Gail is a bank executive who runs a team engaging in cross-functional projects across Europe. The 44-year-old is used to travelling – first train out in the morning, last flight back (getting home past midnight), then back in the office by 7am the next day. He’s cheery and supportive, never fails to pick up his bosses’ calls and is often the last to leave the office.

He looks successful, but doesn’t feel it. Gail’s noticed that he pants when walking up the stairs and feels self-conscious about his bulging belly and receding hairline. Like many other highly accomplished senior executives, he knew he needed to take better care of his body and mind to be at his best. But he just couldn’t seem to get it done.

The need for ruthless self-care

Many leaders like Gail are familiar with the concept of self-care and even work in organisations that advocate it. But they aren’t typically acquainted with ruthless self-care, a practice that I (Derek Deasy) have been teaching for over a decade. 

Ruthless self-care means adopting a disciplined and comprehensive approach to self-care and prioritising it above all else, especially before reaching the point of burnout. Stress is accumulative. If we don’t process it, it will get too much – and before we know it, it will erupt. Rather than letting your inner critic interpret self-care as indulgence, it’s important to be self-interested – or, as we say, ruthless – in this respect.

This requires a solid foundation built on self-reflection. Many people aim to eat healthier, exercise more and protect their “me time”. They start off well in the first week but lose steam by week three. This isn’t because they lack persistence. Instead, there are hidden factors at play that inhibit them psychologically. 

Take Gail, whom we met during a leadership development programme. Executives come to these courses thinking they will learn skills to lead their teams and drive performance. And while they do, they benefit most from the opportunity to slow down their thinking to reflect on their own habits, behaviours and mindsets.

When I (Enoch Li) engaged with Gail in a coaching session, we dug into his worries and fears about setting aside time from his job to exercise. Gail was concerned that if he wasn’t as present and available at work, he’d be left behind in his career, and his identity and reason to exist would go out the window. He felt the loneliness and anxiety of not being wanted or recognised professionally and linked these fears with his difficult childhood.

Working through these hidden, deep-rooted anxieties helped Gail rethink the relationship between his identity and work. As we explored this further, he realised that simply going for a run or visiting the gym was a band-aid fix that wouldn’t really solve his problems. Instead, he needed to devise targeted solutions that directly addressed his specific self-care needs. 

Some leaders, like Gail, only confront the situation when they can no longer cope with the stress. Sometimes they try to find short-term fixes to distance themselves from the feeling of stress, using different measures they might have heard of from others. However, that isn’t sustainable or personalised, nor does it address the root causes.

Ruthless self-care is not only reactive (i.e. knowing what to do depending on one’s state of well-being at that moment), it’s also proactive. It allows leaders to plan ahead – for instance, by anticipating heightened stress next week due to a big project – by doing something in the present moment to amplify and maintain the support they would need in the future. To do this, they can use the “self-care matrix”.

The self-care matrix

We taught the self-care matrix in the latter part of the leadership development programme. I (Li) developed this step-by-step tool to help executives identify their self-care needs based on the World Health Organization’s mental health continuum model. It helps them calibrate their state of mind and level of anxiety to make time- and context-appropriate decisions on what to do for their well-being.

Before filling out the self-care matrix, we teach participants about the different states of well-being based on the mental health continuum model. The scale runs from well, to mild distress, to moderate distress, to unwell. Most of us hover between mild and moderate distress, because stress is an integral (and necessary) part of life. We can fluctuate between feeling very calm to feeling overwhelmed in the same day, especially in the face of external triggers. 

The way to combat these states varies, so you need to be able to pinpoint your stress and energy levels before choosing the most suitable method of relief. Most executives miss out this crucial step of determining how they are really doing at that point in time. Others think they are either well or unwell, and miss the grey, fluctuating zone between these two extremes. 

The key to the self-care matrix is to identify the different states: “need a quick fix”, “want a time out”, “I’m on shaky ground” and “help!”. Next, determine the appropriate channel of relief (“me only”, “with others” and “who I can talk to”) early on before you feel overwhelmed and struggle to think straight and make the right decisions. 

The next step is an individual reflection that allows participants to reconnect with the resources they already have for their well-being – the people, places and practices that work for them – but are sometimes forgotten. Then, we guide participants to insert these resources into the appropriate cells in the self-care matrix. 

As they fill out the self-care matrix, many leaders come to the realisation that they might not have someone they can talk to when they are distressed and in need of “help!”. This becomes the catalyst for them to find those resources and people, and proactively manage this ahead of time, so the support is there for them when they need it.

This is part of the ruthlessness: prioritising your needs above all else in that moment and acting on them. The power of the self-care matrix is that it frames self-care as dynamic – a decision-making capacity that leaders must discern for themselves, informed by a process of deep reflection and learning. 

Ruthless self-care in practice

We caught up with Gail around a month later. He told us that he was on the verge of burnout when we’d first met. Through the programme, he discerned that he may have been overamplifying his worries about work, which stood in the way of prioritising his well-being. He worked out his self-care matrix and realised he wasn’t talking to his wife as much as he used to, even though he’d named her as his source of support. He decided to take these reflections seriously and make a change.

Today, Gail exercises every morning, arrives at the office at 8am and declines meetings that start before 9am. He suggests Zoom calls for non-essential client meetings and leaves work earlier so that he can be fully present for his wife and children over dinner. During our last coaching call, he said with a grin, “I finally can sleep. Like, really sleep. Seven hours a day.”

Find yourself in a similar boat? Our advice is to be ruthless in your self-care. Reflect on what could be holding you back from prioritising your well-being and determine what you really need to address it. It could be a sabbatical or a new therapist, a change in diet or working hours. If you know a period of heightened stress is coming, ask yourself what additional self-care practices you can employ during that time to process the stress as it happens, rather than allow it to accumulate. 

So many like Gail and have gone over the edge. But, like him, you can come back from it – or, even better, find and develop the self-care practices that allow you to avoid it altogether.