How Open-minded am I? Paradigms & Dogmas

     “A paradigm, most simply, is both a model of and a template for reality. Complementary terms include ‘belief system’ and ‘worldview.’ Just as a fish cannot breathe outside of the water it swims in, so an individual operating within a paradigm is subject to the illusion that the paradigm represents the whole of reality. But no paradigm does. All models of reality, no matter how complex, are bound to leave out some aspects of the ‘reality’ they are attempting to model. Many paradigms come to constitute relatively closed conceptual systems that discount or exclude incompatible information, regardless of its potential validity within another paradigm. In the Structure of Scientific Revolutions (1970), philosopher Thomas Kuhn demonstrated that, far from being an accurate model of reality, the most a paradigm can be is a set of beliefs about the nature of an ultimately unknowable universe.

     The limitations of paradigms are counterbalanced by their advantages: paradigms provide clear conceptual models that facilitate one’s movement in the world. In acting not only as models of – but also as templates for – reality, paradigms enable us to behave in organized ways, to take action that make sense under a given set of principles. ‘To paradigm,’ if you will, is to create the world through the story we tell about it. We then can live as cultural beings in the organized and coherent paradigmatic world we have created. We cannot live without paradigms. But we can learn to be conscious and aware of how they influence our thoughts and shape our experience, to understand that they open some possibilities while closing others. That awareness can bring a rare kind of freedom – the freedom to ‘think beyond.’

     Davis-Floyd R, St. John G. “From doctor to healer. The transformative journey.” Rutgers University Press, London, 1998.

     “… the open-minded person is one who is able and willing to form an opinion, or revise it, in the light of evidence and argument.” William Hare
       Sellman D. Open-mindedness: a virtue for professional practice. Nurs Philos 2003; 4(1): 17-24.

     “persons who exhibited ‘intolerance of ambiguity’ were disinclined to think in terms of probability, tended to favor stereotypes and showed a marked discomfort with ambiguity by escaping into whatever seemed concrete. … intolerance for ambiguity (has been defined) as ‘the tendency to perceive situations that are novel, complex or insoluble, as sources of threat.’ Moreover, intolerance of ambiguity has been associated with a constellation of other personality traits including rigidity, authoritarianism, dogmatism and ethnocentrism, with socially relevant phenomena such as religiosity and conventionality, and with the inability to adapt to cognitive stimuli that are at variance with conventional reality.”
       Geller G. et al. Measuring physicians' tolerance for ambiguity and its relationship to their reported practices regarding genetic testing. Med Care 1993; 31(11): 989-1001.

      See also: http://www.johnlovas.com/2013/02/managing-uncertainty-re-creating.html

View from Wolfville, Nova Scotia

Reptiles eat their young - We must be wiser

     Ideally, the older, wiser members of our profession mentor young colleagues. Mentoring is of course more than handing down techniques, and even more than professional socialization. Mentoring should, above all, be about embodying wisdom and thus helping to nurture the young protege's own wisdom. Wisdom can best be embodied. And regardless of our level of wisdom, we do embody it - it exudes from our every word and action.
     "Wisdom, (according to Barry Schwartz) is 'moral jazz.' A great jazz musician is a genius of improvisation, and so are those who are wise. Wise people also possess simple empathy and the ability to choose among virtues or rules when they conflict. There is often a choice between being honest and being kind, and wise people make the right choice.
     The essential common ingredient for all of these qualities is experience. ... 'No one is born wise; Everyone is born with the capacity to be wise.' That capacity, however, seems to be undermined constantly." http://www.psychologicalscience.org/index.php/publications/observer/2012/july-august-12/war-on-wisdom.html

     Health care continues to be dominated by a macho mentality. This mentality scoffs at patient-centered care, and is openly scornful toward fellow health-care professionals who simply wish to live a balanced life. It displays a stunning level of ignorance and intolerance towards colleagues who experience psychological difficulties.
     Colleagues with cave-man attitudes require counseling, not promotion to leadership positions. We no longer dwell in caves - so let's stop promoting the biggest, (physically) strongest & loudest to lead us. Today, more than ever, we need WISE leadership.
     PS Sadly, the title is based on a common saying: "Nurses eat their young."

Empathy, Healing Connections, Civilization

     All human beings are on a lifelong maturation journey:
     • from stuck in the past & future toward dynamic presence
     • from rigidity & cynicism toward psychological flexibility, acceptance, humor & joy
     • from self-centered reactivity toward altruistic response to others’ needs
     • from “I can’t handle this” toward increasing abilities to manage complexity, ambiguity & difficulty with competence & composure

     For health-care professionals, this journey should be an intentional practice, since we can only effectively form healing connections with our patients, others, and ourselves, at an elevated level of consciousness - towards which this ageless human journey leads.

     “Much of our daily interaction with our fellow human beings is empathic because that is our core nature. 

     … the extraordinary evolution of empathic consciousness is the quintessential underlying story of human history.”   Jeremy Rifkin

Self-care or Repair?

     We've been promoting "an ounce of prevention is worth a pound of cure" to our patients for a long time. By and large, they don't listen to us. If understanding concepts were the key, there would be no more obesity, nobody would smoke, and everyone would get regular aerobic exercise.
     Practicing what we know to be reasonable, right, beneficial etc is on an entirely different level - and that includes US living healthy, balanced lives - and if we run into trouble, seeking appropriate professional help. Why do we, who know better, still only seek help AFTER a wheel has fallen off? We're smarter and can do better than that - for our selves, our families, our patients and professions.

Photo: TClair   www.dpreview.com

Science, Paradigms, Beliefs & Places that scare us

     "belief in unfounded ideas occurs in four contexts: when unfounded evidence is created as an explicit fraud, when sound evidence is subject to distortion by anxieties or wishful thinking, when sound evidence is absent, and when sound evidence can be easily ignored." Stich, S. (1990). The fragmentation of reason. Cambridge, MA: MIT Press.
     "there are three major reasons that people believe in ideas lacking sound supporting evidence: credo consolans, an unproven idea may be comforting if it predicts a good outcome, makes us feel powerful, or makes us feel in control; immediate gratification, an unproven idea may be attractive if it offers instant solutions for difficult problems; and easy explanations, an unproven idea may be accepted if it offers a simple story about something that is difficult to understand." Shermer, M. (1997). Why people believe weird things: Pseudoscience, superstition, and other confusions of our time. NY: Freeman.

Both above quotes from: Waterhouse L. Multiple Intelligences, the Mozart Effect, and Emotional Intelligence: A Critical Review. Educational Psychologist 2006; 41(4): 207-225.

 Some (most?) constructs cannot be operationalized to permit meaningful quantitative scientific validation nor invalidation. Therefore, the most meaningful aspects of human life, such as love, will never be backed by "sound supporting (scientific) evidence." Yet many of us fantasize that nature operates by our "scientific laws" much the way Koch originally envisioned the behavior of pathogenic microorganisms. In fact, even these simple life forms failed to 'follow' any of his famed postulates. Like all scientific paradigms, it was the best simple model of reality available at the time. 

It's critical for all of us to not take ourselves, our theories, or our tools too seriously. We must stay open to learning, not just in the sciences, but above all in places that scare every one of us - the big questions of life.

Canada geese over Nova Scotia, flying south for the winter

Upset and angry?

     People have to be "outraged, upset and angry" and behaving in an outrageous manner themselves, to be on the news these days. The more violent and over-the-top, apparently the "better TV."
     Mimicking Hollywood shoot-em-ups, the aggrieved captured on video feel not only justified, but apparently feel a duty to enthusiastically avenge some perceived injustice - to defend their honor (bruised ego) with butchery and mayhem.
     Every nation, ethnic group and religion (even peace activists!) contains violence-prone uneducated rabble, easily triggered to react like reptiles. It's their low stage of development, and does not represent the larger society to which they belong. We have such groups in North America as well.
     A very serious human problem is projecting evil onto others in order to help deny our own imperfection. Regardless of the difficulty of the situation, reptilian reactivity escalates and prolongs problems, whereas "grandmotherly love" invariably works in the long run: http://mindfulnessforeveryone.blogspot.ca/2012/09/188-grandmotherly-love-like-oxygen.html

     For a sophisticated look at the psychosocially immature ("the great unwashed") in our own backyard, see the excellent 1998 movie "American History X" starring Edward Norton.

"Slow Dance" - poem by a young cancer patient

Have you ever
watched
kids

On a merry-go-round?

Or listened to
the
rain

Slapping on the ground?

Ever followed a
butterfly's erratic flight?

Or gazed at the sun into the
fading
night?


You better slow down.


Don't
dance so
fast.


Time is short.


The music
won't
last.

Do you run through each day

On
the
fly?

When you ask How are you?

Do you hear
the
reply?

When the day is done

Do you lie
in your
bed

With the next hundred chores

Running through
your head?


You'd better
slow down


Don't dance so
fast.


Time is
short.


The music won't
last.


Ever told your
child,

We'll do it
tomorrow?

And in your
haste,

Not see
his
sorrow?

Ever lost
touch,

Let a good
friendship die

Cause you
never had time

To call
and say,'Hi'


You'd
better slow down.


Don't dance
so fast.


Time
is short.


The music won't
last..


When you run
so fast to get somewhere

You
miss half the fun of getting
there.

When you worry and hurry
through your
day,

It is like an unopened
gift....

Thrown
away.

Life is not a
race.

Do take it
slower

Hear the
music



Before the song is
over.

When Our Whole World Collapses Around Us

      Sharon Danloz Parks writes eloquently about the major traumas - "shipwrecks" - that, if we live long enough, we'll all inevitably experience: relentless change, end of relationships, betrayal, job loss / retirement, serious illness / death of loved ones, our own aging, illnesses and ultimately, death.
     “To undergo shipwreck is to be threatened in a total and primary way. … what has dependably served as shelter and protection and held and carried one where one wanted to go comes apart. What once promised trustworthiness vanishes.” 
       Parks SD. “Big questions, worthy dreams. Mentoring young adults in their search for meaning, purpose, and faith.” John Wiley & Sons, San Francisco, 2000.

     "‘ontological security’ ... refers to the important need to maintain a sense of security in a context of constant change and potential threat. Ontological security is what is lost when, at times of experiencing a major loss or a trauma, we lose our sense of who we are.”
       Thompson N, Pascal J. “Reflective practice: an existentialist perspective.” Reflective Practice 2011; 12(1): 15—26. 

     How do you feel reading this? Does it make you want to switch to a more pleasant topic - to distract you from "depressing" reality? Is it possible that the well-known ineffectiveness of suppression applies equally to our own existential angst?
 
     "Real liberation comes not from glossing over or repressing painful states of feeling, but only from experiencing them to the full.” Carl Jung
 
     A common lesson in perspective: A toddler sits crying bitterly on the floor - his whole world has collapsed for him. His Mom stands above him smiling with love in her heart for the little dope, whose inexpensive toy has just broken. If the child saw Mom smiling, he'd think that Mom doesn't understand the seriousness of this catastrophe at all - or is laughing at him. But of course, it's the child who lacks the long-term big picture - "the 30,000 feet perspective". Mom's been through such calamities herself, and has confidence that sooner or later, the boy will grow and understand ... and indeed we all have this potential. We all are BOTH the frightened child AND wise grandparent.

Photo: Vittorio Fracassi   www.dpreview.com

Authors of our own life

     “We have the innate capacity for a more accurate seeing, for learning, growing, healing, and transformation across our entire lifespan. You are the authority and the author of your own life. If you are always paying attention to other people’s lives rather than your own, you are missing not only the point, you are missing your life. The challenge is to live your life as if it really matters. And to be conscious of how you conduct your life – from what you eat and drink to the newspapers you read and the television programs you watch, to how you are in relationship with everything with those you love, with nature, with your body, with the world.”                  Jon Kabat-Zinn

         Gazella K. Bringing mindfulness to medicine: An interview with Jon Kabat-Zinn, PhD. Adv Mind Body Med 2005; 21(2): 22-7.

Peggy's Cove, Nova Scotia

When reality intrudes

     Perspective is huge. We're used to looking at patients with objectivity - from a distance. Often it can feel like we're in a helicopter hovering over a capsized boat with a man flaling away, drowning in the water below. We know that yelling out swimming instructions now are useless, and probably irritating as well.
     Sooner or later, it's our turn in the water, with others above in the chopper. Have we learned how to swim? Can we swim gracefully?
     How much time and effort do we expend to keep our mind off the inevitability of ourselves being in the water? Maybe we need to intentionally learn from graceful swimmers? Elisabeth Lesser has been studying these folks for many years - her book is excellent: “Broken open. How difficult times can help us grow.” Villard, NY, 2005.

Attitude First & Foremost

     “To be relaxed and in the right frame of mind is of prime importance. Everything else comes later. To recognize whether or not you are in the right frame of mind is more important than experiencing peaceful states or having a ‘good sit’ ” writes meditation teacher Tejaniya.

     What general principles can we immediately take from these words?

     Being 'relaxed' here refers to a balanced state of attentiveness, neither strained nor slack. Like a guitar string tuned just right (neither sharp nor flat), our perception is most accurate when we're emotionally balanced. 

     'Peaceful states' and 'good sits' are goals. Let's face it, many of us are goal-oriented perfectionists. But we know that students preoccupied with getting an 'A+' or runners preoccupied with crossing the finish-line first, cannot possibly perform as well as if they were embracing the process by which to achieve these goals. By embracing the process, I do imply an open-hearted engagement with the activity itself, with the least egoic interference.

     Letting go of eagerness to achieve a goal eg getting the golf ball into the hole, and letting go of fear of embarrassment of really messing up a golf shot in front of others, trusting muscle memory to do its own thing with the least amount of ego noise, markedly improves quality of life as well as performance.

     Isn't this a tricky, slowly-learned life-lesson? Embracing whatever life offers with curiosity, an open mind, and a somewhat mysterious confidence that I can and will grow from this too? 
     How does embracing each moment of life - even for a few moments - feel, compared to our usual, anxious, future-oriented, striving mode?

Time - only a construct to understand

     “As Kant pointed out two centuries ago, time exists solely as a construct of the mind, expressed in linear form, sequentially, as chronos and vertically, meaningfully, as kairos.”

     yet, isn't time one of our greatest worries?

     "Nothing in life is to be feared. It is only to be understood."                 Madame Curie 

        Hollis J. What matters most. Living a more considered life. Gotham Books, NY, 2009.

Photo: DMGoldie   www.dpreview.com

Healing journey

     The healing journey is a set of transformations all maturing humans are required to undergo. Healers are also teachers, and we teach most powerfully by example. Thus, it is extra important that we undertake this journey earnestly and thoroughly for our collective welfare:

• from stuck in the past & future toward dynamic presence 
• from rigidity & cynicism toward psychological flexibility, acceptance, humor & joy 
• from self-centered reactivity toward altruistic response to others’ needs 
• from “I can’t handle this” toward increasing abilities to manage complexity, ambiguity & difficulty (ie real life) with competence & composure

Norval Morrisseau 1932-2007

Mindfulness for Health Care Professionals - Continuing Education Course

     It's surprising and humbling to catch oneself overreacting! We all do it in one way or another. Some of us "explode" for all to see and hear. Many of us unwittingly allow resentment to fester in our guts, which inevitably spills out in all forms of short- and long-term fallout: cynicism, irritability, anger, perfectionism, workaholism, dogmatism, presenteeism, absenteeism, somatization, burnout, even suicide.
     Interestingly, we may be able to handle more serious upsets with grace and maturity, yet "go ballistic" over something completely meaningless in the overall scheme of things eg when a car cuts us off. What's that about? Could it be the festering stuff in our guts spilling out? There is a reasonable explanation for everything, including what appears to be unreasonable behavior. All effects have causes.
     One of the key benefits of mindfulness training is learning to see things with increasing clarity, and thus, learning to respond to them with increasing appropriateness - regardless of the difficulty of the situation. We can't make the external environment conform to our wishes, but we can, through mindfulness practices, provide favorable conditions for our consciousness to evolve, thereby learning to relate increasingly more wisely to life's many and varied challenges.

     Working ever harder & "more perfectly" at your profession, at some point, becomes glaringly inadequate. Consider learning a critical life skill in this immersion course with like-minded, mature heath-care professionals. Life can be more peaceful, even joyful, despite aging and many other inevitable ups and downs!

Mindfulness for Health-Care Professionals: 

An 8-week Immersion in Self-care

Presented by: Dr. John Lovas

Sept 27, 2012 – Nov 15, 2012

Thursdays, 5:30 - 8:00pm (light dinner included)

Faculty of Dentistry

Dalhousie University

Halifax, NS, Canada

For detailed brochure: 

http://www.dentistry.dal.ca/cde/currentschedule.html

For additional information phone or email Rita:

(902) 494-1674

Rita.Davis@Dal.Ca

Do no harm - Know yourself

     “Most of us would agree that it matters that we bring no harm, or at least less harm, to others. This noble desire asks that we become progressively aware of, explore, take responsibility for our personal shadow. The shadow includes those parts of ourselves that make us uncomfortable with ourselves, whether it be our capacity for evil; our insurgent, narcissistic agendas; or our most spontaneous, healing, instinctual grounded selves.”

     “Jung challenges us directly: ‘Real liberation comes not from glossing over or repressing painful states of feeling, but only from experiencing them to the full.’”

        Hollis J. What matters most. Living a more considered life. Gotham Books, NY, 2009.

Nancy Camden Witt "Moon Rising" 1990 http://www.crossmillgallery.com/nancy.html

Ideals, Energy, Ambition, and Self-Reflection

     "J. Edgar" is a fascinating character study of a complex, well-meaning, energetic, ambitious, yet deeply troubled man. Hoover contributed much to criminal investigative science, but his unexamined inner life caused widespread suffering.
      "Ignoring the shadow side of our personalities can only lead to what Freud once called 'the return of the repressed'.” (Mark Epstein MD) It takes a mature human being to consciously self-reflect, and thus position herself to live well and serve others, minimizing 'collateral damage'.

"J. Edgar", Clint Eastwood's 2011 movie, starring Leonardo DiCaprio

Transitions, Changes, Transformations ...

     Change is constant, ceaseless, relentless. "Rust never sleeps" sings Neil Young. I wonder if Paul McCartney still sings "when I'm 64"? How much of our efforts are wasted on trying to freeze, slow down, or deny the existence of change?
     Some wisdom traditions are about learning how to flow with the river of life, to learn how to be more like water, to develop the suppleness of willow trees. We know conceptually that psychological flexibility is healthy, while rigidity is one of the oldest, best known psychopathologies.
     Can we intentionally, consciously begin to soften, become porous, and flow with life?

Hope to see you in Montréal !!!

2012 AMA-BMA-CMA International Conference on Physician Health

Oct. 25-27, 2012, Montréal, Quebec
Register now!

Peter Sawatzky's "Seal River Crossing" Winnipeg http://www.lochgallery.com/content/view/145/50/