People enduring chronic stress are less likely to eat right, exercise, sleep enough, or do many of the basic things necessary for good health, says Jan Bruce, co-founder of meQuilibrium. The answer, of course, is simple. Find ways to reduce stress, but the path to a less stressful existence isn’t as clear as it might be. Bruce co-founded meQuilibrium to deliver individualized plans for employees designed to help them build “resilience” to stress. Psilos CEO Steve Krupa and Bruce delve into the actual impacts stress is having on health and the economy.
Jan Bruce has devoted much of the last twenty years to pioneering new brands in health, wellness, consumer lifestyle, and holistic medicine. She has a passion for building strong business strategies and cohesive management teams that deliver results. She is widely recognized as an authority on women’s attitudes toward a balanced healthy lifestyle and sustainable living. She also regularly speaks on business turnarounds and LOHAS business issues. In 2004 Bruce sold her company, body+soul/whole living, to Martha Stewart Living Omnimedia and then served as her former firm’s managing director for five years, during which time she led the growth of the business: quadrupling the revenues and tripling the circulation, spawning a multi‐platform franchise that includes website, video on demand, a daily radio show, and a new green cleaning product‐line. She then co-founded meQuilibrium after having a surprising personal epiphany that stress was keeping her from enjoying the rewards of her work.
Steve Krupa: Welcome to the Breaking Health Podcast. I’m here with Jan Bruce, who’s the cofounder and CEO of meQuilibrium, and the co-author of meQuilibrium: 14 Days to Cooler, Calmer and Happier. Welcome to the Podcast, Jan.
Jan Bruce: Thank you, Steve.
SK: So we you and I have known each other for a couple years now. I’ve been following your company, and one of the sayings I think you have is “stress is the new fat.” And I kind of take that to my own heart, and I say, well, stress is the new smoking, and because maybe it’s voluntary, maybe it’s not. I’m not sure. But one of the things that I’ve come to recognize over the years is that society places a lot of burden on people in their work and home life, and that it’s good to be under stress, but chronic stress can lead to some significant health issues. And over the course of your work at meQuilibrium, you’ve become an expert on stress. Are you stressed right now talking to me?
JB: Actually, I’m not. It’s great to talk with you. And by the way, I would tell you that I do like to say stress is the new fat, but lately, people are saying to me that sitting is the new smoking.
SK: That’s right. Sitting is the new smoking. That’s a very good one. I like that one, too. And I’m standing up right now talking to you, in case you’re wondering.
JB: OK, there you go.
SK: So I think I mentioned to you I’ve always understood stress, right? We all feel it. But chronic stress, you know, I’ve had the misfortunate to experience chronic stress at some point. Really kind of takes over. And we don’t realize it’s taken us over until it ultimately goes away. And the bottom line is as we look out into the employee population in the US, and we can probably say that there’s a fair number of people that experience stress, and a smaller group that experiences chronic stress. What do you know from your research about that situation?
JB: Well, I think that first of all, you’re right to make the distinction. A little bit of stress is what we need to get things done. We think about it was the stress of failure that made us do our term papers and get out of school. I think that, as you also point out, you can get stuck in a pattern of being chronically – of being hyper-stressed, and that’s what we call chronic stress. Where a little bit of stress makes you productive, to be in a perpetual state of stress actually has the opposite effect. You get foggy and unproductive. And so what you want to do is you got to – people need to – I always say you need to recharge yourself. You recharge your phone, you recharge your battery; you need to recharge yourself and not get into that state where suddenly, unawares, you’re – it’s a steeper hill to climb out of.
SK: I mean it’s interesting. I’ve seen data that suggests everything changes under chronic stress. Blood pressure goes up, right, you drink more maybe, you eat more, you cross the threshold of diabetes and so forth. So chronic stress can lead to chronic illness in many people.
JB: Yes. The numbers are astounding, and they keep on coming out. Chronic stress is implicated in most of our chronic conditions. And let me remind you that it’s those conditions and life style, sort of life style behaviors that account for about 75% of the cost of our healthcare in this country. I can also say that people who are under high stress sleep half as much as people who are under normal stress. They also are twice as likely to fail at a diet or a weight management plan. They eat more, they drink more, they sleep less, as I said. And they also don’t get as much exercise. So you know, you do get in this state of just it’s you and the stress.
SK: That’s right.
JB: And you’re not doing the healthy things that might make – you stop putting other things into your life to ameliorate that situation.
SK: What’s interesting is you meet people, you hang out with your friends, they say, Oh, I’m really stressed. And of course the answer is, go exercise, go do some yoga, go do some biofeedback, go do all these things. And at least what I’ve come to learn is those are really temporary soothing agents. But if there is an underlying thought process that is driving the body’s reaction to stress, those things are only going to temporarily solve the problem.
JB: That’s right.
SK: They’re not going to solve any permanent issues. So where is, in fact, stress in terms of the mindset of corporations and their human resource departments? Do they understand its effect? Do they care about it? What are they doing about it?
JB: Oh, absolutely. I mean we’ve seen in the last 2 years alone the awareness amongst HR professionals, but also the c-suite that is exacerbating their employee engagement, employee absence and turnover, and frankly, top line results as well as the costs of people being out, the cost of people not doing their work, the cost of people quitting. So I think the awareness now that stress is a force to be reckoned with, and it’s not just the physical manifestation of stress in chronic conditions, in chronic – and utilization of healthcare. But that when people are stressed, they simply don’t bring their best self to work. There’s a growing trend I see in leading top companies today to help employees take care of themselves, and then they’ll be better able to take care of business. And I think that’s also part of the whole sort of consumerization of health. Not to go off on a tangent, Steve –
JB: – but it’s not just here’s – it’s getting less rigid. It’s not just about get the biometric screening and do these 6 things, and then we know you’re well taken care of. I think there’s a growing realization that, as I said, people bring their whole self to work. If they’re stressed, if they’re overwhelmed, if they have problems at home, if they don’t have good coping skills, it’s going to reflect in our bottom line. So I think there’s – it’s a pretty big change.
SK: Yeah. Well, and to me it’s also a private matter for people as well, right? So nobody likes to turn around and tell somebody they know very well that they’re stressed. Nobody wants to say, you know, I’m taking a tranquilizer to get to sleep at night because I’m so stressed, right?
SK: So when you think about how would you go about – well, first of all, if you walk into an HR department and say, I’m going to sell you a product and the results of my product is an overall reduction in the stress of your employee population, it seems to me that’s a value proposition that one would have to investigate, right?
JB: Oh, absolutely.
SK: And in fact, that is your proposition. So then since we’re talking about digital health, right, you’re coming to it from a standpoint of how to use computing and the digital infrastructure to provide stress therapy, I think, to employees that are feeling like they need some help. Is that a good way to think about your company?
JB: Well, you know, it’s interesting. The business has – the value proposition is really about employee and performance optimization, about resilience much, much more than stress. Stress is one of the symptoms. Stress is something that increasingly employers, as I said, are making the connection about you know, stress costs us $300 billion a year and drives up our healthcare costs. But I think increasingly, that’s the pain point, and the focus is on the solution of making everyone more resilient and more up to the task of tackling the challenges that face them.
SK: Yeah. Well, OK. So we’ve gone from stress to resilience, or the idea of being more resilient.
SK: And my knowledge of this is resilient is an adjective. Why don’t you be just a little more resilient, Buddy, and you’ll feel better? But it’s actually, in your world, it is a way of measuring someone’s ability to cope with change or with the world around them. Is that the way to think about it? It is, in fact, a number or a measurement tool, right?
JB: Yeah, absolutely. I mean resilience – yes. Resilience, the study of resilience actually grew out of the psychological study of why certain people perform and others done. And we know that a person’s resilience can be measured, like your IQ or like your – it can be sort of catalogued like your Myers Briggs score. But it also, unlike some of those things, it can be changed. We can actually help people improve their coping skills and make them more resilient. And the way that happens is that our coping mechanisms are often really ingrained in us from a very early age. We inherit them from our parents, ways of assessing what’s going on and making – shortcutting ways of thinking about it. You know, I’m not good at sports, you know? I shouldn’t do sports, things like that. Or whatever. We develop these ways of interpreting things, and we have found that we can actually change that so that people can cope better and feel better, and feel more adaptable in certain situations. And that’s kind of the core of resilience training. And what’s been masterful is when you apply that to stress management, it’s so much stronger than just tools that were our traditional stress management tools that help people kind of relax or calm, things that kind of work on the symptoms of the stress rather than the root cause of stress, which is usually your thinking styles and your approach to adversity. So I hope that wasn’t too much for you.
SK: No, no.
JB: But that’s kind of the segue from the stress, from the painfulling of the stress to this really scalable solution of helping everyone be more resilient.
SK: Right. And the resilience is correlated to higher job satisfaction, higher health status; in other words, healthier people have higher resilience generally. And it’s inversely correlated to things like symptoms of stress and feeling burnt out and not wanting to go to work and feeling productive. So if your resilience is down, you’re not going to be excited about going to work. If your resilience is higher, you’re going to be a better worker, you’re going to be a more productive father or more productive mother or grandmother, and you’re going to sort of have a view of life that’s more up for the challenge, as opposed to feeling overwhelmed by the challenge. Is that a good way to sum it up?
JB: That’s absolutely right. That’s a really good assessment. And in fact, we have validated that exactly with our meQuilibrium Resilience Assessment. We actually see that the people, you know, employees and people in general, non-employees, who have higher resilience scores have lower perceived stress scores. They have fewer absences. They have fewer hospital stays. They have better health status. So when we can improve people’s resilience score, we can see pretty quickly that their perceived stress scores go down in inverse proportion. And now also –
SK: So if you’re able – go ahead, sorry.
JB: Go ahead. Sorry, we’re now also seeing – you know, we work with large employers. We work with employers who have lots of large customer-facing work forces like call centers and people who lay cable, and people who sell retail in big box stores, things like that. And we see that when people are able – when these people learn a little bit about resilience, you know, we could teach them stress management techniques until we’re blue in the face, Steve, and those are very good. I’m not trying to say that they’re bad. But when we help people start to get more in touch with their emotional reasoning with how they sort of solve or don’t solve problems, how aware they are of their reactions to adverse situations and problems, they start feeling less stressed.
SK: And essentially, what we’re talking about here is a product where we could, right, ship in a team of educational instructors and psychologists and give a sort of a program to our employees in an auditorium and teach them all about resilience. Or we could offer them the benefits of the modern Internet structure and the privacy, which I think is important when I look at your product, the privacy of being able to deal with this on their own, not in front of others, right? And the next thing you know –
SK: – we have a scalable solution that’s much less expensive for the employer, where we’re essentially taking people on a volunteer basis through a program as to how to increase their resilience. And that’s really fundamentally your core product today, right?
JB: That’s exactly right. I mean essentially, that is our core product. Just for the record so understands this, meQuilibrium today is essentially a coaching platform which uses – it is a digital platform that has a coaching models that helps every individual with a clinically validated, highly personalized resilience coaching solution. And we deploy this through employers and health plans and wellness providers, and also direct to consumer. And the goal, the result is that we improve people’s ability to manage their stress, but also their engagement, their productivity, and their performance and their health.
SK: Yeah. And before people say, well, this is a digital wellness product, I want you to have the opportunity to sort of quantify a little bit about the dollars that we’re talking about.
SK: I mean just in the ability to improve productivity and reduce absenteeism, right, and reduce turnover, the numbers are pretty compelling. So just walk us through those.
JB: Well, absolutely. I mean what we are seeing is that we – I mean meQuilibrium can save $600,000 for every thousand participants. And that’s – every thousand eligible. So that is a pretty compelling statistic. And it’s not health cost reduction. That is productivity, absence, turnover, those sort of related costs that are hard to get at. Now what we’ve done here is, you know, you started talking about this before. We’ve basically taken the methodology that coaches and therapists were using off line, and we’ve made it algorithm driven and very, very scalable, so that you can leverage this against hundreds of thousands of people at a manageable cost.
SK: And this is cognitive behavioral therapy, essentially, for the most part, right?
JB: It is. It is cognitive behavioral therapy made scalable, affordable, personalized, as you said earlier, and then don’t forget that people can use it 24/7, whenever they want. So the stressed out employee who’s never going to pay attention to your benefits, who’s not going to make an appointment to see someone can do this after she puts her kids to bed. Or can do it again and again, can practice off of her cell phone. So that’s why it’s – you know, part of the reason it’s effective is that it’s personalized and very efficient for each individual. But another part of it is that it is very much on demand and meets every employee where they need to be.
SK: Right. And that’s the part about it that – well, I find the whole digital idea fascinating. It’s clearly going to be a lot cheaper than in person therapy sessions, which are a pain in the neck to go to and are expensive, and are subject to sort of the luck of the draw, depending on who your therapist is and so forth. This is a way to go through a fairly inexpensive, convenient, private cognitive behavioral therapy exercise that’s customized. And by the way, the content is very good. I mean it’s a combination of –
JB: Well, thank you.
SK: – tests and videos and it’s real.
JB: And it’s interactive.
SK: And get people started. And I would imagine you’ve thought about quantifying the healthcare benefit, but that’s tough because –
SK: – the experiment is multi-variable, right? Who knows what other things are going on to impact that? But I don’t think any good physician would argue with the notion that if someone’s resilience is higher, they’ve got lower stress levels among other things, and they ought to be healthier, if you will, relative to that person with lower resilience.
JB: Oh, absolutely. Absolutely. I mean there’s so much literature about the impact of stress on health and healthcare costs that that is almost a given. I actually like to say that that’s a given, but if you just bank on the benefit, if you just consider the ROI on what this will do for employee productivity, engagement, emotional well-being, absence, turnover, that stuff, and then the healthcare costs is sort of extra –
JB: – you know, there’s a lot to be gained from that. You know, the interesting thing about this, just go back to the technology aspect of it for a moment, we love in the innovation world when technology can take something and take a product or a service and make it better, faster, cheaper. And that’s really what we did with this. We saw this coaching model in a world where there was so much effort spent and so many products coming out for tracking and focusing on diet and fitness and sleep. And we kind of said, Wow, there’s this emotional well-being, there’s this stress and coping area, self-awareness, personal growth that was really white space. And most of the products, and there are a lot of fine products, anything from mindfulness and mediation to stress management and, you know, resilience training, coaching, all of that stuff was off line. And we said at meQuilibrium, why don’t we use technology to essentially build a product that can scale this, that can do it affordably, and that over time can get smarter and smarter for all different types of people and different types of problems? And that’s what we are doing, and what we’ve been building. So you can get – and because of the technology and because this is accessible, you can get so many more people to engage than the typical models of 2 to 3% of people who are really at risk have to engage.
JB: So you can 10 to 15 times that number.
SK: That’s enormous. I think people would love to know that they’d get 20, 25, 30% of their employees to engage.
JB: We do. I mean do. We get this across our book of business, and we are dealing with Fortune 50 companies and Fortune 1000 companies. We get in cable, technology, in retail, and also knowledge workers. In financial services, we get typically a 20 to 25% enrollment rate. And here’s the thing that’s really astounding or astoundingly different. We are getting 45 to 50% of our base, of our enrolled base to continue to engage with us month after month.So this is not really a wellness – this is way beyond. Resilience is something – and meQuilibrium goes beyond a wellness platform. We like to say this is a gateway service.
JB: This kind of takes a disruptive idea that your thoughts really are the control of everything, that if you can change your thinking, everything else will be possible. And we want to be there for people month in and month out as they have new things to cope with because that’s really the way to achieve stress management.
SK: That’s terrific. I don’t think I’ve seen this idea before we met. And I think it’s probably going to become very important over the years. If you’re getting that kind of engagement now at the beginning, and you’re getting that kind of stickiness, you really almost have like a media product on your hands. Granted, it’s a health and wellness product, but it’s turning into a media business right in front of you. Just a couple –
JB: Well, that’s interesting because –
SK: Oh, I forgot, you have a media background, Jan. Let’s talk about media for a minute.
JB: Some of the people – you know, we have actually taken media, taken with subject matter expertise in consumer wellness media, and they basically drive consumer engagement in our company because they are the kinds of people who know – you know, why is it that you buy or consume that media about how to run the marathon every year for ten years? You already know what to do. You’ve already run the marathon. But yet you go out and you buy that new update.
JB: And it’s those people, the people that understand how to write that for you and keep it fresh, that’s who works at meQuilibrium.
SK: Yeah. I mean how many books does a golfer read about the golf swing? Right?
SK: We always go back and relearn the same things over and over again because we forget them. We start to make mistakes –
JB: That’s right.
SK: – and we’ve got to go back. And as long as we’re finding – the most frustrating thing is when it’s not relevant to you. So as long as you’re making the experience relevant to the user, they will continue to come back if it becomes important to them. That’s for sure.
SK: Here’s some numbers. I just want to clarify some numbers and then move on. So if we’re saying $600,000 per one thousand eligibles, and you’ve got sort of a 20 to 30% engagement rate, you’re saying $600 per eligible per year of savings. That’s like $50 per month. And I’m assuming – you don’t have to tell me what you charge –
JB: I think it comes out to be about $1600 per participant for savings.
SK: That’s amazing.
JB: Which is a fraction of what we’re charging.
SK: And I’m assuming you’re not charging anywhere near that.
JB: No, we’re charging a fraction – we don’t charge nearly that much. We charge based on how many employees. We like to charge based on how many employees are in the company in a per eligible per year. And we often find that our customers start adding spouses and dependents after a while.
SK: Yeah, why not, right?
JB: Because often – Why not? I mean a lot of the stress comes from our favorite scenario: you come home from work and your spouse says, You’re not making this marriage important or a priority, and therein lies the stress.
SK: Sure. In the family unit.
SK: Family unit. OK.
SK: So let’s talk about how you got to this. People don’t just think of becoming an entrepreneur overnight. I know you spent some time working with Martha Stewart. Is it possible that the stress that she caused you led you to this idea?
JB: Well, it’s interesting that you say that.
SK: I’m basing that purely on reputation, not on first-hand knowledge.
JB: Right. Well, first of all, when Martha bought my company – see, I had sold my wellness company to Martha because she was a big believer in health and wellness on a personal level. On a corporate level, given that her company in those days was set up to own the Home Arts entertaining, decorating, all that good stuff, she thought well, why not make taking care of yourself versus taking care of your house an adjunct subject matter. We were very successful working with her as a wholly owned subsidiary, yet I will say that as an entrepreneur at heart, after working for Martha Stewart Living on the media for five years, I had learned a little something about stress, and some of it comes from the fact that when you’re an entrepreneur, and then you work for other people, their priorities become yours. And entrepreneurs sometimes like to march to their own drum. On the other hand, the awareness that came to me watching people – you know, I was in a highly successful, highly visible place. Really, it was one of those be-careful-what-you-wish-for-you-might-get-it kind of things. Because it was fabulous, it was high profile, it was engaging and challenging. But it was ultimately you see how so many very, very talented, very, very successful, very, very smart people do not take care of themselves, and stress overruns them. And I fell into that, too, even though I knew as well or better than most how to take care of myself. And that was where I got the epiphany that we needed to – that stress, like overweight, was going to become a force to be reckoned with in our culture. And so I set out to see what would be – the seeker in me said, Well, let’s look at everything. Let’s look at biofeedback, let’s look at meditation, let’s look at mindfulness, brain focus, calming, relaxation, what is there? And I ended up seeing that with resiliency, actually helping people change their thinking, it was like an obvious, no nonsense, effective, translatable way to get this – to move the needle. And that is in fact what’s happened.
SK: Well, we’re talking with Jan Bruce, cofounder and CEO of meQuilibrium, also author of meQuilibrium: 14 Days to Cooler, Calmer and Happier. Just to let people know that this is a private company. You’ve got terrific backers: Safeguard Scientific, Chrysalis Ventures, to name a couple. Am I missing anybody in that list?
JB: Those are the big guns right now.
SK: Those are the big guns. And congratulations.
JB: Thank you.
SK: We’ve come to our last question. So obviously, you go from Martha Stewart, you get to start your own business again. You get to take what you’ve learned both in that experience, and then you’re starting a business around resiliency for employees. And my question is how does all of that inform the way you manage your company?
JB: Oh, that’s a great question. Well, I think that first of all, the thing that comes first and foremost to my mind is that you can’t do it all. And I think I’m in – I think that leading from behind, seeing that it’s a priority to have great people and give them what they need so that they can lead, and they can make it happen is really important. The other thing that I would say for me is that I’m in an exciting situation. Our business is really taking off, our numbers are on fire and growing. We’re adding staff and adding business constantly. So I’m in flow. And the thing about flow is that you feel good and you want to get out there and do it, but you do need to make sure that you and your people take care of themselves. So for example, I want people to take 2 weeks off. At a time. I don’t mean 2 weeks every 12 months or 1 week here and 1 week there. I want people to get out and recharge the batteries. And it’s hard because there aren’t enough of us.
JB: But I know that if we don’t do it, then they’re going to get foggy. And I need people to be able to, when they get into flow and they’re working nights and weekends for a few weeks until they figure something out, they need to have the stamina and then they need to recover from it. So flow is good –
SK: IT’s the hardest thing in the world to take a vacation these days. Do you know that?
JB: I know.
SK: Not to interrupt you, but I mean whenever I go on vacation, somebody will say, Well, can you just be on this conference call? And the next thing you know, if I say yes, I have a conference call every day and I’m supposed to be on vacation. In today’s day and age –
SK: – with all this connectivity, that in and of itself can create stress. I’m sorry, I didn’t mean to interrupt you.
JB: No, it’s true. No, you’re right. You have to let go. You have to, as I said, you have to turn off your phone, you have to recharge your batteries. I often think that there are a couple things that I try to practice, and I try to speak about and instill both in my team and then also in other people, whoever will listen to me. I think that simply observing – making a habit of sitting quietly and observing yourself, like saying to yourself, how am I feeling now, can make a major difference on your day. I think that when you’re in a busy, fast paced startup world, you need to be a monster about what you will and will not focus on. And then because what you focus on will flourish. And if you focus on too many things, it’s not going to happen. Then you can’t focus. So you have to have some discipline around these things. And I guess lastly, I would say positivity. You’ve got to be – you know, positive continually trumps negative. Lots of companies kind of charge a dollar when you say a negative thought in a meeting, stuff like that. And I don’t mean sugar coat, but I mean you have to assume good intent and be positive.
JB: So anyway, I think these are all – it’s interesting how the challenges of running a growth business, fast paced, where you have to be really tough about performance and judgmental about performance, you know, you’ve got to get great people and you can’t sugar coat. But you also have to be nurturing.
JB: These are very interesting ideals to juggle.
SK: Very cool. Well, listen, let me just say thank you for taking the time to focus on this. I know you’re very busy. But I loved talking with you today and thanks for being with us.
JB: Oh, my pleasure. Enjoy the conference.