A critical element of effective leadership is behavior competency. The key to behavior competency is gaining an awareness of why you choose certain behaviors in certain contextual settings.
Behind every behavior choice is a set of neural circuits and neural chemicals that influence social bonding, trust, reward, motivation and gratification. When operational in the upper brain—the prefrontal cortex—this neural activity enhances individual and team performance while sustaining personal well-being.
When these neural circuits and neural chemicals respond to fear, loss or doubt (elements of disruptive change and chaos), we default to the limbic brain, referred to as the lower brain, to manage survival. This shift to the lower brain to manage the response to fear diminishes and inhibits the prefrontal cortex’s capacity to focus on growth, development and achievement.
So, we have two competing operating systems within the brain—the upper brain, which is designed for us to thrive, and the lower brain, which is designed for us to survive. Both work exceptionally well, just not simultaneously.
Stress is an important determinate of whether you are functioning in your upper brain or your lower brain. Your brain goes where you tell it to go based on the judgments you make about your external environment and the behavior of the people around you.
When you are managing stress, frustration and conflict from your upper brain, you manifest a set of behaviors that are positive and productive and therefore drive performance. When you are challenged in your ability to manage stress effectively, you manifest corresponding lower-brain behaviors that help you survive in the same contextual environment, limiting the effectiveness of the upper brain to focus on performance.
“Allostatic load” is a term used to describe this polarity between positive stress and negative stress affecting the upper brain and lower brain functions. The concept of allostatic load dates to the Yerkes-Dodson theory of arousal beginning in 1908. McEwen and Stellar coined the term “allostatic load” in 1993.
We can understand this scientific phenomenon in simple terms: The left side of the bell curve represents your upper brain, and the right side of the bell curve represents your lower brain. Chronic allostatic load disrupts your executive skill functions along with correlated effects on your emotional intelligence attributes, such as adaptability, resilience, empathy and effective communication. The bottom line is that when you lose the capacity to manage stress, thereby disrupting the function of the upper brain, you lose performance capacity and well-being.
Neuroscientific research underscores the importance of creating psychologically safe environments that promote innovation, collaboration and continuous improvement. When leaders engage in behavior that stimulates optimal stress levels, the upper-brain functions are unencumbered by negative stress disrupters. When leaders engage in behaviors that push the limits of stress management, the immediate impact is a loss of performance and negative effects to immune responses and psychological safety, impacting the well-being of individuals.
This insight is invaluable in understanding why emotional intelligence and resilience strategies alone are ineffective at improving team performance. A leader who is struggling to manage stress effectively, and therefore manifesting lower-brain survival behaviors, will struggle to exhibit behaviors typically associated with emotional intelligence: adaptability, resilience, empathy and effective communication.
These elements of emotional intelligence require upper-brain capacity to manifest the behaviors that typify them. Rhee and Sigala published a systematic literature review of the role of neuroscience in leadership development. Understanding and adopting this one neuroscience concept alone can transform the thinking necessary to shift future leadership development programs to a neuroscience-based approach.
Transformational healthcare leadership development programs will equip leaders with neuroscience principles to align team goals with strategic key performance indicators, foster a growth mindset among healthcare professionals, and drive individual and team performance to higher levels of performance outcomes in care delivery. Most importantly, leaders can leverage neuroscience strategies implementing targeted interventions to cultivate leadership competencies at all levels of the organization.
Functioning as “neurochemical bartenders,” leaders can promote lifelong learning and adaptive leadership behaviors tailored to each person’s brain patterns. Doing so will produce effective leadership navigating healthcare organizations to capitalize on future disruptive innovations in the industry.
Editor’s Note: This content has been excerpted from “Best Behaviors: Leveraging Neuroscience to Enhance Leadership Skills,” Frontiers of Health Services Management, vol. 41, no. 2, by Michael E. Frisina, PhD. It has been edited down for length.
The full article received the 2026 Dean Conley Award, and the authors will be recognized during the Congress on Healthcare Leadership.