The Four Fundamentals of Healthy High Performance at Work

In our rush to optimise the work, what got lost was the worker.

By Dr John Briffa | edited by Patricia Cullen | Aug 13, 2026
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For years we’ve been encouraged with ‘work smarter, not harder’. And yet, rates of fatigue, presenteeism and burnout are at all-time highs. What happened? Well, in our rush to optimise the work, what got lost in the mix is the worker.

I have advised organisations on wellbeing and performance for over 30 years and have seen up close how easy it is for people to be ground down by the world of work. Much of this experience has come from more than 8,000 one-to-one consultations in which business professionals and executives have sought my advice on their most pressing challenges. These might relate to physical and psychological struggles, or issues that are more performance and productivity-related. However, whatever their precise nature, what I’ve consistently seen is that the resolution they seek will almost always be found by attending to four key areas – what I call the Four Fundamentals:

  1. Emotional Regulation

How people respond to stress and challenge, and their ability to keep their emotions in check, is critical to success in work and life. However, work pressures are the norm, and so is domestic stress in one form or another.

One key to unlocking our inner resourcefulness is understanding that events and circumstances are not the cause of stress – but our perspective on them is. This is why different people can react very differently to the same situation. 

Feelings of stress and ‘threat’ will typically trigger activity in the ‘stress centre’ of the brain called the ‘amygdala’. In turn, though, this can downregulate activity in the part of the brain necessary for keeping calm, thinking under pressure, and coming up with creative solutions to problems (the ‘pre-frontal cortex’).

One way to reduce emotionality and regain our critical thinking is to imagine the stressful situation is not ours, but someone else’s. What would our thinking be, and what advice would we give, if we were less emotionally tied to the issue and therefore more able to use our rational and creative capabilities? 

Another useful mental technique is to broaden our perspective. Stress tends to narrow our focus to the extent that all we can see is ‘problems’. Widening our view to take in elements of work and life that are fulfilling and ‘make us happy’ can be a good way to keep negative emotions from running the show, thereby boosting our cognitive capabilities.

  1. Energy

Abundant and reliable energy is essential for leading an engaged, fulfilled and productive life in and out of the workplace. Several factors are at play here, with the key ones being nutrition, exercise, sleep and specific breathing patterns.

Most people benefit from leveraging each of these factors, but if I were to isolate the area most in need of an upgrade, it’s sleep. Sleep needs vary from person to person, and from time to time, so this has nothing to do with someone ‘not getting their 8 hours’. Whether sleep needs are being met is best gauged by symptoms (and perhaps sleep-tracking data, for those who are more data-driven).

Two questions I like to ask here: how many hours of sleep do you need to feel your best, and how many hours do you get on average during the working week? Very rarely are these numbers the same, and usually the second number is about an hour lower than the first. This alone signals that sleep debt is being allowed to mount up during the week at least. This is why many will find that while watching TV on a Friday night, sleep can become irresistible from around 8.00 pm.

It’s easy to see how sleep gets squeezed, not least because it looks like unproductive time. However, many people’s performance is affected by sleep debt to the degree that getting more sleep revives them, boosting their overall effectiveness and productivity. Yes, that’s right: by sleeping more, people may have less time to do things, but still get more done

I don’t think standard advice to ‘schedule sleep’ is particularly practical for busy professionals with unpredictable and varied commitments. However, going to bed earlier when the schedule allows – even semi-consistently – is often all it takes for someone to feel and function very much better, quite quickly.

  1. Environmental Design

Our immediate workspace can have a surprising impact on our performance and output. However, beyond ergonomics, this area gets scant attention. Other factors that have important relevance here are light, sound and air quality.

The effect of these factors can be profound. Taking air quality as an example, research shows that as carbon dioxide (CO2) levels climb in our immediate environment, brain function can fall precipitously. One study found that, compared with levels of 600 parts per million (ppm) in the air, 1,400 ppm caused overall cognitive function to halve.

Using a CO2 monitor has revealed to me that sitting in a closed room at home allows CO2 to build up to levels well over 2,000 ppm very quickly. The same is true for the bedroom, and high CO2 levels here have been shown to impair sleep quality and next-day performance.

Adequate ventilation is essential to keep CO2 levels down, ideally with two openings that allow air to flow into and out of the room (e.g., a window and a door, even slightly ajar, on opposite sides of the room).

  1. Execution

Almost every business professional and executive I have spoken to feels overwhelmed. Ironically, for many people, the technology that was supposed to make work easier – collaboration platforms, communication tools and, of course, AI – has actually added to the load.

One particular issue common to almost everyone is our move to hybrid working, and our newfound ability to conduct meetings online. It’s so much easier now than before for the day to be consumed by a steady stream of meetings and calls. The distraction of synchronous communication compounds this. All of this constitutes work, but the problem is that no actual work is getting done. Almost inevitably, tasks and ‘deliverables’ get shunted into the evening. Other than an overly long workday, this risks a delayed bedtime and insufficient sleep.

Also, many people find their mind is preoccupied with work, even during leisure time. This is connected to a phenomenon known as the ‘Zeigarnik effect’ – tasks yet to be done and things that need remembering tend to intrude on our thinking until resolved. This is why some people can find it difficult to stick to the task and may even drift off mentally to work-related matters while supposedly in a conversation with their partner or child.

One way to get something off one’s mind is to do it, of course. However, when is everything ever done? It’s a rhetorical question, of course. Fortunately, research has identified that planning and scheduling tasks can prevent these intrusive thoughts and allow us to be much more present and focused during tasks and conversations.

My advice is to preserve time in the working day to schedule tasks into. A genuine emergency can, of course, take precedence. That notwithstanding, giving ourselves time to get more done during the day and scheduling tasks for the next day’s calendar is a winning formula for enhanced productivity and a less cluttered, calmer mind.

For years we’ve been encouraged with ‘work smarter, not harder’. And yet, rates of fatigue, presenteeism and burnout are at all-time highs. What happened? Well, in our rush to optimise the work, what got lost in the mix is the worker.

I have advised organisations on wellbeing and performance for over 30 years and have seen up close how easy it is for people to be ground down by the world of work. Much of this experience has come from more than 8,000 one-to-one consultations in which business professionals and executives have sought my advice on their most pressing challenges. These might relate to physical and psychological struggles, or issues that are more performance and productivity-related. However, whatever their precise nature, what I’ve consistently seen is that the resolution they seek will almost always be found by attending to four key areas – what I call the Four Fundamentals:

  1. Emotional Regulation

How people respond to stress and challenge, and their ability to keep their emotions in check, is critical to success in work and life. However, work pressures are the norm, and so is domestic stress in one form or another.

Dr John Briffa Medical doctor

Dr John Briffa is the author of The Performance Prescription: The Science of Sustainable Success... Read more

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