Some practices take a while to establish, and it’s worth.every.minute.
I first learned about “Yes, and” from my residency classmate, c.2001. She was taking an improv class in her spare time (a revelation in itself for me at the time—you can do that?). One day after rounds, she came into the workroom eager to share this new learning. I warily accepted her invitation to try it. For those of you unfamiliar, the “Yes, and” exercise goes thusly, according to Wikipedia:
“Yes, and…” is a rule-of-thumb response in improvisational comedy that suggests a participant should accept what another participant has stated (“yes”) and then expand on that line of thinking (“and”).
The “Yes” portion of the rule encourages the acceptance of the contributions added by others. Participants in an improvisation are encouraged “to agree to the basic situation and set-up.” Thus, “By saying yes, we accept the reality created by our partners and begin the collaborative process.” 
In addition to accepting the premise offer by others, a participant in an improvisation is expected to add new information into the narrative. Hence the phrase “Yes, And!”
The goal is to open our minds, allow possibilities, expand our boundaries, and encourage creativity. I can still see her smile, the gleaming light of engagement and anticipation in her eyes. I also remember my own hesitation and self-consciousness. What do you mean, pimple on my forehead? Is it really about to burst? I need a mirror! I was distracted, trepidatious, reserved—less than an engaging partner. Sadly, I think she left that interaction a bit deflated. So sorry, Carol!
In August of 2003, I read an interview with Tina Fey. [Hey, isn’t that AMAZING, that I can Google “tina fey interview 2003 yes and” and it pops right up??] In it, she recalls, “A couple of times I’ve been called on to do things—jobs or whatever—where I’ve felt, ‘Maybe I’m not quite ready. Maybe it’s a little early for this to happen to me.’ But the rules are so ingrained. ‘Say yes, and you’ll figure it out afterward’ has helped me to be more adventurous. It has definitely helped me be less afraid.” For whatever reason, perhaps primed by Carol’s invitation to try improv, this spoke to me, and I resolved to say Yes more often. The very next day, I was invited to attend a luncheon at my church at the last minute, when another attendee had cancelled. Normally I would have said no, thanks, and gone home. I would not have wanted to overstep usual social boundaries, assume a position higher than my own (the luncheon was to honor benefactors). AND, as I had nothing else going on that day, I thought of Tina Fey’s advice, and said yes. I learned about all the people who give their time, talent, and treasure to help our faith community thrive. I was humbled and grateful to be included. Years later, I would give the keynote address at that annual event.
In 2005 I started working with my life coach, Christine. The “Yes, and” idea resurfaced again, this time as a practice in mindfulness. Rather than saying, “I want to be in Colorado, but I am stuck in Chicago,” I redirected to say instead, “I want to be in Colorado, AND I am stuck in Chicago.” The first was a straight-up complaint—a whine. Changing the one word made all the difference, propelling me beyond the ‘stuck’ness. After the ‘and’ statement, I intuitively accepted the current situation as it was, and a logical, sequential question arose: “So, what do I want to do now?” In the following year, I moved (somewhat) past my resentment, feeling anchored in Chicago for the rest of my professional life, and embraced the opportunities a life here could offer. The but-to-and modification played an important role in this attitude shift. I was even able to apply it to my patient interactions, holding space for their stuck-ness and inviting them into new possibilities.
Fast forward to 2009, my first time at the Harvard Coaching Conference. I had the enormous fortune to attend a presentation by Rosamund Stone Zander and Benjamin Zander, based on their book, The Art of Possibility. I had my picture taken with Mr. Zander, and soon became of disciple of the book’s teachings, including the practice of substituting ‘and’ for ‘but’ in daily vernacular. ‘But’ implies limitation and scarcity. ‘And,’ conversely, opens our minds to movement and possibility. I would say that by this time, my Yes, And practice was almost second nature.
And, it was February of 2013 when everything truly gelled. I was offered the privilege of leading a group of internists in the Chicago area, in an innovative educational initiative—weekly board review webinars for practicing physicians. The format was new to all of us, so we took an improv workshop to hone presentation skills and build the team. My partner, Sean, and I engaged in iterative exercises to demonstrate the power of ‘No,’ ‘Yes, but,’ and finally, ‘Yes, and.’ You can try it yourself. Get a partner, and whatever you say, your partner says, ‘No.’ Do that a few minutes, then switch to ‘Yes, but,’ then finally, ‘Yes, and.’ The first two responses have essentially the same effect—shutting down the conversation, tempting the initiator to disengage in exasperation.
When we got to ‘Yes, and,’ I could feel my anticipation rising. Where would this go, what positively outlandish ideas could we possibly come up with? I understood Carol’s excitement at sharing an imminent journey of imagination and creativity. Between Sean and me, we devised a plan to hitchhike to California through the Badlands and Yellowstone. We would stop on the Golden Gate bridge after our car broke down and help tourists take pictures. Then we would steal one of their cars and joy ride down to Jay Leno’s house, or some professional athlete’s house, by way of Candlestick Park, I can’t remember for sure. We would somehow convince the celebrity to drive with us, in his car, back to Chicago, taking selfies along the way, and make a presentation to our colleagues about the importance of primary care… Or something like that! I patted myself on the back; I am a Yes, And pro.
Our webinar series is now well into its second two-year cycle, and the Yes, And approach has guided us well through changes in communication, marketing, staffing, and expansion.
I’m reminded of a strategy that that Dr. Phil McGraw’s team implements when they brainstorm content for his show: “We love every idea for fifteen minutes.” That is the essence of Yes, And! Take any idea, love it, embrace it, flesh it out, water it, pour Miracle Grow on it, throw it around, bounce it off the walls, crack it open, dissect it, sit on it, taste it! You never know what will come of it until you let loose your imagination—YES, AND it!
Yes, And can be applied in every conversation, every relationship, every decision. Yes. And?…