Change is always difficult for people, even when they have a hand in directing the change and can see its benefits. The main reason is that the unknown is scarier than the known. Most changes, even ones with positive goals, are painful for those who must change. Implementing change effectively requires managing three elements of change, which the author calls P1, P2, and P3: P1 = the pain of continuing to do things as you did in the past; P2 = the pain of not having the change in place ("the unfulfilled desire for the change"); and P3 = the pain of actually going through the change. Applying those steps usually requires the willingness to be honest and to communicate directly, even when it is about something unpleasant. Such directness can be challenging for many people who were taught always to be polite and nice, not to express opinions openly if they might offend someone or hurt someone's feelings. But such honesty can be refreshing when expressed in the right spirit and without attacking anyone personally. The author stresses that effective leaders know how to balance toughness and tenderness to create a sense of teamwork and collaboration.