Allostatic Load and Anti-Fragility

On a recent trip, I forgot my phone, couldn’t access wireless, my computer battery died, my connection was delayed, I only had one chapter left in my book, no time to grab food during my layover, and when my delayed flight landed everything was closed. While these were all minor events, the wave of accumulating insults reminded me of the concept of Allostatic Load. 

Allostatic Load

First described by McEwen and Stellar in 1993, the term refers to “chronic exposure to fluctuating, repeated, or chronic environmental challenges” that can lead to health consequences as a person’s normal coping mechanisms become overwhelmed. The cumulative effect of both ordinary and major life events can impair one’s ability to maintain both physical and mental balance. Basically, the repeated, ongoing, and accumulating “load” of stress can result in an impaired ability to function. 

As healthcare providers, we’ve begun to realize the impact of Allostatic Load and “non-medical” stressors in our patients’ lives. This is directly aligned with why we include the “social determinants of health” into our diagnostic and therapeutic recommendations, which all contribute to achieving the individual state of homeostasis. This got me thinking about the impact of Allostatic Load for organizations, including my own. 

These days, companies and their employees are faced with what seem to be unending waves of internal and external challenges. There are pressures due to geopolitical issues, the economy, clients’ changing requirements, new market demands and the constant influx of new technology, products, and services. The “fluctuating, repeated, and chronic” changes can make people in any organization feel like the Allostatic Load they’re carrying becomes too heavy, challenging, and difficult.

Anti-Fragility

So how does any team, leader, or organization approach the challenge of managing  Allostatic Load versus being overwhelmed by it?  The literature on this topic includes concepts like resiliency, adaptability, and growth mindset, which in some sense all focus on helping return to homeostasis—predictive stability if you will. However, I’m of the opinion that individuals and organizations can look to address Allostatic Load in a different way—to actually use uncertainty, change, and challenges to achieve a “gain in function” from these stressors. 

I was introduced to the concept of different growth strategies between deciduous trees vs. coniferous trees to describe approaches to growth and change after reading the Dao of Capital. The deciduous trees takes a fast path to growth with a rapidly spreading canopy while the coniferous takes a “roundabout” strategy in which its pine cones wait for a traumatic event to sprout. Once the right conditions present themselves (often after severe environmental challenges like a large-scale forest fire), they not only germinate but their growth increases as well to take advantage of the new conditions. This strategy encapsulates many of the tenets of “Anti-Fragility.” The term was first described by Nassim Taleb, a well known financial prodigy turned philosopher, who also popularized the “Black Swan Theory.” Basically, he attempts to define the quality or characteristic that is the exact opposite of fragile. Anti-Fragile doesn’t mean you just cope or manage your way through shock, randomness, disorder, and stressors, but that you actually–and consciously–experience a gain in function or increase in capacity as a result of increasing Allostatic Loads. To paraphrase, “the resilient resists shocks and stays the same; the Anti-Fragile actually gets better.”

Managing Allostatic Load by become Anti-Fragile

As we are all finding in this decade, the future is extraordinarily unpredictable. I see continued stress and change as inevitable. Anti-Fragility has the singular property of allowing us to deal with the unknown, to do things without necessarily understanding every detail—and to do them well. While not without strain, the current environment is an opportunity for individuals as well as companies to respond in kind—not just dealing with issues as they arise, but instead increasing our capacity to handle future issues.

While the concept of battling Allostatic Load by becoming Anti-Fragile (thereby actually increasing capacity for the future) sounds obvious, how does an ndividual or a company actually develop this attribute? I shared my thoughts on this topic in a recent company update that I thought might have some wider applicability. 

For Individuals

1. Take Care of Yourself: The “first rule of First Aid” is that the rescuer’s safety must be ensured first. If you want to be able to evolve through tough situations then you need to be getting rest, time off, taking care of your mental, physical, emotional, and team health. Individuals must be intentional in how they care for themselves so they can care best for those they serve.
2. Engage with Your Manager and Your Team: Every single person in every company deserves a great manager. Individual managers are the primary point of contact, they run into the daily fires, and they are what hold teams together through all the ups, downs, and sideways. We invite our individual team members to proactively engage with their managers, ask questions, understand the context, and then determine how they can bring answers to help solve the issues that arise in our organization. I love the phrase “Lift Where You Stand” highlighting how every role and everyone can contribute to solving problems. 
3. Remember the Why: What attracts people to your company? What motivates people to stay? What allows people to “choose to persist”? I believe it is a deep connection to the knowledge that what your people are doing for your company will have an impact larger than their individual contribution. For our company, the great cause our team members resonate with is being the catalyst within the commercial industry to help employers move to new care, delivery, and payment models (“health as it should be”) at scale. What is the great cause that each individual team member can be extremely proud of and grateful to contribute to?

For Companies

1. Take Care of Your Current Clients: Every company exists to create value for their clients with the technology, products, and services they offer. There’s a tremendous opportunity in working with existing clients to understand their needs, adapt how you work together, and ensure that you become a trusted partner in helping them achieve their objectives. It all starts with how you serve their needs, which can then create multiple rounds of future opportunity. 
2. Continuously Innovate Your Products to Achieve Growth Objectives: Most businesses are required to continually innovate to address the evolving needs of their clients. There is no rest for the weary in product development, as there is only increasing creativity required by the innovative! Growth is both an indicator as well as a byproduct of your ability to solve problems for your clients. 
3. Build a Culture that Thrives on Change: When challenged to change by external forces, the question is how will the company respond. This is where a strong corporate culture, built on principles that allow people the creativity and confidence to “do the right thing” when faced with uncertainty, becomes a major differentiator. Culture feeds on clear communications, consistent actions, and a clear link between corporate values and subsequent value creation. 

At Crossover, we are carrying over the momentum from a strong close to last year. Filled with optimism and confidence, we head into 2024 knowing that our industry will continue to rapidly evolve and there will be plenty of challenging situations. Instead of being paralyzed by all the unknowns, we can bear up under increasing Allostatic Loads by building on existing, and developing new, capabilities that help us become more Anti-Fragile. Our goal is not stability nor predictability,  but instead adaptability and agility in becoming a stronger, better, and more capable company.  We are purposefully developing these capabilities to rise beyond whatever situations present themselves in 2024 as well as whatever curves the world throws at us in the years ahead. Most importantly, we are building the learning capacity to help our company increase its Anti-Fragility, to gain from the disorder that we anticipate to increase in the future, and in so doing ensure our organization is “Built to Last”.