Get Beyond Treating Symptoms: Identify Root Causes

As an executive coach, I help people get unstuck. And after three years and 1,400+ hours with clients, I wanted to take a minute to share a bit about how I do that. With this post, I hope to equip some people to solve their problems. On top of that, I’m also hoping to provide a way of thinking that will help you work more effectively with any caregiver (e.g., couples therapists, physical therapists, executive coaches, etc.).

All of us get stuck. We struggle. We thrash with coworkers, parents, spouses, siblings, BMW drivers who don’t put their damned blinkers on, and the guy at the bagel shop who always puts red onion on when you ask for your lox without. On top of that, accidents happen, our bodies ache, and we lose people and parts of ourselves. Some of our difficulties lie outside of the realm of solutions. Resurrection is out of the cards, COVID isn’t returning to the raccoon dog’s underground laboratory, and you can’t unsay that dumb thing you said at work. But how we react and adapt to the parts of life we wish we could disappear or undo is often within our grasp.

The key lies in differentiating between symptoms and root causes, and you can work through just about any problem by following the following five steps:

1. Identify the symptoms
2. Relieve the symptoms
3. Diagnose the root cause
4. Treat the root cause
5. Create a Prevention Plan (i.e., avoiding “re-injury,” relapse, or recurrence).

This works at work, and it works not at work. It just works. But since abstractions are dull and less memorable, let’s apply this process to a few examples. Imagine you have a headache.

1. Symptom Identification: What are your symptoms? Easy. Your head hurts.
2. Symptom Relief: Take two Advil liqui-gels and think to yourself, “For all the shit I give the pharmaceutical industry, Advil is pretty legit.” Wait 30-60 minutes, and feel better (hopefully).
3. Diagnose the Root Cause: If you take Advil for every headache, your stomach will start bleeding. So what’s the root cause? You’ll need to run some experiments. A quick chat with your sister, the nurse, leads to a hypothesis: “I might not be drinking enough water.”
4. Treat the Root Cause: You drink a big glass of water twice in the morning and twice in the afternoon. Your headaches go away.
5. Create a Prevention Plan: You buy a new water bottle and tape a sticky note to your monitor, “Say No to Headaches, Drink Water.” You stick to the plan, listening to the almighty sticky note, and months later, you think, “I can’t believe I accepted headaches were a part of daily life for so long.” Roll credits, applause.

“Okay, Andy, this is a basic example my fifth grader could have walked me through. Help me solve something gnarlier, like the employee on my team who isn’t pulling their weight.” Okay, let’s try that.

1. Symptom Identification: Employee X’s work is constantly late and of mixed quality, and their attitude is a bit off. The department isn’t hitting its goals. All of this makes you feel angry, confused, and sad. You don’t like feeling that way, and if the department was hitting its goals, the company would perform better. That board member would stop harassing you, and you might finally be able to take a vacation.
2. Symptom Relief: You yell at your dog when she wakes you up to go outside at 5am, you write a sternly worded Slack message to Employee X about their “disappointing performance,” you tell Employee X’s manager they need to “solve it or else,” or you decide to fire Employee X.
3. Diagnose the Root Cause: Again, you can’t keep doing whatever you choose in Step 2 without ugly consequences. So, you will need to develop a hypothesis around what’s going on. Maybe Employee X’s Mom has cancer. Perhaps you haven’t set clear enough written expectations in writing. Maybe you’re skipping 1:1s. Maybe Employee X is working really hard but afraid to ask for help. Maybe they’re just a lazy sod, and your hiring process doesn’t weed out lazy sods.
4. Treat the Root Cause: After reading step 3, you realize you aren’t doing 1:1s and don’t have clear expectations written down, so you decide to implement a more rigorous and structured 1:1 approach like Dave Kline suggests here.¹ It works. After holding four weeks of 1:1s using Dave’s method, Employee X turns things around. Unexpectedly, your three other direct reports who adopted the 1:1 method from Dave began to improve as well. Alternatively, it doesn’t work, and you realize Employee X isn’t qualified. So you fire them.
5. Create a Prevention Plan: Whether Employee X turned it around or got fired, you need to ensure there isn’t a “relapse” or recurrence. If they turned it around, how can you keep holding structured 1:1s (and teach the wider company to do the same!)? On the other hand, if you sacked Employee X, you need to analyze your hiring process for what you missed, update your hiring process, and train any hiring managers on the updates before you can honestly say, “Problem solved.”

Too often in my work as a coach, I notice problem-solving attempts stop at step two for “Issue A” because CEOs tend to skip (3-5) to work on relieving symptoms for “Issue B” once we resolve symptoms of “Issue A.” For example, once a CEO fires Employee X, they move on to an issue with “Board Member A,” only to have a performance issue surface with Employee Y that could have been prevented had they successfully identified, treated, and “defended” against the root cause with a good prevention plan.

Diagnosing and treating the root cause is more demanding in the short term. It requires effort, while symptom relief initially feels easy but can have costlier long-term consequences. Establishing a habit of drinking enough water daily is harder in the short term than simply taking an Advil for each headache, but stomach bleeding from the pills will be harder in the long term.

Similarly, writing down clear job expectations, training your team to run great 1:1s, and implementing a culture of accountability is much harder in the short term than writing a sternly worded Slack message. Still, the former will make for a more effective and resilient team than the latter.

So, how do you begin to apply this in your life? Remember to start small. Problem-solving is a skill that needs to be trained. Don’t start with the work or life equivalents of 100 lb dumbbells. Start with something that seems “easy.” Maybe you wish your spouse would stop leaving all those cardboard boxes in the garage. “What do they think? Some magic faerie comes and breaks the cardboard down every Wednesday?”Or maybe you keep getting questions about vacation, sick leave, or weather-related work-from-home days. Work through the steps, and don’t stop at step two. Good luck!

Hoo Boy, indeed.

Andy.

On My Mind Lately

Reading

• The Terra Ignota Series (Ada Palmer, 2016 - 2022). Humanity has done away with nation-states and the nuclear family. Any two places on Earth are no further than four hours travel away. Planetwide, workers have adopted a 20 hour work week. Happy workaholics are dubbed “vocateurs”. War is a thing of the past. Or is it? One line that I’ve been unable to shake, from book three (aptly titled, The Will to Battle):
  
  “Hobbes tells us that war consists not in Battle only, but in that tract of time wherein the Will to Battle is so manifest that, scenting bloodlust in his fellows and himself, Man can no longer trust civilization's pledge to keep the peace. If so, we are at war.” (p. 13)²
• Psychoanalytic Diagnosis (2nd Edition) (Nancy McWilliams, 2011). This is the latest of several books I’ve read on psychoanalysis. Nancy is a psychoanalyst, professor, and author. She’s uniquely skilled at taking ideas usually relegated to the arcane language of academic psychology and writing for both a clinical and lay audience. That said, this book probably isn’t for you if you’re just generally curious about psychology or therapy. If you’re a practicing therapist or coach, however, I think you’ll find this book fascinating.

Doing

• Wedding Planning: It’s remarkable how this manages to suck up 5+ hours every week. Special shout out to Tailor’s Keep in San Francisco for helping me with my tuxedo. If you’ve ever wanted a bespoke suit, these guys rock.
• Learning Greek: My fiancée’s family is Greek and our wedding is in Greece. I’ve been using Duolingo for the first time, practicing for about 30-60 minutes a day, and this is so much better (and fun) than learning a language in college was!
• Conducting Weekly Reviews: Khe Hy’s guide to conducting a weekly review³ (a la David Allen’s “Getting Things Done”) is terrific. I’ve tried to do versions of this several times in my life, but I’m now on week six of doing this every Monday morning. Benefits include: avoiding less, focusing on priorities more, missing fewer commitments, processing email faster.