Monday 29 April 2013

Wholeness in Healers AND Patients demands Curative AND Healing Capacities

     "In the classical sense, medicine can be considered the science and art of treating persons suffering from injury, disease and illness. The history of medicine reveals that almost universally such treatment can be discriminated into two primary approaches: curative and healing capacities.
     The Asclepian approach, is more focused upon causes of disease as targets for intervention. 
     The Hygieian approach is more cross culturally engrained and broadly salutogenic, embracing attempts to promote wellness and/or evoke healing mechanisms within the individual, so as to maintain health or reduce illness.
     ... we posit that modern medicine, in its Asclepian focus, has subordinated the need and importance of Hygieian healing and caring, and in so doing has lost a radical quality that is both essential to medicine, and fundamental to its perdurability. Therefore, we argue that an integrative medicine must be based upon a core philosophical foundation that rejoins Asclepian and Hygieian approaches, not singularly or co-optationally, but in true conceptual and practical dialectic, such that integration represents a synthesis of these orientations in epistemic, humanitarian and ethical domains."


       Giordano J, Jonas W. Asclepius and Hygieia in dialectic: Philosophical, ethical and educational foundations of an integrative medicine. Integrative Medicine Insights 2007; 2: 53–60.



adameisterc   www.dpreview.com

Sunday 28 April 2013

Negative Effects of the Male Gender Role for ALL Health Care Professionals


     The characteristics & behaviors required to get into, survive, and do well in the health-care professions - regardless of one's gender - are much more in line with a traditional masculine, rather than feminine, gender role. These masculine characteristics & behaviors are antithetical to those of an ideal healer. As expected, research (summarized below) shows that this mismatch is unhealthy. Why wouldn't a competitive, striving, go-getter find herself living an unsatisfying divided life when she's supposed to enact the role of a nurturing healer?
 
     "Recent research indicates that men have poorer outcomes on a broad array of health and well-being variables when compared to women, including higher rates of inherited and behaviorally influenced disease, problematic development, educational difficulty, violence perpetration and victimization, addiction, unemployment and shorter life expectancy. A substantial body of evidence suggests that these differences are the result, at least in part, of maladaptive behaviors encouraged by a traditional view of the male gender role that is restrictive, harmful, and dysfunctional
     Research also suggests that traditionally bound masculine gender roles have a negative effect on psychological well-being especially when men with a traditional outlook are faced with changing societal roles and the ascendance of women at work and in society. The challenges some men experience as the result of changing gender roles, and their effect on well-being and life satisfaction, have been the focus of an increasing body of research. Social commentators have articulately described the difficulties that many men have in finding satisfaction as fathers, as coworkers, and as members of their communities in a world of changing gender norms."

     Burke CK, Maton KI, Mankowski ES, Anderson C. Healing men and community: predictors of outcome in a men's initiatory and support organization. Am J Community Psychol 2010; 45(1-2): 186-200.

 

Saturday 27 April 2013

Somatic Fixation - Avoiding Complex Reality - Health Care's version of “Task Saturation”

     “Somatic fixation is a process whereby a physician or a patient or a family focuses exclusively and inappropriately on the physical or biomedical aspect of a complex problem. Somatic fixation can occur not only in hypochondriasis, somatization disorder, and psychosomatic disease, but in any illness, especially chronic illness, when there is a one-sided emphasis on the biomedical aspects of a multi-faceted problem.”
       McDaniel SH, Campbell T, Seaburn D. Treating somatic fixation:
 A biopsychosocial approach. Can Fam Physician 1991; 37: 451-6.

     This "process has been largely ignored. Furthermore, the idea that somatic fixation might be averted by promoting awareness of it in medical school and 
during residency training has been given virtually no attention. … a process involving doctors as well as patients and, at times, the health care system to which they belong. We propose means of prevention and attempt to distinguish between somatic fixation and the terms ‘somatization’ or ‘somatoform disorder’, the former a tendency usually learned in the family and the latter a psychiatric diagnosis.”
       Biderman A, Yeheskel A, Herman J. Somatic fixation: the harm of healing. Soc Sci Med 2003; 56(5): 1135-8. 

     Biderman et al's 2003 paper (above) was the LAST one written with "somatic fixation" in the title, according to PubMed.

     Clinical Essentialising: http://healthyhealers.blogspot.ca/2012/03/essentializing.html

     Task Saturation: http://healthyhealers.blogspot.ca/2012/02/prioritization.html

 
Alex Gregory - New Yorker

Friday 26 April 2013

Emphasizing the Positive in Health-care

     Health-care education turns many of us into versions of the dogs used at airports to detect illicit drugs or explosives in luggage. We're programmed to spot what's wrong.
     Positive psychology is an attempt to correct this overemphasis on pathology. It's essential to concentrate at least some of our efforts on thriving, flourishing, and finding true contentment & joy in life. Clearly, there's far more right than wrong with human beings (otherwise, we'd be extinct).
     Intelligent, non-pathologizing approaches that effectively encourage human flourishing include: 

• Mindfulness-based interventions eg MBSR, MBCT etc http://www.umassmed.edu/cfm/index.aspx
• Solution-focused therapy (SFT) http://www.solutionfocused.net/solutionfocusedtherapy.html
• Internal family systems (IFS) http://www.selfleadership.org/about-internal-family-systems.html
• Appreciative inquiry (AI) http://centerforappreciativeinquiry.net/
• Non-violent communication (NVC) http://www.cnvc.org/

     These evolved approaches benefit clinicians and patients! It's a welcome, hope-inspiring relief to be skillfully bringing out the best in people (vs "waging wars" on diseases).

     See also: http://mindfulnessforeveryone.blogspot.ca/2013/04/320-self-centered-judgments-breed-fear.html

lindal63   www.dpreview.com

Wednesday 24 April 2013

Basically Good Yet Misbehaving - Human Nature - Primitive & Evolving Parts

     The vast majority of people are fundamentally decent, kind & altruistic, even capable of heroic acts of self-sacrifice for strangers. Wisdom traditions and religions understand the basic goodness of human beings. Secular author Jeremy Rifkin agrees: “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.” (*** See video below ***)
     At the same time, we all make errors in judgment, harming others, ourselves, & the environment. How can we reconcile our basic goodness with our proclivity to "screw up"?
     Neurologically, we know that we operate from both a primitive brain stem (reptilian survival reflexes) and a highly-evolved pre-frontal cortex (mature human judgment / executive function). Under certain conditions (eg alcohol, stress), we can regress / devolve: our pre-frontal cortex temporarily shuts down, and we can "behave like animals." Afterwards, when the pre-frontal cortex comes back online, we may not believe how we just behaved, & may earnestly deny or rationalize. The evolved part of us cannot - YET MUST LEARN TO - recognize & acknowledge our primitive part. Such "parts" are subpersonalities we all have.
     A nuanced model by which we can understand "parts", and improve upon this vexing dichotomy is Internal family systems (IFS). "IFS, developed by Richard Schwartz PhD, is an experiential, non-pathologizing model of therapy that gently and respectfully allows clients to explore their inner lives. The basic assumption of the model is that every human being, regardless of circumstance or trauma, possesses, at their core an untarnished Self from which flows a never-ending resource of love and self-compassion. IFS therapy helps clients understand themselves more deeply, unburden negative beliefs about themselves, and access their internal resource of Self, thereby experiencing profound shifts in well-being." http://toni.therapylinq.com/psychotherapyconsultation/


     A very useful perspective on this comes from the research of psychiatrist Iain McGilchrist: http://healthyhealers.blogspot.com/2019/11/conflicting-perspectives-and.html

     We always have 3 basic choices: regression, staling, or intentionally evolving in our development as conscious loving human beings. Postponing our inevitable evolution in consciousness prolongs needless suffering, while nurturing this process personally & globally is wise and healthy.

     “The most important question facing humanity is this: Can we reach global empathy in time to avoid the collapse of civilization and save the earth?” 
       Jeremy Rifkin. “The Empathic Civilization. The Race to Global Consciousness in a World in Crisis.” Penguin, 2009.
 

Tuesday 23 April 2013

Misbehavior & Inappropriate Shame; Appropriate Guilt & Perfection in an Imperfect World

     While mediating disagreements between students & students, staff & students, staff & faculty, or between students and faculty, I'm always impressed by how differently each side relates their version of the same event. As in the news, there is vehement denial of any wrongdoing. I'm starting to think that people actually believe what they're saying, even when there's overwhelming evidence to the contrary.
     When a person does something harmful, I suspect that they FEEL COMPELLED, DRIVEN to do it - everything in their life, up to this point in time, "made them" behave in this way. It seemed reasonable to them at the time - inevitable. They DON'T do this because they want to "be bad." If they eventually admit to committing the offense, they tend to deflect blame, pointing out who or what "made them do it".
     People seem to be losing the ability to accept blame for harmful inappropriate actions - they cannot take direct personal responsibility - they find GUILT unacceptable. Perhaps they "reason": since I'm not evil, I could not have done this, or at least, could not be responsible. Even when "caught red-handed", they flatly deny everything AND angrily accuse their accusers of humiliating them. They feel SHAME, but seem incapable of feeling appropriate GUILT.
     Yet, in order to grow as a responsible adult, one must learn to accept responsibility for, and correct inappropriate behavior WITHOUT feeling diminished as a human being.
     Everyone's behavior is, at times, mindlessly harmful, and needs to be corrected. AT THE SAME TIME, deep within, we all contain a seed of perfection (according to most wisdom traditions). Every one of us is capable of thinking, speaking and acting, with increasing consistency, from this place of wisdom & stillness, instead of mindlessly acting out of self-centered primitive reflexes. We need to intentionally nurture this normal, healthy maturation process within ourselves and those around us.
     See also: http://healthyhealers.blogspot.ca/2013/04/self-conscious-shame-guilt-and-basic.html

LolloRiva   www.dpreview.com

Monday 22 April 2013

Intrapersonal Bullying - Doesn't it really all start & end within ourselves?

     If we carefully examine the various elements of bullying: http://healthyhealers.blogspot.ca/2013/04/intimidation-bullying-within-dental.html and do some deep self-reflection, we may find that the most frequent sources of stress are NOT external eg fellow students, clinical teachers, professional colleagues or administrators. Psychological mistreatment - the most frequently reported form of mistreatment - is ultimately SELF-INFLICTED. This means accepting & identifying with (ie cognitive fusion) names, ideas, concepts etc that are not truly who or what we are.

     This does NOT mean that bullying of one person by others should be tolerated - it should not. But this DOES mean that it's in each individual's best interest to become as resilient / hardy as possible, to minimize or eliminate altogether negative effects of bullying and other potentially injurious external forces.
     Intellectually we all realize that nobody, no external situation can MAKE us do anything. Regardless of external circumstances, what we do, and how we feel, is up to us (internal locus of control). Striking exemplars include Gandhi and Mandela.
 

     "Resilience refers to the ability to thrive despite adversity and has been defined as a multidimensional phenomenon, spanning internal locus of control, sense of meaning, social problem-solving skills, and self-esteem. The concept of hardiness integrates many of these characteristics and describes individuals who are committed to finding meaningful purpose in life, believe that one can influence one’s surroundings and the outcome of events, and trust that one can learn and grow from both positive and negative life experiences. High levels of this personality trait have been shown to enhance posttraumatic adjustment, possibly by means of a faster physiological recovery from stress."
       Daniels JK et al. Neural correlates and predictive power of trait resilience in an acutely traumatized sample: a pilot investigation. J Clin Psychiatry 2012; 73(3): 327-32.


Sushmita   www.dpreview.com

Friday 19 April 2013

Fear, Avoidance, Ineffective, Existential Angst, Mindfulness, Effective Maturation

     For any educated person it's obvious that by learning about a situation, we can better control it, and thus ensure a better outcome. (There's a large body of research about "self-efficacy": http://cancercontrol.cancer.gov/Brp/constructs/self-efficacy/index.html)
     Yet, despite all our education and unlimited information literally at our finger tips, we are far less rational and infinitely more emotional than we assume.
     Fear easily derails our rationality and behavior. What do we fear? Like everyone, we fear change, aging, sickness & death. And these phenomena are omnipresent - we exist in a sea of constantly changing phenomena, everyone aging, sickness & death everywhere, sparing no one.
     Fear (eg stress & shame) can shut down the prefrontal cortex, allowing the brain stem run the show. Avoidance is a very common, terribly ineffective way of dealing with things we fear. There's a reason for the high rate of workaholism, alcoholism, substance use, problem gambling, and other compulsive escapist behaviors.
     Instead of avoiding, intelligent people approach challenges. “One of the mantras of social work is ‘lean into the discomfort of the work.’” Brene Brown PhD  Obviously it's wisest to approach one's life in general intentionally, with clarity of mind.
     See: http://www.johnlovas.com/2013/08/dealing-with-fear-skillfully.html

     Mindfulness practice is an evidence-based, surprisingly gentle yet effective way of learning about ourselves, approaching & embracing our entire experience - including fears, and thereby learning to feel at home with & find joy in this very life.

     See: http://mindfulnessforeveryone.blogspot.ca/2012/03/88-avoidance-approach-dichotomy.html
     also: http://healthyhealers.blogspot.ca/search?q=avoidance
     and: http://mindfulnessforeveryone.blogspot.ca/2013/04/316-fear-reactivity-mindfulness-mature.html

Gellert Baths, Hungary 1930, Hans Hildenbrand - National Geographic

Thursday 18 April 2013

Wisely Motivating Behavior Modification - Nurturing Full Potential vs Bullying

     We clearly feel when we are being judged negatively, especially when bullied by someone with power / authority over some aspect of our lives. This tends to have a strong negative effect on our self-esteem and performance - we tend to under-perform, down to their, and now our, low expectations. A study many years ago divided young children into 2 groups, closely matched for intelligence: one group was told they had above, the other group below normal intelligence. Both groups were taught identical curricula for a year. The "smart group" significantly outperformed the "below normal" group.
     It's critically important that we learn to intentionally create a freeing atmosphere: being completely nonjudgmental & open-minded about everyone's - our own & others' - capacity to go completely beyond - our own & others' - current ideas of what is possible. A person's potential is NOT carved in stone, it is unknowable.
     Health-care professionals / educators need to & can learn to find within themselves the emotional intelligence, the stillness, the inner wise grandparent that can nurture & bring to fruition the full potential of their patients, students, and yes, themselves!
     The potential in all of us, IF WISELY NURTURED, is completely beyond anyone's current concepts.

     See also: http://mindfulnessforeveryone.blogspot.ca/2013/04/315-glass-half-empty-dont-be-so-sure.html
     and: http://mindfulnessforeveryone.blogspot.ca/2013/04/316-fear-reactivity-mindfulness-mature.html 

cand1d   www.dpreview.com

Wednesday 17 April 2013

Intimidation & Bullying within Dental Teaching & Training Environments?


     A recent multi-national study concluded that "intimidation and bullying is prevalent within dental teaching and training environments" - as it also is in medical and nursing education.
     "the most frequent sources of stress came from other students and clinical faculty members and psychological mistreatment was the most frequently reported form of mistreatment." 
     Yet we know that “rapport between faculty and students, whether positive or negative, seems to have the largest impact upon dental student morale and dental students’ perceptions of their educational experiences”

     Academic incivility can been defined as “any action that interferes with the harmonious and cooperative learning environment.”

     “Bullying is a social interaction in which the sender uses verbal and/or non-verbal communication regularly, weekly and for a period of at least 6 months that is characterized by negative and aggressive elements directed towards the personality and self-esteem of the receiver.”


     "Bullying and incivility can occur among faculty, staff and students and cause a myriad of problems both personally and professionally for the victims. Incivility, like bullying can happen multidirectionally, such as faculty bullying students, students bullying faculty, students bullying staff, etc. The profound consequence of these acts may cause permanent emotional, physical and/or professional damage."
    "feelings of mistreatment and harassment can 'impair the well-being and emotional development of students, and establish poor modelling of the professional role, all of which may translate into impaired physicians and even impaired patient care.'”
 
       Rowland ML,
Srisukho K. Dental students' and faculty members' perceptions of incivility in the classroom. J Dent Educ 2009; 73(1): 119-26.
 

We're ALL capable of greater Emotional Intelligence than this gent, though he is out standing in his field.   image: wikipedia


Tuesday 16 April 2013

Bullying in Health-care - Raising Awareness

     "Bullying has been defined as persistent, offensive, abusive, intimidating, malicious or insulting behaviour; abuse of power; or unfair penal sanctions
     Bullying is a very serious issue with serious consequences as bullied health workers report higher levels of job-induced stress, depression, anxiety, and lower levels of job satisfaction.
     The definition of bullying is wide - ranging from innuendo and sarcasm to physical violence. Fears have been expressed that the definition is so wide as to risk unfounded claims.

Types of bullying behaviour:
Threat to professional status

Persistent attempts to belittle & undermine your work 

Persistent & unjustified criticism & monitoring of your work
Persistent attempts to humiliate you in front of colleagues 

Intimidatory use of discipline or competence procedures 
Threat to personal standing
Undermining of your personal integrity
Destructive innuendo & sarcasm
Verbal & nonverbal threats
Making inappropriate jokes about you
Persistent teasing
Physical violence
Violence to property
Isolation
Withholding necessary information from you
Freezing out, ignoring or excluding
Unreasonable refusal of applications for leave, training or promotion
Overwork
Undue pressure to produce work
Setting of impossible deadlines
Destabilization
Shifting of goal posts without telling you
Constant undervaluing of your efforts
Persistent attempts to demoralize you
Removal of areas of responsibility without consultation"


       Keeley PW, Waterhouse ET, Noble SI. Prevalence and characteristics of bullying of trainees in palliative medicine. Palliat Med 2005; 19(1): 84-5.



Hurricane Sandy



Monday 15 April 2013

Hatred of the Feminine Archetype, Cynicism, Suffering

     “Hatred of women and of women’s autonomy is the most intimate of the psychic diseases that brings us down. As with Lyme disease, it can be years before we even recognize we are infected. More years pass before treatment is sought. Sometimes there doesn’t even seem to be a name for the way one feels. All the while, there is weakness, bitterness and pain. Violence, in word or deed, is often the only language familiar enough to express our confusion. To those who wish to shed a bit of this particular old skin of suffering, to swim more freely in the ever-changing, ever-multiplying rivers of life, I dedicate this book.”

       Walker A. “The same river twice. Honoring the difficult.” Pocket Books, NY, 1996.


     We stunningly underestimate the degree to which we're traumatized by the imperfect love ALL of us INVARIABLY receive from our parents - particularly men from their mothers, women from their fathers. Such imperfection is universal. Our damaged "inner child" can control our entire adult lives, driving us to depression, anxiety, cynicism, workaholism, violence, substance use, burnout, suicide. 
     CYNICISM is HUGE among those who consider themselves educated, intellectuals. FEAR of (another catastrophic) betrayal prevents acknowledgment, acceptance and nurturing back to health, the hurt inner child that colors our every thought, word & action. And yet

         "We are stardust.
          We are golden.
          And we've got to get ourselves back to the garden."              Joni Mitchell


     See also: http://mindfulnessforeveryone.blogspot.ca/2012/06/140-love.html



Bullying in Medicine - letter to the editor of BMJ & a response

       "The tears ran down my face, hidden by my surgical mask. My consultant continued relentlessly, “Why can't you do this? It really isn't hard. Are you stupid? Can't you see how to help me?”
Some doctors should ask themselves whether they are part of the caring profession
       I hated myself for crying. I avoided her eyes so she couldn't see my tears and the deep hurt in my eyes, but I couldn't speak without betraying myself. I managed a few one word answers. The criticism continued, if not with words, then with sighs and angry tutting.

       The atmosphere in the operating theatre was tense. The staff had all seen this happen many times before—hard working, pleasant trainees reduced to non-functioning wrecks in the space of an operation. I looked helplessly at the scrub nurse, another trainee. She saw my distress immediately and gave me a supporting glance. But she too was suffering. “No, not that one. Why do we have to have trainees in my operations? Not like that,” she lashed out at the scrub nurse. Another hard working, competent trainee, now shaking and anxious, her self confidence fast diminishing.

       I didn't know what to do. I felt uncomfortable continuing in such distress. Either my consultant didn't notice or she didn't care. I wondered what would happen if I asked to leave and decided that it would probably just make things worse for me. I stayed. Three hours of hostility and criticism. At the end I ripped off my mask and gloves and turned, only to find her standing behind me. She registered my swollen eyes and tear stained face in complete silence. I have never seen such a cold, emotionless stare, and I hope never to again.
Her behaviour was always the same—on the ward rounds, in clinics, and in theatre
       Her behaviour was always the same—on the ward rounds, in clinics, and in theatre. She was hostile, critical, and discouraging. I continued in this post for the complete six months, becoming increasingly anxious and depressed. I left my post feeling suicidal.
I am now taking a year away from medicine. The past year has been hard, coming to terms with what happened to me in my last post. I had naively hoped that bullying stopped at school. Now I know that bullies continue to bully people throughout their lives. The bullying I endured has left me traumatised. Despite being told that she treated everyone this way, I believed it was all my fault.

       I couldn't believe that such an intelligent and talented surgeon should need to make herself feel better by making those around her feel terrible. I couldn't believe that this was the basis of basic surgical training. This behaviour is often seen as traditional in surgery, and when I brought it to the notice of consultants at my routine assessment and to the postgraduate dean it was ignored: further abuses of power.

       As I look back on this time, I wonder why I felt so helpless. While trying to come to terms with the fact that I effectively let myself be bullied, I read about the experiments in which learnt helplessness was described. A dog was put in a cage and given electric shocks through one side of the floor of the cage. The dog quickly learnt to stay on the other side. The same happened when the other side was used, the dog avoiding the shocks. Then the dog received shocks from all parts of the floor at random. Initially, the dog tried to avoid them, but when unable to it gave up and lay down and received the shocks. After this the cage door was opened. The dog did not escape but stayed on the floor of the cage receiving shocks. I realised that the feeling of being unable to escape is all part of the torture.

       I don't know why bullying is still a part of medical training. It does not encourage learning and certainly does not bring out the best in the members of a team. In the past I have been cared for by kind and encouraging seniors. I am now a disillusioned junior doctor, not only because I was bullied by my consultant but also because she is considered suitable to train junior surgeons and because evidence of her bullying is ignored by those who should help and protect junior doctors from such inappropriate behaviour.

       Perhaps some doctors should ask themselves whether they are part of the caring profession at all."


BMJ 2001;323:1314.1

ONE RESPONSE:

Surgical Professionalism                        24 February 2002


(The above) "case of bullying of a junior doctor by her surgical consultant and the case currently under trial of a consultant surgeon who stands accused of manslaughter after he allegedly ‘lost his temper’, leads us to scrutinise the behaviour of surgeons.

Anon writes of her consultant ‘She was hostile, critical and discouraging’ and adds ‘This behaviour is seen as traditional in surgery’.

No surgeon would condone such behaviour and most would in fact, consider such behaviour as being unprofessional. However, many of us know that to a greater or lesser degree, this kind of behaviour goes on, particularly in the operating theatre.

In stressful environments, people react in different ways, some calm and collected, others becoming frustrated and bad-tempered with ease. Should we expect more from doctors? If we equate loss of temper with loss of control, then yes.

Of course, being the surgeon, and having overall responsibility for the care of the patient means that in the theatre environment, control of external factors is vital. Utmost awareness of the central and peripheral 'goings-on' in the theatre and reacting appropriately to them is crucial. This heightened sense of awareness required may actually be aided by the ‘stress’ of operating. However, surgeons need to be able to control the effects of he 'fight-or-flight' reaction that is going on within them, otherwise it can be detrimental too. Just as one is encouraged and taught to be methodical and calm in cardio-respiratory arrest situations, can the same be taught to operating surgeons?

As trainees, we are exposed to many different types and styles of surgery and surgeon. As well as gaining surgical skills from this, we also form opinions of how we should behave as surgeons ourselves. ‘Bold and brash’ or ‘meek and mild’ or ‘somewhere in-between’? It is important that we have good role models to base these opinions on, so that this aspect of our professional behaviour is correctly developed.

In theatre, the operating surgeon is at the top of a pyramid with the assistants, theatre nurses and ancillary staff forming its base. In this position, surgeons must not lead by their subconscious selves, but by their conscious, intelligent and rational selves. Only if this is done, can they maintain their professionalism."

By

Dr. Dipan Mistry, SHO General Surgery, Calderdale Royal Hospital &
Dr. Kanchan Bhan, SHO Ophthalmology, Leeds General Infirmary

Sunday 14 April 2013

Mirrors, Body Image, our Stories, Art, & Beyond

     “I belong to a people so wounded by betrayal, so hurt by misplacing their trust, that to offer us a gift of love is often to risk one’s own life, certainly one’s name and reputation. I do not mean only the Africans, sold and bought, and bought and sold again; or the Indians, who joyfully fed those who, when strong, gleefully starved them out. I speak as well of the shadowy European ancestor, resentfully denied, except that one cannot forget the thatched one-room hovels of old Europe, put to torch by those who grabbed the land; and the grief of the starving, ashen ancestor, forced to seek his or her lonely fortune in a land that seemed to demand ruthlessness if one intended to survive.
     I belong to a people, heart and mind, who do not trust mirrors. Not those, in any case, in which we ourselves appear. The empty mirror, the one that reflects noses and hair unlike our own, and a prosperity and harmony we may never have known, gives us peace. Our shame is deep. For shame is the result of soul injury. Mirrors, however, are sacred, not only because they permit us to witness the body we are fortunate this time around to be in, but because they permit us to ascertain the condition of the eternal that rests behind the body, the soul. As an ancient Japanese proverb states: when the mirror is dim, the soul is not pure.
     Art is the mirror, perhaps the only one, in which we can see our true collective face. We must honor its sacred function. We must let art help us.”

       Walker, Alice. “The same river twice. Honoring the difficult.” Pocket Books, NY, 1996. 


     See also: http://www.bodymonologues.ca/Home.html

libertylady   www.dpreview.com

Saturday 13 April 2013

Stressed-out or Centered? Choose the one that Feels Right



     We've all been stressed-outfeeling like a fearful little kid, alone, lost in a big dangerous world. We’ve also seen young children crying like their world has collapsed because they broke a favorite toy. This brings out the wise loving grandparent in us, as we smile at the child’s minor temporary upset and console them lovingly, knowing that everything will be fine. In this mode we feel centered: peaceful, relaxed, loving - radically different from stressed.
     As adults,
we can be in either mode. Most stressful situations today only threaten our ego, not our survival, so we can usually allow ourselves to become lost children for a while - or even for life. But in life-or-death emergencies, we become instantly, automatically centered because we simply can’t afford to be anything less than calm, clear, focused, effective, and efficient.
     Many of us mistakenly believe that being stressed-out, multitasking, sleep-deprived, running on caffeine, etc is unavoidable, even normal throughout life for responsible health-care professionals. While being stressed-out is indeed common, it’s mostly unnecessary, inefficient, ineffective, and compromises everyone’s quality of life - ours, our loved ones’, colleagues’, and even your patients’. 
     Developmental psychology models of healthy adult maturation involve: leaving behind stressed-out (egocentric) states, and progressively maturing toward a centered (hypo-egoic, allocentric & ecocentric) way of being.
     Is there a way I can ensure that this healthy adult maturation process or evolution in consciousness actually takes place for me, in my lifetime? How can I learn to intentionally, when needed, switch to a centered way of being? Is there a way of letting go of being stressed-out and all the negative things that go with it, and learn to establish an increasingly stable home base in this centered state?
     Mindfulness practices eg mindfulness-based stress reduction (MBSR), started at UMass Medical Center by Jon Kabat-Zinn PhD in 1979, are secular, evidence-based mind-body exercises, specifically designed to facilitate this journey for healthy providers of care as well as for patients.

     See also: http://mindfulnessforeveryone.blogspot.ca/2013/04/311-fearful-child-wise-grandparent-were.html