Influential Leadership – Game-Changing Research to Unlock Performance Excellence

Was it hiding in plain sight?

INTRODUCTION:
You’re listening to Tiller-Hewitt’s Leadership Lens Podcast. If you’re a leader - or an aspiring leader - who wants to stay relevant and impactful… YOU’RE IN THE RIGHT PLACE.

At Tiller-Hewitt we believe it’s faster, smarter -- and less painful -- to learn from leaders who have walked before us. That’s why we invite top leaders to be our guests on the Leadership Lens.

Your host is Tammy Tiller-Hewitt – Founder of Tiller-Hewitt HealthCare Strategies. Let’s jump into the podcast.

TAMMY:
My guest today is Dr. Michael Frisina an internationally recognized leadership expert, speaker, and author. He has developed leaders and organizational teams worldwide.

Every year he speaks to national and international healthcare organizations, non-profit organizations and audiences as diverse as engineers to organ procurement organizations.

He is a featured speaker for the American Hospital Association, The American College of Health Care Executives, and The Joint Commission. His work in healthcare leadership, safety, and quality has been recognized by The Joint Commission in their publication, Doing the Right Things Right.

Dr. Frisina has authored countless leadership books, publications, and educational courses. He literally wrote the book on Influential Leadership: Change Your Behavior, Change Your Organization, Change Healthcare.

Get ready to take copious notes – Dr. Frisina is about to rapid-fire his game-changing research results and how you - as a leader- can take action today!

TAMMY:
Dr. Frisina, author, teacher, leader, and overall healthcare leadership guru, welcome to the Leadership Lens Podcast. I am so honored that you are my guest today.

DR. FRISINA:
Well Tammy, thank you. It's a pleasure to have opportunity to speak with you, and share a topic of common interest, and make an impact in the lives of people in the daily challenges they face in the world in which we live today.

TAMMY:
Well, I know without a shadow of a doubt, you will do that today. For our listeners, I've had the privilege of studying under Dr. Frisina in several leadership courses with ACHE, including Leadership Behavior Smarts and Influential Leadership. I mean, what leader doesn't love the word smarts and influential?

DR. FRISINA:
It's interesting. The concept of becoming behavior smart as a leader follows from three science-based equations in our research about what creates effective leadership, and why effective leadership is both necessary and absolutely critical to the performance outcomes of teams and organizations, and (and this “and” is a coordinating conjunction in the grammar that to me is inseparable) not just the performance of the organization and the well-being of the people of the organization. So, we can't separate performance from well-being. Otherwise, we start to treat human beings as fungible commodities, “as a means to an end” and we lose a sense of the humanness of leadership in compassion, empathy, caring for people. And as we care for them, what that happens to their neurochemical cocktail in regards to loyalty, to engagement, to commitment to the organization long-term, to fulfill the purpose of why the organization exists.

TAMMY:
Wow, that's powerful. In your training and, I'll use the word “and”, in your book Influential Leadership: Change Your Behavior, Change Your Organization, Change Healthcare. I love that title and it's what hooked me right away. Something that you wrote early in your book, you say, “Leaders make things happen. Influential leaders go a step further. They perform at a higher level, are more productive, and achieve greater results than other leaders with similar circumstances and resources” - or the same twenty-four hours a day rule - right? Where can we start having you impart your influential leadership wisdom to our leaders listening today, and in the future, giving them some timeless knowledge?

DR. FRISINA:
Yeah, the first thing that we start with is helping leaders understand and identify their key behavior traits. Over the last ten years, neuroscience has exploded with the opportunity of imaging to see the brain in action in certain contextual environments. In high-stress, high-threat environments, what does a brain look like? Particularly the prefrontal cortex that houses your skills, your talents, your intellect, your sense of achievement, growth, development, innovation, creativity, and problem-solving. All of that's right behind your forehead in your prefrontal cortex along with the cingulate cortex which sits right underneath it, and perhaps, more importantly, the limbic part of the brain which has a host of different components to it, primarily the amygdala, that manages threat and fear response.

So, the human brain is really good at growth, development, achievement, and performance, and it's really great at keeping us alive. It just won't do both at the same time. What leaders really need to understand (which is the title of my new book with ACHE and Health Administration Press,) is this concept of leading the brains of people to higher levels of performance, but you can only do that as a leader if you're leading yourself well. If you think about how to define the term influence, it's really a capacity. It's not a character trait. It's not a personality trait. Influence is a capacity. It's the ability, a skill or, to affect and impact character of another person, the intellectual development of another person, and most importantly, influence behavior of someone or something to a common end in a positive direction, which is where the behavior smarts influence all comes together. They conjoin in being smart about behavior. So when a leader is smart in their behavior, they now have the capacity to influence others to higher levels of performance and well-being.

A leader shows up to work with a team in one of three ways. They show up neutral. Their behavior doesn't do anything to mess with the brains of their team members, but it doesn't do anything to influence, inspire, and motivate, and drive them to higher levels of engagement. The performance dynamic and well-being of the individual, and the performance for the team is neutral as well. You can get good performance, but you don't get great performance.

The worst effect is leaders who show up with the lack of self-awareness in their behavior and self-management behavior, where their behavior is disruptive to the performance dynamic of the brains of their team members. When a leader shows up, the question is when you show up and you’re present with your team, does a frontal cortex light up like the 4th of July for performance and well-being, or does their lower brain in their amygdala, blow up in fear, loss, doubt, worry, fear, threat, anger, resentment, bitterness so that their brain doesn't work the way their brain is designed to work in their intellectual and skill capacity, and they lose engagement dynamic. They don't connect to their team. They don't connect with their leader. They don't connect with the objectives and key performance indicators of the organization and performance suffers greatly.

The primary objective is to teach leaders how to be influential effective leaders aware of their behavior. Aware how their behavior affects the dynamics of their team, to their self-management component, which drives that engagement. Engagement becomes the foundation for behavior capacity of influence that then drives performance and well-being. For those leaders that set themselves apart, not just being a leader whose behavior is neutral, and at worst case, bad on to the performance well-being dynamic of the team members, but the influential leader rises above that because they use their behavior with great discipline, with great purpose, and with great intention that as people connect to them positively, in their behavior and influence, that leader’s behavior now moves, has the effect, the impact, the capacity, of creating high-level personal and professional character of their team members, their intellectual and technical development and performance. It brings together the positive behavior dynamics that makes a working together in a team, both physically and psychologically safe. And when you create that kind of cultural dynamic, you can't help it become a high-performing team, that drives the performance objectives of the organization to the highest level.

TAMMY:
Wow, that was worth the price of admission, that one answer. I want to go all the way back to the beginning of that answer when you talked about how we cannot work both growth and development, while we're facing fear, loss, or threat.

Talk about that because on any given day, you have a leader who could potentially be facing both. Is it the self-awareness that helps them navigate and switch gears?

DR. FRISINA:
It is because of the advance in neuroscience of how the brain actually works. We can start talking about the science of leadership, not just the art of leadership and we can make a very clear distinction between personality vs. behavior. The science is very clear now that personality has very little impact on performance. It's almost all about behavior. Performance is a function of behavior in demonstrated behaviors, that affect the brains of other people, and you know this, so when we talk about key leader behaviors, we're looking for leaders to learn, and so again because it's science, behaviors observable and measurable. Two key criteria for what makes something science-based: Can I observe it and can I measure it? We can do that with behavior. We can't do that with personality.

A leader who might have an introverted personality must at times be assertive. They must know how to take control of a crisis situation. So even a leader whose personality is introverted will exhibit behaviors that are opposite of what their personality would tend to dictate. And the reason they can do that is because behavior is a choice, and behavior is also coachable and teachable. If you need to become more assertive, you can learn how to do that. If you're too assertive and you need to calm down a little bit, you can learn how to calm down. If you struggle to listen, and you tend to talk more than you listen, you can learn to talk less and listen more.

There are two valuable assets in communication for leaders. Leaders need to be able to talk in such a way that people will listen. They need to be able to craft and communicate their vision, their purpose, their plans, the strategic aspect of the organization, but more importantly, leaders need to learn to listen in such a way that everybody else will talk to them.

If you're a leader, if you're in a leadership position and people aren't talking to you and sharing information to you, if you're not approachable, you see none of this has anything to do with personality, it has everything to do with behavior. Leaders can learn systematically, programmatically, the spectrum of what their predicted behaviors are for their own upper brain, when they're safe, and predicted behaviors of how they tend to behave when they're in stress that is now overwhelming to them. We need stress. There's a confusion that all stress is bad. No, there's good stress and there's bad stress.

The good stress is what gets us up, gets us motivated, gets us curious, gets us interested. It drives performance, but it's on a bell curve. When you reach the top of the bell curve, there is a fine point of distinction between the positive stress that gives you the top of your peak performance, and going over the crest of that bell curve into increased arousal and stress, that now becomes negative. And as that disrupted negative stress increases in its intensity, performance goes down. And all of this is teachable. There are methodologies for this, and we also have an assessment tool that doesn't assess personality; it assesses your key behavior dynamics.

So we can teach leaders where they're at risk for going to their lower brain in fear, how to mitigate that, and how to stay in their upper brain managing stress appropriately, manage the context of their environment appropriately, and also demonstrating to them what kind of contextual environment is as leader is their brain built for, because there are four different brain types. So we teach these four patterns.

Each members of the team tend to have one of these four patterns. We match these patterns up and now we have a science-based approach to leadership effectiveness, that drives teams to high-performing team dynamics, and everybody wins.

TAMMY:
Where can one find the assessment or is that something you do with the engagement?

DR. FRISINA:
It’s something to do with the engagement. I write about it in a new book. You can find it online. It’s a proprietary tool that comes from Wiley. It's called the Profile Performance Indicator Tool. Like any of these tools, it's not just being able to buy them, and take them and get results. It's being able to use them productively to make changes. That's where the gap typically comes into play to some degree with these consulting engagements, where people are trying to build culture, build engagement, or create a committed workforce. They don't link the appropriate information about you as an individual, and then how to make the necessary changes. Personality is who you are. Behavior is what you do.

Understanding specifically about how your brain links to specific behaviors, predicted behaviors, and I want to emphasize that, these are predicted behaviors. If you're of for example, a high-scale one behavior pattern, you engage risk, you appreciate risk. You have a high-risk tolerance. Your fear factor doesn’t get triggered, to go to your lower brain. When you're in a context that's volatile, that's uncertain, that has a high degree of complexity, and chaos to it, and a high degree of ambiguity. So, take the pandemic, there are individuals as leaders who have thrived through the pandemic. The pandemic provoked their stimulation for growth achievement, curiosity, achievement driver, competition, “going to beat it. This isn't going to beat us”, This isn't a stumbling block - it's a steppingstone. These are what we call accelerating leaders. Their behavior pattern type is built for a context in which they have to operate at that are volatile, uncertain and complex.

There are other people who have been exact opposite behavior pattern. They've struggled to lead effectively in the pandemic because they need a higher degree of predictability to their execution of their strategy to outcomes. They tend to rely and need a high degree of data and so under ambiguous circumstances, uncertain circumstances, the data isn't there. What they need to calm their lower brain so their upper brain can work for them as leaders, doesn’t exist. This is where we talked about a concept of situational team leadership. Somebody's going to have the title position of authority, as a leader, the CEO, the president, or whatever. But they aren't necessarily built in their brain to match their leadership capacity to the context in which they find themselves. But if they have this open architecture within their teams, somebody in that team, most likely, hopefully will, and so you let that person take the lead and dictate direction, dictate action, predicated on their ability to manage the stress in a positive way, whether it be for their critical thinking, for their problem solving, for their innovation and ingenuity to overcome the problem where somebody else may not be built for that.

Conversely, there are contextual environments of sustainment. Things are calmer. Things are more predictable. Sustaining leaders tend not to do well in those environments because their brain needs more stimulation. They’ll get bored. They'll start messing with something for fun, just to see what will happen. All of this starts with the component of effectiveness as a leader, and that starts with understanding yourself, your self-awareness in your behavior, and then self-managing that behavior.

When you take effective leadership and you multiply it with a cultural dynamics and cultural values, now you can create engagement, and engagement becomes the foundation for behavior capacity that drives technical skills to higher levels of performance and well-being.

These are three science-based equations. They are linked together in cause-and-effect relationships between how people process what's happening to them and external events, how they process behavior to them from other people, and it fulfills four fundamental human needs.

I've taught these principles all over the world. I've talked to leadership teams in Japan, in Thailand, in Korea, in the Middle East, in Dubai, in other Middle Eastern countries, in Europe, in Central and South America.

There are four fundamental human needs: trust, compassion, safety, and hope. Those are not personality dynamics. Trust, compassion, safety, and hope, they all have a brain connection to emotion dynamic that influence your brain to either go upper brain because you're safe, or lower brain because you're in fear. When leaders know how to behave in ways that manifest into those four fundamental cups as I like to call them, you pour yourself into someone in your behavior to maximize trust. You pour yourself into someone's life in such a way to maximize compassion, safety, and hope. Now, you're connecting brain-to-brain, and, in that connection, everybody goes upper brain together and then you make the magic happen for performance and well-being.

TAMMY:
Wow, I love the way you don't just tell them, “Here's what it is”, but you also tell them how to put it into motion through the cups, or the architecture of a team. You help them understand each other. I love that so that they can work more effectively. What's the name of your newest book that's coming out soon?

DR. FRISINA:
Leading the Brains of Your People to Higher Levels of Performance.

DR. FRISINA:
When a leader is leading, if you think about this - as a leader, what are you actually leading when you lead another person? Unless you take them physically by the hand and drag them behind you, but you don't do that. The leadership component has to be an influence. And influence is this capacity to affect, to impact the brain of another person in such a way that they want to follow you. For fun I call this neurochemical bartending.

In these four fundamental behavior patterns, there are four fundamental neurochemical drinks, neurochemical cocktails. If you know how to mix the drink in the head of somebody that matches their pattern, right? If you know somebody wants an Old Fashioned, somebody wants a Cosmopolitan, somebody wants a Shirley Temple, even though it has no alcohol in it at all.

The key is what is my team members, and what is my colleague’s primary neurochemical drink? How do I mix that drink in their head in my behavior - because it's a physical reaction. Neurons firing with each other, neurochemicals stimulation of the amygdala, which produces the cortisol to manage the fear dynamic or the upper brain excreting serotonin and oxytocin, which are the key bonding trust neurochemicals.

See, your brain tells you when to trust somebody. You don't choose to just trust someone, your brain tells you they're trustworthy and your brain tells you they're trustworthy based on how you’re processing their behavior to you. Is their behavior trusting? Is their behavior compassionate? Is their behavior safe? Is their behavior hopeful? Those are the things that draw us together in our uniqueness as human beings because we desire, we are built for social community. This is what has been so mentally disruptive and increasing mental health challenges for so many people, children particularly, was the loss of social community, face-to-face, touch, face-to-face exchange of social community, because of the isolation of the pandemic.

TAMMY:
I don't even know where to start or stop with all this. This information is so powerful, so rich in content. If you were to go into a healthcare organization with an engagement for your expertise, how does it start? How is its process and how does it end?

DR. FRISINA:
Well, we start with the top. We start with the senior leaders team. You know, far too often, sometimes tragically, senior leaders think everything's broken from the neck down in the organization at the head. But it really does start at the head. I'm going to give you one thought that started all of this work for me, twelve years ago. Here's the thesis, which is now no longer just a hypothesis, it's now fact because we can prove it with science.

Individual leader behavior, let me say that again, individual each leader, individual behavior is the single most important predictor to how a team will perform and achieve in key performance indicators, strategic objectives, and engagement to fulfilling the objectives of the organization. And here's why: If a leader behaves poorly and messes with the brains of their people, the first thing that happens is the team members get angry. And we can measure this, we have dynamics by which to measure this emotional response. When someone treats you poorly, when someone offends you, your first emotional response is anger. Now if that anger doesn't get resolved, with an effective apology, (and when a leader is lacking self-awareness and self-management and offends the brains of their team members, they don't even know they need to make an apology). And the apology starts off with, I was wrong. The second is, I regret and I'm sorry for what I've done to you in the offense. The third is, would you please forgive me?

We teach leaders how to apologize for having offended their team members because every leader has done this. And if you don't think you have as you're listening to this podcast, is because you're lacking self-awareness and self-management. I do a tremendous amount of executive coaching. The first thing I ask is to do interviews of the key members and stakeholders that surround the individual leader and I find out where they have offended people and I make them go and offer an apology for the offenses. And if you don't do this, you can never get into a high-performing team and you can never gain influence. Because when someone is angry with you, and someone has moved into an external form of resentment toward you, and then they move into an interstate of bitterness toward you, they moved into a state of hatred for you, and then that hatred can also then eventually personally affect them in their mental health, their physical, and then to depression, and anxiety.

And so, one of the most effective things, a leader can do to start moving their team members from the lower brain to their upper brain is to apologize, but in the apology, the most important thing is requesting forgiveness. Would you please forgive me for behaving toward you in a way in which I didn't know it was hurting you? That gives the team members the opportunity to release all the anger, release their bitterness, and if you want to know the science of this, a new article, new research out of Cornell University just was published by Forbes Magazine that says that forgiveness is the advantage over revenge in mental health and in improving the performance dynamic of team members. It just came out this week.

TAMMY:
I would love to get it. I'll put a link in the podcast notes.

DR. FRISINA:
Start with leaders taking personal responsibility and accountability for violating their personal core values and violating the core values of their organization. I watched a CEO just completely disrespect and destroy the emotional state of a mid-level director who was delayed getting to a finance committee meeting on quarterly financials and I use the word delayed not late. Now the meeting started at 10 and he was not on time. He got there about 10:15 and with the word “respect” right over the head of the CEO (I wish I would have taken my phone out and taken a picture of this) with the word “respect” right over his head, with the core values of the organization behind him on the boardroom wall, he acted in the opposite in his behavior of at least, three of those five core values. When the meeting was over this young man immediately came up to him and said, Sir, can I tell you why I was delayed for the meeting? Now, if you're not on time and it's 10:15, which did your brain like better, would you want to be accused of being late? Or would you want to be known as having been delayed getting to the meeting? I learned this about eight years ago, in this meeting watching this happen in hearing this conversation. Everybody likes delayed, everybody. I have used all over the world and regardless of the language and the culture, people get the difference between being accused of being late (as if somehow you’re irresponsible, or you’re lazy, or you’re reckless). It's 10:00 and you should've been here at 10:00. And the reason he was delayed is he stopped in the parking lot to help an elderly lady who fell, and she fell, because most likely she was having a heart attack, myocardial infarction, and she most likely broke her hip when she fell, and he stopped to do everything in accordance with the core values of that organization to help her which made him delayed for his CEO’s meeting. And instead of being asked, Are you okay? I noticed you weren't on time and getting an explanation for his being delayed. He was treated with disrespect. He was embarrassed in front of colleagues. When do you think to CEO apologized for his behavior after having found out the facts in a broader context of the situation?

TAMMY:
I hope immediately.

DR. FRISINA:
The answer is he never did. He didn't do it immediately. He didn't do it at the next opportunity when he could have done it in a more public setting. How long did it take this fellow to float a resume with a headhunter looking for a world-class Surgical Services Director and be gone from the organization? He was gone in three weeks. This is the impact when we talk about retention. How many times does Harvard Business Review need to publish an article that people don't quit their jobs, they quit who they work for as a leader? And what they're quitting is, they're quitting that leader’s ineffective behavior. Behavior that's offensive. Behavior that's disrespectful. Behavior that messes with their brain in such a way that they can't focus on their work. They feel negative stress and anxiety and start to feel physical illnesses. When you talk about chronic absenteeism, a large majority of chronic absenteeism is caused by negative stress of people afraid to go to work. And they're afraid to go to work because they're afraid about how they're going to be treated when they get to work.

TAMMY:
I don't know about our listeners, but I've been convicted a couple of times by hearing about some leadership mistakes that I've made and so I appreciate and I certainly plan to go back and apologize to people.

DR. FRISINA:
The brain loves the number 3, Tammy, in so many ways. It's in the universe all around us. We have time, space, and matter, in the universe. In children's literature, we have The Three Little Pigs, Three Blind Mice, The Three Musketeers. It’s something about this number three. When you're giving a legitimate apology, you can't leave one of those three steps out. You have to begin by accepting personal accountability: I was wrong when I did this. You have to express remorse and regret for messing with someone's brain and driving them into their lower brain, rather than allowing them to stay in their upper brain for safety, and trust, and compassion, and hope; those are upper brain behavior dynamics. The lower brain’s dynamic is the opposite of those. So you express legitimate regret, sincere regret. Number three: Ask for forgiveness. You give the opportunity for the other person to release you from the prison of their heart, so they give up the anger. They give up the resentment. They give up the bitterness. They give up the hatred of you. I've been in organizations and interviewed people and in the interview process, they can speak and very visceral, emotional terms about just how much they do not like their leader.

TAMMY:
Wow.

DR. FRISINA:
None of that's good for them. None of it's good for the leader. None of that’s good for performance. And in healthcare, none of that's good for what shows up at the bedside of the patient regarding patient safety, quality, and patient experience.

TAMMY:
That's good stuff. I feel like it was a counseling session for me. I hope others got even more out of it. What I'm sad about is that our time, it has come to an end. This has been such incredible information, but I do like to close with what we call the rapid five wrap-up. But before I fire a few questions your way, where can listeners get your book? I know one is on Amazon with Influential Leadership. Where can we get your newest book?

DR. FRISINA:
The Influential Leadership is out. If you're an American College Healthcare Executive (ACHE) members, you can get a discount, and group discounts by contacting Health Administration Press online at the ACHE website.

The new book will be coming out from ACHE as well. I’m fortunate that they're taking a new approach in marketing. It will be available in much broader outlets but it's not available yet. I'm looking to see if we can do some pre-purchasing things. But just keep looking for that.

You can also join my LinkedIn at Dr. Michael Frisina and I'll be publishing things about it, as soon as available on my LinkedIn social media., Also at my company website, www.thefrisinagroup.com. Hopefully, we'll have an early or mid-spring release on that book. And that's the one that really goes in and details all the new neuroscience research, talks about the PPI assessment tool, knowing your brain type, matching up to the brain types of your team members and co-workers, and colleagues. It's all about leading with your upper brain and making life good for everybody.

TAMMY:
Honestly, everyone wins, right? It's a total win-win. I love that. Well, let's wrap up. Tell me what you're currently reading.

DR. FRISINA:
I am reading America: The Last Best Hope by William Bennett. Bennett is a historian. It's a book about reconnecting with history. So as George Santayana, the American philosopher said, if you don’t learn from history, you are doomed to repeat it. We're making too many mistakes today that have been made already in our past that we just need to stop repeating mistakes and start making real change for the betterment of everybody and reducing the amount of pain and chaos in the world and bringing a greater degree of hope for those who are in extreme suffering.

TAMMY:
How do you start your day?

DR. FRISINA:
I wake up and I start with meditation. I’m big on expressing gratitude. I give thanks that I was awake that I get to start another day. I remind myself and connect to my core values of integrity, compassion, and excellence. And look to remind myself how to live in my behavior every day expressing those three core values. Integrity: to be honest with people, to be real with people, to be authentic, and genuine with people. Compassion: giving, caring to their needs. Seeking to look for the welfare of others above myself. In excellence: committing to do everything I do to the highest level possible with my skill, my intellect, a talent. Then I do my physical exercise, and then I go to my daily routine of prioritizing high payoff events, and that's the way the day rolls.

TAMMY:
Awesome. And what's the most important characteristic of a leader?

DR. FRISINA:
The most important characteristic is your self-awareness and self-management.

TAMMY:
I love that it's not personality, but it's behavior and we can all change it and learn it. So everyone can win here. Okay. The next question is, what's your secret talent or do you have a secret weapon to your success story?

DR. FRISINA:
I would say over the years, and I'm talking about a long time, forty plus years, continuing to keep my focus on one primary thing, and that is: the ability to listen empathically to others, listening to hear their pain. Not looking to solve something, not looking to give them a solution, just the willingness to let them tell me their story, non-judgmentally, not oh if you have done it differently or this way, you wouldn't be in the situation, just the willingness to let them tell me their story, share their pain, and ask them, what can I do to help?

TAMMY:
That is a good talent. I love what you said earlier, talk in such a way that people listen, and listen in such a way that people want to talk.

DR. FRISINA:
I guess it would be listening so others want to talk to me.

TAMMY:
That's good. What is one word of advice you would give to your younger self?

DR. FRISINA:
I remind myself with this every day. I live to exceed my own expectations. I don't live my life to exceed the expectations of others.

TAMMY:
Awesome. All right. Well, Dr. Frisina, again, thank you so much. This has been a powerful interview that everyone will love. We'll put Dr. Frisina’s contact information: LinkedIn, thefrisinagroup.com. You can reach out and contact him directly. Bring him to your organization. You can clearly hear that he knows what he's talking about and can really help any organization, individual by individual, right?

DR. FRISINA:
Absolutely.

TAMMY:
Well, thank you so much.

DR. FRISINA:
Thank you, Tammy. It's been a pleasure. Thank you everyone listening. I want to wish you well. Stay positive. Stay hopeful. Find something in your day-to-day that you can give thanks for, and you'll find yourself moving from your lower brain to your upper brain and relieving the burden of the day.

CLOSING:
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