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Introduction

Just after 8 A.M. on a summer morning, Mark McLaughlin is sprawled on a ratty armchair that he’s shoved into a dark corner of a hospital locker room in central New Jersey. In a few moments, McLaughlin, who is a neurosurgeon, will make a six-inch incision into the back of a seventy-three-year-old patient whose arthritis has caused the lower part of his spinal nerve to crimp, threatening his ability to walk. The operation will take more than three hours. 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, the nurse calls his phone to signal him. Then McLaughlin—who is fifty-one, wears glasses, has graying hair, and retains the broad, muscled back of a former college wrestler—gets up and walks briskly toward the operating room down the hall.

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. As he scrubs his hands at the sink, a lead-lined apron now over his scrubs to protect him from the X-rays used during surgery, his eyes are again closed. If a colleague tries to talk to him, McLaughlin replies a bit rudely: “Not now.” He’s engaged in his presurgical routine, which evolved from a practice he first learned to use 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. Over time he identified what was holding him back. “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. “The psychologist taught me to remember the sights and sounds of positive events—the feeling of the mat, what was around me, the colors,” he recalls. “We focused the preliminary routine to try to get me into that autopilot mode and let my body fall into that groove.”

After he began using this prematch routine, McLaughlin’s experience on the mat changed. He no longer heard the crowd. His sense of time was altered. Though wrestling matches last six minutes, it felt as if they ended after thirty seconds. 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, where he was team captain (twice), won the Virginia state championship, and was inducted into the college’s athletic Hall of Fame. 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. As a surgeon, he has to stay hyperfocused; if his attention wanders, something bad could happen very quickly—just as it could, albeit with lower stakes, in wrestling. As a surgeon, he achieves a positive or negative result, and over time his reputation depends on his win-loss record—just as it had in wrestling.

So before every operation, he began utilizing the techniques that made such a difference in his wrestling career, by going through a systematic, ritualized process to put his mind in the optimal state.

The routine began early this morning, when McLaughlin drank the first of the three cups of coffee he consumes before entering the operating room. If he’s awakened late at night while on call to do emergency surgery, he may drink even more, especially if it looks like a long procedure. (McLaughlin’s longest operation lasted eighteen hours.) To stay attentive during long periods with limited sleep, some surgeons rely on a prescription medication called Provigil, a “wakefulness-promoting” drug that allows users to stay awake and focused for twenty-four to thirty-six hours. (It’s also used by truck drivers, entrepreneurs, and Wall Street traders.) Some surgeons and dentists also rely on beta blockers to steady hands during procedures that make them especially anxious. McLaughlin has never suffered from uncontrollable tremors, and he’s tried Provigil but doesn’t like it; it makes him paranoid. So he relies on coffee as his sole presurgical chemical aid. “I strongly believe caffeine is a performance enhancer,” he says. “When I’m operating, I’m a really good concentrator, and I have no doubt caffeine adds to that.”

As he moves from the cafeteria to the locker room and then into the surgical wing, McLaughlin is engaged in the next step in his process: 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 this is the most important moment of his life. 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. “It’s such a privilege to be able to use your skills to help this patient.” 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 the surgical team as they gather around the operating table. But in certain situations, especially when confronting a fast-moving trauma case, McLaughlin uses another pre-performance technique: He 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 on what needs to be done. Don’t get frustrated.” If he gave these talks before every case, they would probably lose their power. However, since he uses them only in extreme situations, McLaughlin believes his words help the group perform at its best.

Like most surgeons, McLaughlin plays music before and during an operation. Unlike most doctors, he has extremely specific preferences based on the type of procedure he’s doing. 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 some George Strait. For reasons he can’t explain, it helps him staunch the flow. 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, and if you don’t know their significance, you wouldn’t readily recognize why he does them. For instance, just before this operation begins, he injects 19 milliliters of lidocaine into the site of the incision. Most surgeons would use a round number such as 20 milliliters, but McLaughlin prefers dosages that end in 9s, which he considers a lucky number. And 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.”

While McLaughlin typically exudes a calm confidence before he operates, occasionally he’ll display a flash of anger—not unlike the hostility he used to feel for his opponent before wrestling matches. “My opponent is the disease I’m operating on, and I think about it as an adversary,” he says. “It’s not driven by hatred. It’s more of an intellectual process of ‘How am I going to defeat this thing?’ ” Occasionally he’ll trash-talk his clinical opponent during the procedure, muttering: “I’m gonna kick your ass.”

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 were 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.

McLaughlin admits there is no hard proof that the things he does in the moments before operating increase his performance, nor is there an easy way to test whether they make a difference. But he believes his routine 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. Scrawny and slow, I was a second-string offensive lineman on the football team; my biggest fan was the team’s laundress, since my game uniform rarely got dirty. In basketball, after some success in ninth and tenth grades, everyone else got taller and I became a guard with limited ball-handling skills. By the time I reached the varsity level in both sports, I served a function similar to that of the legendary Celtics’ coach Red Auerbach’s cigar: If I entered the game, it signaled that 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. I routinely discover academic studies that examine 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.

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 just like the surgeons Mark McLaughlin observes, most of us ignore these techniques and just jump in.

Psyched Up is a book about what to do in these vital moments just before you perform. We’ll examine new ways to deal with the flood of adrenaline, increase focus, boost confidence, and otherwise optimize our emotions before we take the stage. We’ll explore how music can (and sometimes can’t) help people do better, whether focusing on a rival can lead to improvement, and what kinds of pep talks work best. We’ll also meet high-performing professionals who are putting these techniques to work. We’ll look at the mental preparation of athletes, actors, musicians, soldiers, salespeople, and others who, despite years of practice and enviable track records, will ultimately be judged on their ability to deliver a single solid performance when it counts.

Most of what we know about the process of getting psyched up comes from sports. We learned it in locker rooms from well-meaning coaches, and it’s based largely on intuition or common sense. But as psychologists and social scientists have begun taking closer looks at what really helps put our minds and emotions in an optimal state before we perform, they’re finding that our intuition often betrays us. Some of the advice is conflicting. Many of us end up doing the wrong things. You really can get better results with a better set of practices, and chances are, they’re not what you’re doing now.

Many of us can profit from a better pre-performance routine. 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. Self-employment and 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. If you work two thousand hours a year but your overall success rests mostly on your performance during a couple of dozen crucial hours—at pitch meetings, sales calls, a key conversation with your boss, and so on—the tools in this book should help you do better.

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 should be able to go home in two or three days,” he tells the patient’s wife. She asks if her husband will be able to walk easily again, and McLaughlin says it looks very good.

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?

This book will show you how to do it.

PSYCHED UP

ABOUT THE AUTHOR

Daniel McGinn

PSYCHED UP

How the Science of Mental Preparation Can Help You Succeed

PORTFOLIO PENGUIN

Contents

Introduction

CHAPTER ONE

Fighting Back Against Fight or Flight

SHOULD YOU “CALM DOWN” OR JUST EMBRACE THE ADRENALINE RUSH?