Always On: Why We Can’t Disconnect

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Stepping away from work can feel irresponsible, but is it? How the inability to truly disconnect can affect your health and productivity.

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Macie Jepson
So, Matt, we’ve been talking lately about what our summer looks like and you and your wife. It’s the summer of fun, right? You’re taking some trips. You’re getting away more than you usually do. Little short trips. Not a lot. And that. I’m kind of doing the same. Nothing. Nothing big planned. But that got us to. To start thinking about whether or not we really shut down from work when we’re doing all of these fun things, and whether or not that’s a problem. And I’m guessing you don’t truly ever shut down.

Matt Eaves
Yeah, I’m probably better than you would think. But that’s an intentional thing. And also, I have a good team around me that can support me. But I think ultimately how we got to this is one of our coworkers came back from a week-long vacation and said, I feel fortunate. I’m able to unplug and it really helps me. However, some of the people (it was a girls’ trip) she was on the trip with were at dinner, where it was beautiful resort on the ocean and they were fully immersed in their phone and email. They are writing a five-paragraph email, not looking up. What we want to talk about today is what are the effects of not unplugging and what causes that? How do we avoid it? Or what are the causes to make people do that?

Patrick Runnels, MD, MBA
I have that same experience. There’s this element of it that is so ubiquitous to turn on and just plug into something. And then you think about, okay, how does that translate to work? Some of that might be pressure, some of it might be your boss saying, I want you to be on or people are going to find you regardless. I actually think more than that, though, is no, we’re just so plugged into work. We can’t unplug. It’s how do I unplug.

Macie Jepson
And why?

Patrick Runnels, MD, MBA
And why don’t they unplug?

Macie Jepson
Yeah. Or why you should unplug. And by the way, I’m Macie and this is Matt. And we’re talking to Dr. Patrick Runnels from University Hospitals. Let’s tell the audience what you do and why you know so much about what you’re going to share with us.

Patrick Runnels, MD, MBA
Yeah, sure. I am a psychiatrist by background. I’ve been here at about 18 years now, along with being a psychiatrist and the Chief Medical Officer for the UH Health Care Transformation Institute.

So I will tell you that within my practice alone, I see people struggling. The big one for me is people have a lot of stress right now about news. And it doesn’t matter what your politics are. People have a lot of stress about news and people are more stressed. There are all these people who are paying too much attention, and there is an element of like, hey, you could pay less attention to the news.

What would that mean? Would you be less stressed? And they shake me off and say that would be terrible, I can’t imagine not paying attention to the news, which is to say there’s an internal drive. Right?

Macie Jepson
Feel like we’re wired differently today than my parents were. And we have everything we want and need right here. And I’m holding up my phone for those who can’t see and, and you know, I feel like it’s to the detriment of our well-being sometimes, especially when we talk about unwinding. And we don’t do that with work. Work is a major issue. And I feel like the more you put into work, for me sometimes without a break, I become less productive actually, because I just have nothing more to give.

Patrick Runnels, MD, MBA
So it’s absolutely the case. And there are these studies go way back before the smartphone existed and it is absolutely the case that there is a cap on the productive hours that we can put in per day. It’s not that we can’t produce something more when we go over that number of hours, it’s that the quality and value of what produce goes down. So if I work 40 to 50 hours a week, I can be at pretty max quality production. The work I’m doing is pretty good. As soon as I pop up over 60, every hour after that becomes way less valuable.

Meaning what I’m doing is more and more garbage, right? So now we’ve introduced this smartphone thing, and there’s a convenience factor to it that says, oh, I can unplug right now to go to a doctor’s appointment. Awesome. Or my kids conference at school. And I can just pick this back up in an hour. But then I start doing that shuffling all the time. And the thing that’s weird is that now I’ve mingled these things all together and there’s no clear boundaries, there’s no time to just appreciate the space I’m in.

And by the way, that’s true of work. Sometimes bosses will say it’s like people aren’t present if they’re not present, and there’s a meeting. There’s a lot of studies on work efficiency that show that having concentrated time at work where you’re not distracted by things is equally as valuable for the quality of work you put in. In the same way that we feel the sense that I’m not putting in quality time in a block of spending time with my loved ones, or focusing on the piece of art or the show that I want to watch. It goes both ways. I think that’s everywhere. I think it’s I think it’s infiltrating everything. I don’t know what you guys feel like.

Matt Eaves
Yeah, I saw a stat, and I actually double-checked it, that said about two-thirds of Americans feel burned out at their job or at work. And if you think about that, it means two out of every three people going to work in the morning are not walking in excited. They’re feeling down about what they’re doing. They’re not energized. What is that from a psychological perspective? What does that do to your health? What does that do to your mindset?

Patrick Runnels, MD, MBA
So burnout, most easily described, is essentially stress that’s not turning off. So if you have that mentality, think about if you’re stressed about something for 30 seconds versus if you’re stressed about something for five minutes versus a day, versus six months, so on and so forth. If you stress something about 30 seconds, it probably doesn’t stick with you. But when you start thinking about the things that stress you out or keep you up at night because I got stressed by work, well, now I’m not sleeping very well. And then I wake up the next day tired, and then I’m a little grumpy, and you start to think about those kinds of things.

If you then move forward with that and talk about the mental health impacts on you, if you’re in that heightened level of stress all the time, what that does is it shuts down the part of your brain that is creative, that wants to connect with people, that wants to solve problems, which is where most of us get the most joy out of the work. And you’re essentially in a space where your brain’s always onto the “I’ve got to get something done.” Whether or not it’s the right or best thing to do and you shut people out in order to get those things done.

So one of those is called the default network, which is the ability to be creative and not have anything on my plate. So I can be open and explore and connect with humans and all that. The task-positive network is the part of our brain that says, I got to get something done. So I need to get rid of distractions. I don’t want to change what I’m thinking. I just need to get my head down and get it done.

The second, the test-positive network, has aspects similar to stress. It’s not bad if I need to get a paper written, or I need to get a set of emails sent out, then it’s good to be able to hunker down and focus, and that’s good. But if I’m like that all the time, then all the things that bring us joy, all the things that bring us a sense that we have autonomy in our lives to make the world a better place, the reasons we come to work, whether your job is that you’re this noble cancer surgeon, and I cure cancers all day, which everyone says, oh, that’s how noble, how great. Or your job is something more mundane, you know, in any job, we whatever your job is, you serve people, you interact with people.

We want to do a good job. We want to we want to feel the work we’re doing is having an impact. And the way we connect with that goes away when we’re always in get things done mode. So to that point, burnout does that. If I’m burned out, I’m not in my ability to be in a space where I can easily connect with people, enjoy those connections and be open to new experiences, be open to new ideas, be creative and think differently about the work I’m in, which has a feedback loop.

And when a workforce isn’t happy, they’re less capable of doing good work. They’re going to put out less quality work. So that’s not good for an organization. But it is the case that burnout leaves us in this place where we feel exhausted all the time. We’re low energy all the time. We are less social. We, whatever the burnout at work is, we take home with us. So the quality of our relationships and our home lives starts to get worse. Or at least strained, shall I say.

I typically put less time into taking care of myself. So exercise goes down. I start eating more comfort foods that are less healthy for me. So people in burnout spaces are often trying to eat the comfort foods to kind of relieve themselves, which means their health is going down. I’m doing less of the activities that bring me joy, that renew me. Those things all happen.

Matt Eaves
Yeah. How do you get through burnout?

Patrick Runnels, MD, MBA
The answer is almost always figure out why you’re burned out and undo that thing. Right? That’s the answer that’s not perfectly available to workers who have less control over their jobs and their schedules and all those things. So I don’t want to minimize the challenge you have when your autonomy is really low. But the degree to which you are in a space where you have control, it’s isolating: Why am I burned out? Usually it’s something having to do either with I’ve given or I’ve ceded control of something, or I am having trouble managing, maintaining and engaging in high quality relationships and a sense of belonging at work.

Those two things, if you that go back and say what’s missing there? Sometimes my job is just not great and, to the degree that I can, I’ve got to get out. But most of the time there’s actions you can take to go: Why is this happening? What’s going on? What could I do a little bit differently?

Macie Jepson
So when we talk about what’s to blame, it’s twofold. You know, we’re to blame for not controlling our situation. And the demands from today’s work environment are also to blame. I read a study that said year over year, 15% more people are getting emails from work or text from work before or outside of business hours. Let’s talk about our employers’ role in this.

Patrick Runnels, MD, MBA
Let’s think about the things that I want to take a step back. I want to say, okay, so what are the things that contribute to burnout? So I’ll start there. The biggest factors in contributing to burnout are loss of autonomy. The feeling of things happen to me, as opposed to I have some control over what’s going on, and the failure to have good quality work relationships. So my ability to connect at work and have a social experience and feel like a belong, and feel like those quality relationships are good and that I contribute and that people like that I contribute.

So those two factors are really, really big. There are other aspects that contribute to being able to be the person you’d like to be at work. So this concept of the ideal me. So if I’m doing a job that is actually nothing like the person I want to be or the thing I want to do for the world, I would like to be a writer, but instead I’m cooking, you know, that would be I’m a chef. That would be something that might actually create some trouble and I might be more likely to get burned out. So as we think about the environment we’re in, anything that puts you in a space where those two things start to get infringed upon is going to create some trouble.

Those are the factors we’re looking for, the degree to which we think about email that way. And we think about all the ways in which work comes to us nowadays. The impact on humans is a massive tax on our ability to both connect with people and have autonomy and control over our lives. So when I step back, that’s the stuff. And then you get into this thing like, okay, what’s the smartphone doing to that? And there is this back and forth now about, is it really convenient that I can get my email on my phone? Or is it now dominating my life and I increasingly feel like I am a slave to that as opposed to it’s a convenience thing.

Macie Jepson
And the expectations have changed too, because the our bosses know that we have that phone. And why aren’t you answering? Because I should be able to reach you, and I know I can at any time.

Matt Eaves
Yeah, at a simple level, back to the culture thing. Sending an email on a Sunday night or at 4:45 in the morning can send a message to employees you should be responding. You also should be working at these hours, right? Whether or not that’s true, I think that there is there’s danger in starting to do business off hours. It’s I think it’s okay for yourself if that’s the time you like to work, great. But I don’t think you send that email until you get later into the day, unless there’s something urgent.

Patrick Runnels, MD, MBA
You know, it’s so interesting. Because you’re right. II work for people who have all kinds of weird hours in which they email me, and there is clearly no expectation. And that is talked about like, hey, I’m if I’m in here, I don’t expect an email right back. They’ll often put that in the email. And there’s elements of that this gets into convenience. Oh, this is awesome. Now I can go to my kid’s school conference and get to that email later the night. So to your point, it actually might just start out as just it’s convenience.

And there’s clearly people who want more and more of your time, more and more of your life. But I think just as much, if not more often, it’s we’ve all shuffled our lives to be highly individualized to exactly what makes sense for me, which is creating all kinds of mixed messages for everybody.

Matt Eaves
Well, especially if that email goes to more than one person and everyone but one person decides they’re going to respect the business hours. Now the one person responds and you’re like, man, now I look bad. I should get it and it sort of feeds in. Then down the road it’s like, okay, I got to be first to respond, and the boss knows I’m attentive and ready to go. Yeah, yeah.

Patrick Runnels, MD, MBA
You know, I think about a solution to that. And it seems to me that’s something where you should have some kind of agreed-upon work rules. Like we could get together and say something like, hey everybody, you’re welcome to respond to emails, but no one is expected to respond to emails after, say, six and before, say, eight or something like that. Even then, though, to your point, that might not be enough, right? Like, well, if everyone’s responding, is that really what they think? I think more often than not it is.

None of us have mastered as a group of people how you turn that off this kind of communication. All these advances happened so quickly. We’ve only had smartphones since like 2007 and 2008. So when it’s only been 18 years that we’ve had that all the things that advanced. Netflix didn’t start streaming properly to the point where we’re watching it like we do now until like 2016. It’s only been like 8 or 10 years that’s been around.

I remember DVR, that was a whole thing. That’s not a thing anymore. But that was how I managed my kids when they were infants. I would DVR all the cartoon Pixar and that was like a thing for five years. But we’ve gone so far, I don’t think we’ve had time to catch up. And I think that’s a task that high level-leaders need to attend to.

Macie Jepson
I think we know we’ve been in the world a little bit longer than our kids, and we know how to set boundaries. Some of us don’t, but kids especially. And we have conversations with our adult daughter a lot, as as she is navigating her first couple of years in the workforce setting boundaries is very difficult for her. And making them understand that really it is okay not to answer that email. No, I have to answer it right now. Why are they emailing me at five in the morning? Well, because that’s when they get their work done. That doesn’t mean that they expect it of you. It’s tough. It’s tough for for kids these days I think.

Patrick Runnels, MD, MBA
You all have some version of a mail a email app on your smartphone, right? Usually some kind of little blue box type of thing or envelope. And when there’s a new mail, what color is the new mailbox? The little circle that has the number of new mails you haven’t read.

Matt Eaves
Red.

Patrick Runnels, MD, MBA
Right. It is red. It is red on almost every app I’ve seen. Which is to say, it’s designed for all the things that make us uneasy. Think about all the ways the stuff is designed that gives us – to the point about your daughter – there are so many things that have nothing to do with the humans on the other end about the technology itself. So if I’m just learning how to set boundaries or learning how to take it easy and and now I’ve got these technologies and all these things that are like hitting me with all this information that says this is an emergency.

This is a code red, right? And I agree with you. This is this is a major problem.

Matt Eaves
One of the things we see in the data is it seems like younger generations are struggling more with burnout and feeling a lot of pressure from work. Is it a matter of toughen up or is it more of we’ve gotten a little extreme with how connected we are? It is a little tough to to manage that because we don’t really know the expectation of, yeah my boss’s email says he doesn’t want a response, but really he would reward me if I did.

Patrick Runnels, MD, MBA
So there are two separate problems going on that feel like the same problem, but they’re totally different problems that I’m going to peel apart.

The first is the idea of what’s different about the generation that exists, that the younger generation, what’s called the Gen Z and the younger millennials. There’s a great book by a researcher out of England named Eliza Filby. She did a book on the difference between generations, and the hypothesis of the book is essentially saying some version of the generations aren’t as different as you think. And what she was looking at was this idea that younger people have the reputation for wanting more gratification upfront, being less ambitious, being less motivated, more quiet, quitting, all that kind of stuff. And what her research showed is that when you talk to them, they’re actually motivated exactly the same way that older generations are. But the world in front of them is organized very differently in a way that makes the kinds of things that are accessible to people of my generation, I’m a Gen X, much less available to them.

So I will use the example of my 17-year-old daughter, who, at the age of 14, when she knew she wanted to be an animator, went on the internet and said, well, what does an animator make? And determined that salary. And then she said, where are the animator jobs? And she determined that. And then she said, what is the price of housing in the markets were at my jobs were likely to be and came back to us in great distress at the age of 14 and said, I’ve done the research. And the research says that if I want to get a job in animation, the jobs are hyper focused in very expensive cities like Los Angeles, San Francisco and New York City, amongst others, and that the price of housing and that the salaries for those jobs are somewhere in the $75,000 - 100,000 range. After five years, they start at $30,000 - 50,000. And when I look at the cost of housing and I think about if I don’t have kids and all I do is save money, I won’t be able to afford a home for the down payment for a home until I am in my 50s. Most kids and young adults have figured that out that the things that our generation, the older generations, got and were able to achieve are just not available to them in the same way.

As a result, they are making different calculations about how they invest time in their lives, and that time is being invested with the idea that there are no more ladders. It is no longer lucrative for me to go get an MBA, and a college degree no longer has the same guarantee of a job. When I get out of it is: all the people who five years ago are like computer science, awesome guaranteed job, are now as they’re finishing the degree saying maybe not. That guarantee is going away, right? So there’s that part of things, which is to say the rules did change and that those generations are dealing with a much less certain job market, with much less clear pathways and what looks like a lot less opportunity for them.

And by the way, the baby boomer generation and the Gen Xers are living longer, staying in their jobs longer, which are, and holding high level positions longer, which means those same people, younger ages are having less opportunities to advance, less opportunities to move into jobs where there’s growth in both their potential to work and their income. That’s all there. No wonder they’re stressed out, right? No wonder they’re making very different decisions. In fact, the book by Dr. Filby points out that the Gen Zers are very wisely saying, where’s all the money? It’s with all the boomers that, when they die, I’m going to inherit that from my parents or my aunts or whoever. That’s actually the people and the relationships I need to invest time in. And they are indeed investing more time in their parents. Which is this interesting thing.

And I think kids are living in a world where there is hyper focus and hyper attention on how other people look like they’re doing. So there’s this fake world out there, and there’s good evidence to show that the world being pushed at you, that you at times are opting into, is actually creating stress for you because it looks like everyone else is doing better than you. So that’s a thing. And that happens more with young people. And all of those things are coming at them lightning fast. Now 9-second clips that keep regenerating and keep you there. Those algorithms are addictive.

Matt Eaves
We’re talking about both about being able to disconnect and burnout, which I think are probably a little bit of causation or at least correlation there. But as a psychiatrist, what is your advice to someone about how to set healthy boundaries in terms of work and or if they aren’t able to disconnect? Or what advice are you giving people to say, hey, it’s okay, you don’t have to check your email on vacation. And again, obviously it’s individual based on the person and their job. But what are you telling folks?

Macie Jepson
Before you answer that, could I just inject too that a lot of it I feel like is on the person themselves. The people themselves, because they are they want to control the situation. Nobody can do it better than they can. Right? And so a lot of the work has to start from within.

Matt Eaves
Yeah. And even as I was analyzing this myself, or just my own self-analysis of people around me that do this, I think some of it is based on the fear that I, in the course of a week, I could quickly find out that I am not essential to every operation in my department and all these things that I thought I was necessary for. I’ve realized someone else can pick it up and therefore that makes me very uncomfortable, right? So that way, if I’m always inserting myself, I never get an answer to the question was I needed in that situation?

Patrick Runnels, MD, MBA
So, a lot of things going on here. One is the anxiety and stress about job security, which is a real thing in our day and age. This idea of, can I be replaced? Let’s be clear, everyone’s worried right now that AI is going to replace them. I, by the way, do not think that AI is going to replace nearly as many people as is prognosticated or people fear, or that tech companies seem to be telling us is going to happen, or the degree to which certain jobs are a place that’s actually going to create new opportunities and needs. That’s because I see the value and the necessity in almost all workflows of the human component. Are there going to be jobs that become obsolete? Sure, that’s true with almost every technology.

But that said, everyone’s nervous about it right now. You may think that the right answer is to always insert yourself, but you’re just actually compounding your brain’s ability to handle stress. The right answer is to have a different kind of conversation with those people that are in charge of you and say: How can I make sure that I’m staying relevant? And how can I make sure that I’m meeting the expectations for the job most of the time?

I think they did a study on this once, that people with smartphones pick up and look at the smartphone every seven seconds. Even if there’s nothing on there, they pick it up, look at it, put it back down. There’s work to be done for a lot of folks to detox in the world. There’s work for a lot of folks to rethink their relationship to the devices in our lives that give us access to the world, but also mean that we’re always aware the world has access to us. And the answer to that is I think more and more to find spaces where you do disconnect entirely and to be comfortable with that.

And maybe that doesn’t have to be for your whole vacation. Maybe that’s not the stress you have, but, you know, don’t go hiking up a beautiful mountain and take your phone with you and check your mail on the hike up the mountain. Certainly, don’t have your anniversary date with your spouse and be picking up the phone when they bring out the wine and the champagne to celebrate the anniversary. If you can’t handle that, then you’ve got some internal habits to look at and focus on.

Macie Jepson
Matt knows this. I’ve used it as an example. I was hiking up a mountain in Colorado for a week, and I worked the entire time.

Patrick Runnels, MD, MBA
While hiking up the mountain.

Macie Jepson
No, but anyway, back to what you were saying about the mountain, work was on my mind in one of the most beautiful places in this country, and I worked. I had deadlines that I needed to meet, and I thought, well, then why? Why I’m doing that? Then why don’t I just go ahead and hop on this meeting while I’m at it? And the flipside of that was I took a day and a half off over the Memorial Day weekend, a half a day Friday and I took Monday off, and shut my computer and didn’t give a second thought to work. I was more rested, relaxed, refreshed and in a better place emotionally, after taking that day and a half long weekend at my house. Then I was a week in Colorado. So why do we do this?

Patrick Runnels, MD, MBA
Research actually showed there’s this thing called network switching that is a term for the amount of work it takes to shift from one task to another task. And it turns out that it takes about five minutes to do it well. There is a guy named Cal Newport who does a lot of work on this and wrote a book called A World of No Email. He was able to look at the research and showed that the average worker in the knowledge industry gets something like 40 to to 80 emails a day.

If they respond to all 80 of those emails, that leaves them six minutes per email. And that’s assuming those emails are all the same thing and that’s all they do. And in fact, that’s not all they do at all. We are constantly network switching all the time in a way that makes us way less efficient. We’re not getting things done. Most of those emails are low value, and yet we’re responding them anyway. All of which is to say, what you’re describing, there’s a lot of evidence to show that the brain does its best work when it is focused on a specific task.

And when you can take a break, say I’m going to just take a day and a half break to focus on my family or hiking up a mountain. I remember I had a trip to Great Britain, you know, England, Ireland, Scotland. And we were out in the Highlands and some of these other remote places. Phones didn’t work and it was glorious. It felt like it was unsettling for about three hours, and then I had a week where I didn’t think about work almost at all. And it was great. And then I came back and it wasn’t like work was bad, but I just didn’t think about I was there. I was present. This concept of presence, we all could benefit from being more present in our lives.

Matt Eaves
Dr. Patrick Runnels, great conversation today. Thanks for joining us.

Patrick Runnels, MD, MBA
Oh, it’s a pleasure. This is a great conversation. And as always, it’s a joy to be here. Thank you.