How to stay calm when you know you'll be stressed

It was a cold winter night in Montreal, a few years back. The thermometer on the front porch displaying a chilling -40 degrees, the point at which Fahrenheit and Celsius chillingly unite. I had just returned from a friend's house and was fumbling for my house keys only to realize they were not in my pocket. Despair began to take over as I could see through the frosty window, the keys lying untouched on my dining table.

Every door and window of my house was securely locked. The thought of calling a locksmith crossed my mind, but considering the hour and the freezing temperature, it seemed a distant hope. A night at my friend Jeff's house was out of the question as an early morning flight to Europe awaited me, for which I needed my luggage and passport.

In desperation and freezing cold, I shattered my basement window with a large rock and crawled through, sealing the opening with a piece of cardboard. Though an expensive solution, it seemed more feasible than summoning a locksmith at that hour. I figured it was a tie.

As a neuroscientist, I understand how the brain functions under stress. It releases cortisol that escalates heart rate, modulates adrenaline levels, and clouds your thinking. The next morning was ridden with stress and fatigue, snowy thoughts about the broken window, the pending call to the contractor, the chilling weather, and the looming European meetings. I was under a fog of cortisol-induced clouded thinking, barring me from realizing my own fuzzy state of mind.

It wasn't until I stood at the airport check-in counter when it dawned on me - I did not have my passport. A frantic drive back home through the sleet and ice allowed me to grab my passport, and I rushed back to the airport. Despite making it just in time, my seat had been given away to another traveler. Consequently, I was stuck next to the bathrooms in a non-reclining seat for a grueling eight-hour flight. The lack of sleep and ample time led me to ponder if there were strategies or systems I could implement to prevent such mishaps or at least mitigate the extent of catastrophe.

It was a month later, in a dinner conversation with my colleague, Nobel laureate Danny Kahneman, when my thoughts crystallized. I shared my forgetful escapade of breaking my window and leaving my passport behind. He introduced the concept of "prospective hindsight" or "pre-mortem", a term he learned from psychologist Gary Klein.

Akin to a postmortem where experts analyze a disaster to understand what went wrong, a pre-mortem is a process where you envisage the potential pitfalls and strategize to avoid them or minimize the damage. Today, I wish to share some concepts and techniques we can employ as a pre-mortem.

A simple and obvious strategy is to designate a place for items that are frequently misplaced. Drawing from the functioning of our spatial memory and the hippocampus structure in our brain, establishing a spot for your keys, passport, and reading glasses can save you from unnecessary stress and wasted time.

When it comes to travel, snapping a picture of your documents like credit cards, driver's license, and passport, and storing them in the cloud could save the day if they ever get misplaced or stolen. It is important to remember that in stressful situations, our brain releases cortisol which clouds our thinking. Practicing a pre-mortem can prepare us for these situations and help us make better-informed decisions.

Consider a scenario where you are faced with a critical medical decision. At some point, we all will be in a situation where we have to make critical decisions about our or our loved one's medical care. Let's take an example of high cholesterol. You might readily agree to take statins, a widely prescribed drug for cholesterol. However, have you ever wondered about the "Number Needed to Treat (NNT)" or asked about the potential side effects?

The NNT for the most widely prescribed statin is 300, i.e., 300 people need to take the drug for a year to prevent one heart attack. The side effects occur in 5% of the patients, which means you are 15 times more likely to be harmed than to benefit from the drug. Of course, whether to take the statin or not is a personal decision, but these conversations are essential with your doctor.

A pre-mortem helps you prepare for potential catastrophes and puts you in a better position to respond effectively when stress confronts you. It's about recognizing our flaws and potential areas of failure, and putting systems in place to minimize damage and prevent incidents.

Returning to my Montreal story, upon my return, I had a combination lock installed next to the door, holding a key to the front door, a simple yet effective solution to prevent a repeat of that cold, stressful night. I admit I am far from perfectly organized, but I see organization as a gradual process, and I am getting there.