March 26, 2019

Resistant to Change? It’s All in Your Head (Literally).

Clinician Leadership | Leadership Development

Reading Time: 4 minutes

… What leaders really do is prepare organizations for change and help them cope as they struggle through it.

– John Kotter, Harvard Business Review

As a senior leader in healthcare, you often find yourself at the forefront of change. You personally grapple with changes in the industry, within your organization, and even perhaps your role. You’re asked to adopt change, lead change, help your team members through the transitions associated with change, and more.

Encouraging movement from resistance toward change is the essence of change leadership. It is part art, part science. And it’s easier said than done.

Experience tells you that you will almost always meet with some resistance when initiating change. Yet, you still likely find yourself, at least occasionally, surprised or frustrated when it happens. You may find yourself labeling resistors (in your head, if not out loud) as “those people.” You may say things like, “They just don’t get it,” or “They just need to get on board.”

In his book Beyond the Wall of Resistance: Unconventional Strategies that Build Support for Change author Rick Maurer suggests, “We may view it (resistance) as a massive wall that must be destroyed so that we can get on with our work. We forget that there are people behind that wall, and when we try to destroy it, they fight back. Often our efforts succeed only in making the wall even stronger.” Maurer explains that “The courageous face resistance and explore it.”

So how do you do it? You may be familiar with Stephen Covey’s phrase, “Seek first to understand.” Seek to understand what is happening on the other side of that invisible, yet powerful, wall of resistance.

Why People Resist Change

It’s all in our heads. There is neuroscience-based model that is a valuable tool for helping you gain insights into resistance. It’s called the SCARF model. It was developed by David Rock, author of Your Brain at Work and founder/CEO of the NeuroLeadership Institute (a global initiative bringing neuroscientists and leadership experts together to build a new science for leadership development).

The SCARF model is an approach for collaborating with and influencing others. It provides a framework for identifying and managing common triggers that can cause people to approach or avoid (resist) change.

First, some quick background.

The brain’s neural networks are organized to minimize threats or danger, and maximize rewards related to our individual survival needs. Interestingly, and importantly, research indicates that the brain experiences social threats very similarly to physical threats. These threats produce what is known as amygdala hijacking, or ‘fight or flight’ reactions. Our auto-pilot kicks in to protect us from threats (i.e. causing us to resist change if it is perceived as a threat, which we are wired to believe as a survival instinct).

What is SCARF?

SCARF stands for:

As a leader, being able to understand, anticipate, recognize, and effectively manage SCARF triggers will help you help yourself and others embrace change.
Let’s explore each one in more detail.


Status is perceived importance in relation to others. If, for example, Mary is complimented in front of her team members for excellent work on a project, she will feel more secure and confident. This perceived status boost triggers ‘toward’ emotions and the release of the feel-good hormone dopamine. Conversely, if Mary’s role is being redefined and she perceives her status is reducing as a result, she will start to feel less secure in the group and experience ‘away’ emotions. In such situations the body releases the stress hormone cortisol and we may see fight or flight behaviors.

It is important for leaders to recognize and understand that the brain experiences this perceived drop in status as a very real threat to the person’s wellbeing. Anticipating and talking through perceived status threats can be highly beneficial.


Certainty involves being able to predict the future. A bit of uncertainty can be exciting. Too much triggers the limbic system to take over, creating an ’away’ response. There is a fair amount of uncertainty in our industry. Help team members understand the reasons behind a change (the “Why”) and provide clarity about what you do and do not know. Also, keep people focused on what they can reasonably control and influence during times of change to enhance their focus, level of engagement, and productivity.


Autonomy is about having a sense of control and choice. When individuals feel they have no choice in a situation, they are more likely to experience an ‘away’ response. At times change is non-negotiable and there is a mandate for what must be done. In these situations, there is likely also an opportunity to engage team members in how it gets done. This can help reduce stress, allowing them to be more accepting of and engaged in the change. Role clarity and clear decision-making authority also enables team members have more autonomy.


Relatedness is about relationships and whether an individual considers someone else a friend or foe. When we connect with people we like, trust, and with whom we feel safe, we experience ’toward’ emotions. If it is perceived that a change may somehow threaten existing positive relationships, that event will trigger resistance.

Likewise, moving to a new team where a foundation of trust has not yet been developed may be perceived as threatening. Help team members get to know each other and facilitate collaboration to build connections and trust.


We all like to feel like we have been treated fairly and dealt with appropriately by others. If John perceives that he/his group is being treated differently, receiving less favorable treatment than another group, he is likely to experience ‘away’ emotions, such as anger, frustration, or disappointment. Conversely, if he believes a decision was made fairly, he is likely to experience ‘toward’ emotions, such as acceptance and motivation.

Engage team members in the development of solutions and explain the thinking behind decisions. These actions can help contribute to a perception of fairness.

Next time you are asked to lead change, think about which SCARF elements will most likely be triggered in you and your key stakeholders. Take the intentional steps outlined above to help move your team, and yourself, to embrace the ‘toward’ movement, and experience the positive rewards of change.

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About the author

Kathy Gibala

Kathy Gibala is a sought-after executive leadership coach with more than 25 years of healthcare industry experience and over 15 years as a coach. She is honored to serve as a trusted partner and change catalyst to healthcare executives across the US to raise the bar on their leadership, build high-performing teams, and accelerate transformative change. Kathy incorporates neuroscience-based coaching techniques to help healthcare leaders expand their impact and reach their fullest potential.

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