging in poor coping strategies, if you're reverting to your lesser self, then you are in the fear freak out.

00:04:02.580 That's when, you know, it's some form of the fight or flight response.

00:04:07.680 So it's important for you to be able to identify that in your own, in anyone's behaviors.

00:04:12.000 For me, it was, why do I keep trying to not think about this problem or put it off or, you know, distract myself from thinking about the problem that's really bothering me?

00:04:22.340 Because once I start really putting my efforts towards what's bothering me and I think it through, my anxiety level goes down.

00:04:30.420 So that's the, that's the thing you need to focus on before you get to the fear of freak out.

00:04:35.560 The fear of freak out is obviously the extreme case when you literally, you just decompensate, you know, instead of, you know, making the phone call to your sick brother who just got a bad diagnosis, you avoid it.

00:04:49.060 You do something else.

00:04:50.840 You don't do what needs to get done.

00:04:52.900 So that's, that's the fear of freak out experience that we all have in certain ways for me, you know, and one of my surgeries that I talk about in the book was a, was a young girl that had profuse bleeding.

00:05:05.640 And my initial reaction was to move and pull the endoscope away from the bleeding, which is the exact worst thing you could do.

00:05:14.900 You need to keep the endoscope focused on the bleeding so that the blood can come out through the endoscope tube and not press on the brain.

00:05:21.980 So it's, it's really identifying your, your fight or flight response and then putting a governor on it and really thinking it through.

00:05:31.200 In this governor, you call it the, you call it cognitive dominance.

00:05:33.840 When did you first hear about this idea of cognitive dominance?

00:05:36.440 And we'll get into it a little bit more in our conversation, but big picture, what are the elements of cognitive dominance?

00:05:42.160 Yeah, I first heard cognitive dominance when I was giving some talks up at West Point for a class in human performance at the Center for Enhanced Performance, which is headed up by Dr. Nate Zinser.

00:05:54.300 And I was asked to speak to the cadets and I go there annually and we talk about, you know, what are the key performance indicators that help us in performing at our best and what impedes our performance.

00:06:07.920 And as I was telling some of my stories, one of the cadets stood up and said, you know, that sounds a lot like cognitive dominance.

00:06:16.080 I, I had never heard the term before and he defined it for me and he said, it's enhanced situational awareness that facilitates rapid and accurate decision-making under stressful conditions with limited decision-making time.

00:06:30.780 And to them, it was a military term and it's defined as such, but I thought to myself, wow, that's more than just a military thinking, that's medicine.

00:06:43.400 And it's also like being a parent and being a husband and living a life and making decisions when you have limited amounts of time and they're important decisions and you need to chart your course in life.

00:06:54.300 So I thought, wow, that's, I need to know more about this.

00:06:58.580 How do I get this cognitive dominance thing and, and, you know, what keeps me from being cognitively dominant?

00:07:05.380 And that's when I sort of began my search.

00:07:07.800 I had been studying human performance for years, but this really crystallized my thoughts and it helped me start shaping the narrative of my book.

00:07:17.740 And a big part of gaining cognitive dominance is understanding fear and our response to fear.

00:07:24.600 And you spend a lot of time in the book going through this and you get into details with it, but like big picture, like what, what is fear?

00:07:31.840 Like when you ask people, how do you define fear?

00:07:34.120 What sorts of answers do you get?

00:07:35.620 And then how do you define it?

00:07:37.760 Let me just take a step back and, you know, a big picture on cognitive dominance first, before we go to fear.

00:07:43.400 And that is because it's intimately related and really cognitive dominance boiled down is it's poise.

00:07:52.600 It's, it's keeping your cool.

00:07:54.540 It's what Rudyard Kipling wrote in the poem, if, you know, meeting triumph and disaster and treating those two imposters just the same.

00:08:04.300 So it's, it's on the big picture, it's really training your mind and your body to react in the way that it was best trained to react over time to the elements, you know, outside of our control.

00:08:21.840 So that leads me more into the fear side of things.

00:08:24.780 So fear is what we experience when something unexpected comes our way.

00:08:30.560 You know, we're all living in the world, we're doing our things, we're trying to achieve the goals that we, that we have set out to, to achieve.

00:08:38.440 And we're, we're sort of, we have like sort of a map of where we want to go.

00:08:42.420 And we begin to experience fear when something doesn't go right on our path from where we are to where we think we should be.

00:08:50.760 And that's when this, this unexpected event comes in and we begin to experience fear and it can be identified as anything from mild anxiety or discomfort or a little uneasiness to, you know, full blown mortification or paralysis of what to do, depending on the level of the unexpected event.

00:09:13.920 And so fear comes in a variety of shades, but it's all really the same mechanism and it's the same apparatus in your brain that's receiving it.

00:09:25.340 Well, you make one big distinction.

00:09:26.880 There's internally dominant fear and externally dominant fear.

00:09:30.340 What's the difference between the two?

00:09:32.180 Internally dominant fear are the demons that we, we conjure up in our own mind.

00:09:38.160 You know, I love the story about, you know, caveman walks into cave and draws a picture of a tiger and looks at the picture and scares himself and runs out of the cave, you know? 0.99

00:09:49.180 And it's one of those, wow, the guy's a fool, isn't he? 0.85

00:09:53.020 But isn't that what we all do in our minds every day when we start thinking up terrible things that might happen or bad events that, you know, could potentially occur? 0.97

00:10:02.800 So that's like an internally dominant fear state that we have to be careful of.

00:10:07.420 And then externally dominant fear states are, you know, are real threats to us, whether that's a threat to our job, you know, when a new person comes in and maybe it's been given the title that you have.

00:10:19.860 And now you're looking at a potential, you know, competitor.

00:10:24.000 It's an externally, you know, physical threat that you might have when you're walking down the street and you notice that somebody's following you.

00:10:30.360 So that's important to distinguish these types of threats because they trigger different strengths of fear in our brain.

00:10:40.060 And then related to this, you know, idea of externally and internally dominated fear is you make the case that in order to figure out what it is you're dealing with, what's this unexpected thing you're dealing with, is to make a distinction between object and subject.

00:10:53.300 So this is where you get philosophical and you, I think you, I think you majored in philosophy before you became a neurosurgeon.

00:11:00.020 So why, why is the distinction between object and subject important in trying to figure out, suss out our fear?

00:11:06.080 Sure. So I learned this from Jordan Peterson, who, you know, I was very influenced by his book, Maps of Meaning, and also his subsequent books.

00:11:16.360 And one of the things I learned from his, his teachings is that he talks about there's being two ways to look at the world, look at the world as a place of objects and look at the world as a place to act.

00:11:28.840 And when we live in a place to act, that's something that's laid out in stories, we are encoded to devour and to digest stories at all times in our life, even when we were little kids, all the way till now.

00:11:44.320 That's how we remember things is through stories and stories are sort of a, they're like a mini map of the world and they teach us, you know, ways to act in this world.

00:11:54.400 And so as I began to try to analyze and break down fear into its molecules, into its really molecular components, I thought that's the first thing we need to split fear into what's the objective part of it and what's the subjective part of it.

00:12:12.680 So the objective part is, you know, what are the specific identifiable features that everyone can agree on, whether that's, you know, there's, you know, a tiger that's gotten loose at the zoo.

00:12:25.400 And that's a physical objective threat that everyone is in danger for, as opposed to a subjective threat, which is, let's say, you know, somebody broke out a peanut butter sandwich in the cafeteria and you happen to be, have a peanut allergy.

00:12:42.520 Okay.

00:12:42.740 That's something that's, that's specific for you.

00:12:46.160 That's something that is related to you.

00:12:48.580 Peanut butter is something that's dangerous to you, but it's not dangerous to other people.

00:12:52.700 So once we understand what's an objective threat and what's a subjective threat, we can begin to sort of start thinking about how to act when we're faced with something that induces fear.

00:13:04.640 And you face this all the time with your work as a neurosurgeon.

00:13:08.020 You actually walk through, there's moments where you, you experience fear and you kind of do this quickly in your head.

00:13:13.880 It's like, okay, what's the story that I'm telling myself?

00:13:16.600 Like, what do I think is happening?

00:13:17.900 That's that subjective part.

00:13:19.080 But then you have to, you actually start talking to people around you and say, are you seeing what I'm seeing?

00:13:25.080 Are you, are you all seeing this?

00:13:26.400 You're trying to figure out, is this thing real that's happening or is this just a part of, am I just making this up in my head?

00:13:33.400 That's exactly right.

00:13:34.460 And that's part of the I-Rise concept that I talk about in the book.

00:13:37.860 So the I-Rise concept is a, a way to bring a higher resolution to an unexpected event.

00:13:45.420 And it's not something, not something I use for everything, but it's something, it's one technique that I use.

00:13:50.860 And what it is, is it's just an acronym for I being identify, really see what you're seeing and define its characteristics.

00:14:00.740 And then it rejects your initial.

00:14:02.720 So the second letter is R, reject your initial impulse, which is usually some type of self-preservation impulse.

00:14:10.040 That's your, what I talk about in the book is brain 1.0, your, your fear guardian, your fear detector.

00:14:17.500 And then the third letter is inventory.

00:14:20.740 So it's I-R-I, inventory, which is basically look around, talk to people.

00:14:25.760 Has anybody else experienced this?

00:14:27.880 Get as many perspectives as possible because that's going to help you solve the problem.

00:14:33.880 And then stabilize, which is the S in I-Rise.

00:14:38.200 And that's act, you know, try and buy some time, act with the lowest possible cost.

00:14:44.100 In medicine, we'd say that first do no harm.

00:14:46.300 So that means like, think about it, stabilize, buy some time if you can, think about it overnight, if it's possible, if it's not an emergency.

00:14:54.940 And then lastly, reevaluate and really try to think laterally, try and come up with alternative solutions to the problem.

00:15:02.740 So that's, you know, one technique that, that I use to kind of deal with an unexpected event.

00:15:08.520 Well, going back, you mentioned this, this idea of brain 1.0, brain 2.0.

00:15:13.340 I want to explore this idea of fear more.

00:15:15.060 It helped, because I think it was really useful for me to, because it helps you, it's sort of a metacognition.

00:15:20.460 It helps you understand what's going on in your brain so you can start manipulating what you're thinking about.

00:15:24.500 And you talk about how, what goes on in our brain when we experience fear.

00:15:29.320 And you make this very simplified version of what's going on.

00:15:33.160 And I guess it's first you said there's a, there's a brain 1.0 and there's a brain 2.0 that this unexpected event gets filtered through.

00:15:40.680 So walk us through that process.

00:15:41.920 So we, we're going through life and we encounter this unexpected event.

00:15:46.520 What's going on?

00:15:47.880 How do we react to that in our brain?

00:15:49.920 Sure.

00:15:50.720 So I took a page out of Daniel Kahneman's book, Thinking Fast and Slow.

00:15:55.800 I think that's a fascinating book.

00:15:58.200 And, you know, he talks about how we make quick decisions with one system, system 1.0.

00:16:03.560 And then we, we make more iterative, careful, and deliberate decisions with a system 2.0.

00:16:09.860 And I think that's a really great model to think about how fear lands in our brain as well.

00:16:15.580 Brain 1.0 is the more primitive part of our brain, the amygdalo-hippocampal area, the medial temporal region of your brain, which has been ingrained to, you know, recognize snakes and to recognize danger and, you know, height and being near the edge of a cliff.

00:16:33.420 Like, you know, even infants have a fear of heights.

00:16:36.500 So that's the ingrained, encoded system that's helped us survive for thousands and thousands of years.

00:16:42.900 And it works great for imminent bodily threats, external forces that can harm us, but it doesn't function well in the operating room.

00:16:51.880 It doesn't function well in the boardroom or when you're, you know, in a family crisis.

00:16:58.140 So the brain 2.0 is the frontal lobes, the prefrontal lobes, the lobes of your brain that are thinking about future actions and consequences of your actions.

00:17:07.720 And how can this fit in a bigger picture?

00:17:11.240 So one layer of thinking about this is that there's this brain 1.0, which is the guardian, that's going to warn you of bodily threats.

00:17:17.980 But you need to watch out because it can overly turn on your reaction to something that's going to be detrimental.

00:17:25.040 And you need brain 2.0 to think through that and be more iterative and deliberate.

00:17:29.600 And then the other way to think about it also, and I talk about this in the book, is, you know, we have two hemispheres and there's a reason for that.

00:17:37.900 You know, generally, the left hemisphere is more logical and language and mathematical-based.

00:17:45.100 And the right hemisphere is more story-based.

00:17:48.220 It's more big picture.

00:17:49.660 It picks up facial expressions better.

00:17:52.660 It can understand the physicality of an event that your left brain doesn't pick up.

00:17:59.440 And we need to sort of toggle between those two hemispheres as well.

00:18:04.320 Take in the immediate right hemispheric big picture, but also utilize your left hemisphere to be logical.

00:18:11.500 And that's really what leads me into graphing unexpected events.

00:18:16.240 So, what I talk about is, you know, we can take an unexpected event and we can literally break it down into its components on an X and a Y axis.

00:18:26.880 And that's a really helpful, it's been a really helpful method for me to really dissect and come up with solutions to complex problems.

00:18:36.220 So, basically, you draw an X and a Y axis.

00:18:39.400 And the X axis is kind of like your left brain.

00:18:42.820 It's also the objective part of your brain.

00:18:46.240 So, that's the, you know, how we deal with the world as a place of objects, the X axis.

00:18:52.120 And the Y axis, that's more your right brain.

00:18:55.520 That's more of how to act in the world.

00:18:59.000 So, that's the subjective component of your world.

00:19:02.740 And if you can think about the world and these unexpected events in those two axes,

00:19:08.440 you can literally plot an event out and it can put you into a quadrant, which will help you know where you're at and how you need to proceed.

00:19:17.740 Okay, I want to get into these quadrants.

00:19:20.020 But before, I just want to recap.

00:19:21.280 So, brain 1.0 is that initial response that we have to an unexpected event.

00:19:27.220 And usually, that's the fight or flight response.

00:19:29.960 Correct.

00:19:30.240 And then, brain 2.0 needs to come in and kind of step in and say, well, do you really need to do what that initial response you want to do?

00:19:39.720 So, I guess, going back to that example you talked about, you had that surgery on that girl.

00:19:44.100 She had a lot of bleeding in her brain.

00:19:46.360 You had a brain 1.0 response was, I got to pull this thing out because I got to protect myself.

00:19:51.920 I want this to stop.

00:19:54.420 Brain 2.0, I guess it was actually a mentor, said, no, don't do that because that's going to make things even worse.

00:20:00.380 I didn't have my brain 2.0 at that point in my training.

00:20:03.740 That's what mentors and teachers help us with.

00:20:07.200 And that's exactly right.

00:20:08.700 He said, don't move an inch, Mark.

00:20:11.640 Stay exactly where you are because as long as that blood is coming through this endoscope and out her head,

00:20:18.160 nothing is going to be damaged.

00:20:19.860 And all we need to do is keep transfusing her.

00:20:22.560 If you take that scope out of her head, the blood's going to build up and press on her brainstem and she's going to die very quickly. 0.54

00:20:30.700 We're going to take a quick break for your words from our sponsors.

00:20:35.320 And now back to the show.

00:20:36.820 And I guess one challenge of modern life is our brain 1.0 responds to, we'll call them subjective or internally dominant fears,

00:20:47.420 the same way as it would to externally dominant fears.

00:20:50.920 So it's like our brain responds to the fear of social status defeat because someone didn't, I don't know, like something on Instagram,

00:20:59.200 the same way it would respond to seeing a snake.

00:21:03.300 Is that, would that be correct?

00:21:04.680 I'm really glad you mentioned that because this is a, this is a really important and, and timely, you know, feature to think about.

00:21:13.440 And that's exactly correct.

00:21:15.140 And that's really where, you know, we all are subject to that.

00:21:19.400 No matter how many times I try to adopt the stoic philosophy of just focusing on myself, my character and my virtue, you know,

00:21:28.260 a nasty email comes across or a patient complaint comes in and, and I'm, I'm hurt by it or I'm, I'm upset by it.

00:21:34.440 And I have to, you know, reach back into my mind and, and, and talk, talk to myself out of that and say, listen, you know what, did you do your best?

00:21:43.680 Yes, I did my best.

00:21:44.660 Did everything work out the way it was supposed to?

00:21:46.660 No, sometimes you can do everything right and some things still go wrong.

00:21:52.040 And that's the job you chose now own it.

00:21:56.920 And similarly, I think that, as you say, this social rejection with, you know, not getting likes on your social media or being ghosted or all the terrible things that are happening on social media is we need to, you know, train brain 2.0 to become stronger, to provide the input, to suppress that brain 1.0.

00:22:18.640 Oh my gosh, I'm a failure.

00:22:20.600 Oh my gosh, none of my patients like me.

00:22:23.240 Oh my gosh, you know, I'm a social outcast.

00:22:26.920 So it's, it's, it's the first step is recognizing it, not knowing about that inner critic that's going to come out and, and then figuring out a way to gradually train.

00:22:37.400 You can, you can literally rewire your brain by thinking different thoughts, by reading different philosophies.

00:22:44.780 I'm a big fan of the stoic philosophy and, you know, I'm, I'm a Ryan holiday fan.

00:22:50.360 I read the daily stoic every day.

00:22:51.880 And I think it's a, it's a great way to train your mind to be not reactive, to be more thoughtful, to be more focused on what you can control, what's within your sphere of control.

00:23:05.300 So I'm glad you brought that up.

00:23:07.720 Okay.

00:23:08.200 So brain 1.0 feels this fear.

00:23:10.320 Brain 2.0 needs to come in and say, okay, wait a minute.

00:23:12.780 That initial response you have, probably not the right one.

00:23:16.540 And so the next phase that you recommend doing is again, putting, you know, sort of mapping this experience, this unexpected event in one of these four quadrants that we've just talked about, this X, Y axis.

00:23:28.080 So what are these four quadrants?

00:23:31.100 I mean, what are the, what are their characteristics?

00:23:33.040 And yeah, walk us through that.

00:23:35.340 Sure.

00:23:35.980 So if you draw the X axis and call that objective and draw the Y axis and call that subjective, you can, let's, let's take an event.

00:23:46.700 Let's say I'm in the operating room like I was the other day and everything's clicking.

00:23:53.100 You know, it's just, you know, timing has been good.

00:23:57.500 The anatomy looks really clear.

00:23:59.880 I have a super great pathway to where I need to go.

00:24:04.040 Everything that I reviewed on the MRI scan is exactly what I'm seeing.

00:24:07.720 I'm able to move the blood vessel away from the nerve that's causing the pain.

00:24:13.480 And I know that that motion is going to relieve this patient's pain and everything just clicks perfectly.

00:24:21.080 And we close and I'm just in, you know, on a runner's high basically.

00:24:25.000 And we all know that quadrant that's, that's the flow quadrant.

00:24:28.340 That's when things objectively are going well.

00:24:31.420 That means everything that you planned is happening, is happening in a logical fashion.

00:24:36.040 And subjectively I'm fulfilling my life mission to be the best doctor I can be.

00:24:42.540 So that's a positive on the objective and a positive on the subjective that puts me in the upper right hand quadrant, which I call flow.

00:24:51.680 And we've all experienced it in many different ways.

00:24:55.900 And that's when, you know, the world is in sync and it just feels wonderful.

00:25:01.360 Then sometimes we have something that's objectively positive that happens in our lives, but subjectively it turns out to be something negative.

00:25:11.060 Like you get a job promotion and so you got, you know, a raise and you've got more status, but then you find out your boss is toxic and it's going to be a miserable experience in this new position.

00:25:25.700 So that's when something objectively is positive, right?

00:25:28.560 You got a raise, you have a higher status, but subjectively, you know, having a peaceful day at work and achieving what you set your life goal to be doing at work is going to be impeded by this toxic boss.

00:25:40.380 That's subjectively negative.

00:25:42.500 So that's going to put you in the lower right-hand quadrant, the quadrant, which I call the calm before the storm.

00:25:48.700 That means you're going along and you're doing what you're doing, but you know, something bad is probably going to happen, or you're going to need to change to get out of that uncomfortable state.

00:26:00.280 Then sometimes we deal with something that's an unexpected event.

00:26:04.160 That's not only objectively negative, but it's also subjectively negative.

00:26:08.920 So that's terrible experiences that we have.

00:26:12.200 That's when a young patient that I operated on passes away, or I see a trauma that comes to the hospital and I do everything I can to save them and they die.

00:26:23.900 I've got to go out and I've got to go talk to this family and tell them what just happened.

00:26:29.180 It's a terrible, terrible experience for the family.

00:26:33.260 It's a sad experience for me.

00:26:35.020 And it's unpleasant in every way, shape, or form.

00:26:39.300 It's going to hurt.

00:26:41.240 Yet, you know, I know that that's something that I have to do and I'm going to go out and I'm going to do the very best job I can in telling them what happened and how it happened.

00:26:51.880 And knowing that that conversation I have with that family is going to be something that they remember for the rest of their lives.

00:26:58.220 So it's got to be done perfectly.

00:27:00.220 And there's sometimes there's no way out of the all, all is lost quadrant.

00:27:05.620 That's the lower left-hand quadrant, but usually over time, you can climb your way out of it.

00:27:12.040 And that will lead you to the upper left-hand quadrant, which is the birthing a new skill set quadrant or the resiliency quadrant.

00:27:19.780 And that's where something, an unexpected event occurs in our lives that's negative.

00:27:24.880 Yet, subjectively, it turns out to be something positive, like you lose your job, but then you get a chance to write the book you always wanted to write.

00:27:34.900 Something like J.K. Rowling had an opportunity to do when she was unemployed and trying to figure out what she wanted to do with her life.

00:27:42.360 She began writing Harry Potter.

00:27:44.000 So these are things that we all experience as well.

00:27:47.800 And we say, yeah, that was not fun, but it turned out to be the best experience I ever had in my life.

00:27:54.400 And those are the four quadrants.

00:27:56.420 And what I talk about in the book is that if you have this unexpected event and you have this uneasiness and you're experiencing fear,

00:28:03.420 if you can map it out to whatever quadrant you're in, then you can figure out what you need to do next.

00:28:09.600 And the moment you figure out what you need to do next, your anxiety goes down, your fear goes down, and you begin performing better.

00:28:18.660 Okay, so are there different responses that you should take, general responses you take, depending on what quadrant you're in?

00:28:25.320 I guess if you're in that flow quadrant, it's just like, man, just go with the flow.

00:28:28.300 Like, don't disrupt that.

00:28:30.160 Just go with it.

00:28:31.400 But let's say you're in that bottom right quadrant.

00:28:34.120 I guess it's objectively good, subjectively not good.

00:28:37.860 Like, what should be your response be in that situation?

00:28:42.300 Exactly.

00:28:43.000 When you're in flow, don't ask any questions, you know?

00:28:46.040 Don't try and break that down.

00:28:48.440 Just go with it and enjoy it.

00:28:50.360 And what I say about both of the quadrants in the lower half, in the negative why,

00:28:56.540 is that sometimes you have to adjust and endure it for a period of time, and you have to wait it out.

00:29:03.740 But usually, the first step that you can do is to what I say is climb the y-axis. 0.85

00:29:11.340 Because if you're moving on your map from where you are to where you should be,

00:29:18.060 and for me, that's being a better doctor, being a more compassionate doctor, being the best surgeon I can be.

00:29:26.240 That's the thing I need to do next.

00:29:28.040 That's the smallest little step that I can do to move up that y-axis is what's going to bring me out of the negativity zone.

00:29:38.080 So, like I said, in the all is lost, that's going to be, okay, this is a terrible situation.

00:29:43.440 There's nothing good that can come of this.

00:29:45.740 It's, okay, I'm going to be the very best, most compassionate, most patient physician that delivers devastating news to a family.

00:29:55.720 And that's something I can do really well.

00:29:57.940 And that's climbing up the y-axis.

00:30:00.400 In the case of a toxic boss, it might be, all right, I'm not going to burn the ships right now, but I better get my CV in order,

00:30:09.120 and I better start putting some feelers out to have some options, because this is not going to be a good long-term solution for me.

00:30:16.460 The second you start making that movement up the y-axis, you're going to feel better, and it's going to be, it's sort of like a positive feedback loop.

00:30:26.020 You're going to start moving more and more back up into the birthing and new skill set and resilience quadrant and into the flow.

00:30:33.460 And, you know, you can't always live in flow.

00:30:36.100 Life would be boring.

00:30:38.080 It would be, you'd be unhappy.

00:30:40.360 It's important that we experience all of these quadrants.

00:30:43.800 It's part of the hero's journey, and that's how we get to a new level, and we keep getting better and better.

00:30:49.640 A lot of times, it's this clockwise fashion.

00:30:53.120 We move from flow to calm before the storm to all is lost to birthing a new skill set.

00:30:58.520 Sometimes it's a lateral jump from one to another, but that's the process of life and getting better.

00:31:06.520 Yeah, I thought it was interesting how you mapped on the hero's quest through these different quadrants.

00:31:10.180 I thought that was a really incisive insight.

00:31:12.940 Yeah, recognizing that is really important.

00:31:16.240 So, you know, I tell the book centers around, and you know this, the centers around a story about a young boy, Anthony, who I operated on when he was eight years old.

00:31:27.920 And although the surgery went perfectly, Anthony suffered many, many complications and side effects of his surgery and his treatments and of his disease.

00:31:40.460 And, you know, even though initially I was in flow, his surgery went perfectly.

00:31:45.740 I'm so, I was so happy about it.

00:31:47.300 I was thrilled.

00:31:47.940 I'm like, man, I love being a neurosurgeon.

00:31:50.540 Then he started not doing well, and I started, you know, wondering why does he having this complication and that complication?

00:31:57.460 And I was sort of in the calm before the storm.

00:31:59.980 I was kind of like, wow, I'm here.

00:32:01.460 I am.

00:32:01.700 I'm a young neurosurgeon.

00:32:02.820 I trained my whole life for this eight years in residency, four years in medical school.

00:32:07.740 And I didn't expect to feel like this.

00:32:09.940 I feel bad.

00:32:10.940 I feel like, gosh, maybe I could have done something more for him.

00:32:14.320 Maybe I could have, you know, did a better operation or picked up his complications earlier.

00:32:20.040 And I didn't, I don't want to feel like this.

00:32:23.180 This is uncomfortable.

00:32:24.280 And then I fell from the calm before the storm all the way to the all is lost quadrant.

00:32:29.240 I basically said, you know what?

00:32:31.180 You can't handle operating on kids.

00:32:33.340 You know, this is too much for you.

00:32:34.820 And something you did, maybe you didn't do as good of an operation as you could have.

00:32:40.040 And that's why Anthony is not doing well.

00:32:43.300 And I lived in that all is lost quadrant for a long time, for 15 years.

00:32:48.860 I had told myself a story that Anthony was not doing well, and it was my fault in some

00:32:55.020 way, shape, or form.

00:32:56.740 And it wasn't until I started writing this book and I reconnected with Anthony and found

00:33:01.740 out that he was alive and still doing well and with his family that I realized, oh my

00:33:07.660 gosh, like it was a blessing to take care of Anthony, even though you ran away from it

00:33:12.740 and you stopped doing pediatric neurosurgery and you kind of put him in a place in your

00:33:19.400 life that said that was a failure.

00:33:21.580 You didn't fail.

00:33:22.760 You actually helped him and kept him part of his family and kept his family intact.

00:33:26.740 And so I, you know, after 16 years, I went, I rose out of the all is lost and moved into

00:33:32.300 the birthing a new skill set.

00:33:34.100 And then it ultimately just flipped me into realizing, wow, what a blessing I have to be

00:33:40.640 a neurosurgeon and, and to have taken care of Anthony and just that revelation and talking

00:33:46.440 to my editor who said, you know, Mark, you're holding yourself to an impossible standard.

00:33:50.740 And I had never really thought of it that way, kicked me back into flow, kicked me into

00:33:56.000 like, oh my gosh, this is such a great privilege.

00:33:58.840 I love what I'm doing and I get to care for people.

00:34:01.580 What a special, what a special job I have.

00:34:05.020 And I imagine that this is, it's hard to do like label what's going on when you're in

00:34:09.600 the moment of feeling uncertainty or uncertain.

00:34:13.040 So how do you, how do you train your brain 2.0 to override brain 1.0 and be like, let's,

00:34:20.000 let's, let's, let's map this thing out.

00:34:21.760 How do you do that?

00:34:22.480 Well, it's, it comes with experience and, and failure and learning from your failure.

00:34:29.580 So it takes time, you know, we're ingrained to react and, and cultivating brain 2.0 is

00:34:36.120 a, is a, that's a, that's an important process that it doesn't, you're not born with that.

00:34:41.260 You're born with brain 1.0.

00:34:43.640 You're not born with brain 2.0.

00:34:45.420 You you're given the apparatus to use it, but you have to train it and create a neural network

00:34:51.780 of cognitive dominance.

00:34:53.780 And you do that by thinking about it.

00:34:56.100 And so if I still have events, not exactly like my, my experience with Anthony, but I

00:35:02.080 have still have events that are like that now.

00:35:04.880 And I'm much more resilient to the event because I say to myself, Hey, this is the job you chose.

00:35:12.760 You're going to do some things.

00:35:14.180 And sometimes, even though you do everything right, something terrible is going to happen.

00:35:18.980 It's a risky business.

00:35:20.300 You took an oath, follow that oath and do the very best you can every day.

00:35:26.300 And that's all you can do.

00:35:27.860 And so, um, I think it's, it's certainly studying, studying the West Point cadets and the military

00:35:34.940 philosophy, reading a stoic literature poetry.

00:35:38.600 I always have tell the cadets that poetry is the world's first performance enhancement literature.

00:35:43.920 So by reading poetry poems, like if an Invictus, you know, do not go gentle into the night.

00:35:51.600 Those, those poems are, they're a primal words that land deep in your brain and can help you in difficult times.

00:36:03.940 So it's something you train, you train for just like going to the weight room and getting stronger before you, uh, go to wrestling practice or whatever sport you play.

00:36:12.960 You have to train your brain to do that with, uh, with reading.

00:36:17.640 And, you know, I would hope that cognitive dominance is a little bit of a, uh, a handbook for people.

00:36:23.840 Uh, it's, it's certainly just scratches the surface about the concept, but I think it's, uh, I'm very proud of it.

00:36:31.340 And I think it's the first step to, to understanding the capacity that we all have, which is really unlimited.

00:36:38.480 It's unlimited if we can really tame these demons and, and, and cope with fear in the right way.

00:36:44.960 One thing you talk, we've been talking about unknown events that pop up in our life, but then you also talk about at the very end,

00:36:51.720 sometimes we have in our life, these known unknowns and the big one that hit home close to you.

00:36:58.560 You experienced this is death.

00:36:59.840 And this happens to everybody.

00:37:00.800 We all know we're going to die.

00:37:03.520 Everyone will, but we don't really know.

00:37:06.240 Like, I think, who is it?

00:37:07.260 Someone, Henry Beecher Stowe, I think he called it the, the great mystery.

00:37:11.420 This is the great mystery.

00:37:12.780 How do you manage those known unknowns?

00:37:16.300 I think you focus on your definition of who you are.

00:37:24.860 And I think that's an important thing everybody needs to do in their life is literally put down

00:37:29.560 on a piece of paper, who you are.

00:37:33.380 What are the words that describe who you are?

00:37:37.100 Integrity, partnership, selfless, generous.

00:37:41.440 What do you stand for?

00:37:44.960 And then put that maybe on the left side of the column.

00:37:48.400 And then on the right side, put down the things that you've been in the past that maybe are part

00:37:54.720 of you, but you don't want them to be.

00:37:57.080 They're parts of you that you want to have less of.

00:38:00.180 Maybe that's being selfish.

00:38:02.660 Maybe that's being, I would say, break it into zero-sum gain.

00:38:08.100 In other words, being jealous, seeing somebody else's success and feeling like, oh, wow,

00:38:12.960 you know, that, that should be my success.

00:38:15.400 And then I put in my left column, I always put non-zero-sum gain.

00:38:19.320 That means basically anybody that does something doesn't take away from my possible potential

00:38:24.580 success.

00:38:25.220 They just inspire me to my success.

00:38:27.800 So by, by writing those sorts of things down and what you stand for, I, I think that the

00:38:37.040 way you focus on dealing with something like death or, or death of a loved one, which is

00:38:42.100 what I, how I realized this when my father was passing away was, how am I going to be during

00:38:49.480 this event?

00:38:51.020 And I just said, I got, I got to be a doctor.

00:38:56.620 I got a son, a brother, a husband.

00:39:00.160 I got to do it all.

00:39:01.780 And I got to do it the very best I can.

00:39:04.620 And I think when I, my dad was, my dad was, you know, um, close to the end, I had to administer

00:39:11.820 the morphine for him.

00:39:13.040 And that was the hardest thing I could ever do because he was a, he was an intellect and

00:39:18.440 a polymath.

00:39:19.240 And I knew that when I started giving him the morphine, his mind was going to slip away,

00:39:23.860 but I knew that, you know, he was suffering and it had to be done.

00:39:30.480 And I was the best person to do it.

00:39:32.800 So I leaned into it.

00:39:35.020 And, uh, I think that's what you got to do.

00:39:37.240 You got to lean into what you define yourself as.

00:39:41.020 And if you do that, I think you're living a good life.

00:39:44.700 Well, Mark, this has been a great conversation.

00:39:46.220 Where can people go to learn more about the book and your work?

00:39:49.140 I have a website, markmclaughlinmd.com.

00:39:52.880 There are a number of videos of my talks and YouTubes.

00:39:56.680 I also have a YouTube channel that you can pick up from the website and, uh, markmclaughlinmd

00:40:03.360 Instagram.

00:40:05.040 And obviously the book I think is a great start to be introduced to cognitive dominance.

00:40:11.040 And I'm planning a second book and that will sort of dovetail off of this concept into

00:40:16.100 some of the other concepts related, which is just in the preliminary works now.

00:40:22.220 So mainly the website would be the best way and you can get cognitive dominance on Amazon.

00:40:27.420 All right.

00:40:27.600 Well, Dr. Mark McLaughlin, thanks for your time.

00:40:29.100 It's been a pleasure.

00:40:30.500 Thank you, Brett.

00:40:31.400 It's my honor.

00:40:32.860 My guest today was Dr. Mark McLaughlin.

00:40:34.280 He's the author of the book Cognitive Dominance.

00:40:36.300 It's available on amazon.com and bookstores everywhere.

00:40:38.320 You can find more information about his work at his website, markmclaughlinmd.com.

00:40:42.260 Also check out our show notes at aom.is slash cognitive dominance, where you find links

00:40:45.740 to resources, where we delve deeper into this topic.

00:40:47.760 Well, that wraps up another edition of the AOM Podcast.

00:40:57.540 Make sure to check our website at artofmanless.com, where you find our podcast archives,

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The Art of Manliness - November 17, 2021

How to Achieve Cognitive Dominance

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