Skimming the surface

     How many times have I bought a book, put it on my shelf, but never got the chance to read it. Nevertheless, there's a misguided sense of ownership of the contents by virtue of buying it.

     How about buying the gear for an activity that sounds like fun, but which one never even begins to do eg fly fishing. Or buying a gym membership, but using it maybe once.

     We seem to live in an age where information, activities, clothing, food, geographic locations, even secrets of the world's wisdom traditions are all readily available. We're drowning in choice, but we flail like a drowning person on the surface of things. Have we lost the ability to dive deeply, immersing ourselves in a single activity? Perhaps we fear that we'll become out of touch, idiot savants, unless we keep up with constant newsfeeds, tweets, emails etc?

     “So long as one is merely on the surface of things, they are always imperfect, unsatisfactory, incomplete. Penetrate into the substance and everything is perfect, complete, whole.” 
        Kapleau P. “The Zen of Living and Dying. A Practical and Spiritual Guide.” Shambhala, Boston, 1998.

Photo: Colin Bates   http://www.coastalimageworks.com/

Existential resilience

     “Obviously, it would be wonderful to have a way to deal with all kinds of experiences: sorrow, mystery, happiness, and ecstasy. Our lives would be transformed if we could learn to heal and to withstand sorrow better, to uncover meaning in the midst of mystery, to cultivate happiness, and to invite ecstasy. Fortunately, these are the goals of spiritual practices, and these practices offer a life-changing feast of benefits.” 

     “The word religion has many meanings; in particular it implies a concern with the sacred and supreme values of life. The term spirituality, on the other hand, refers to direct experience of the sacred. Spiritual practices are those that help us experience the sacred – that which is most central and essential to our lives – for ourselves.” 
        Walsh R. “Essential spirituality. The 7 central practices to awaken heart and mind.” John Wiley & Sons Inc, NY, 1999. 

"The wisdom of no escape"

     Most of us realize that the problem-solving approach Arnold Schwarzenegger used in his movies was meant to be comedic. "The war to end all wars" (WW I) didn't. And yet, the public continues to support equally useless wars on drugs, terrorism, crime ...

     To (attempt to) eradicate something, it's first demonized - made utterly hateful AND foreign to ourselves individually and collectively to "our tribe", then it's fine to swat it like a mosquito. It's awkward of course when "one of our own" commits a reprehensible act - then we have to "disown" the unfortunate - an outcast, left behind to fend for himself in the wilderness. Most awkward is when we ourselves mess up! Then we have to disown the act - through lying, denial, repression, suppression, avoidance, temporary insanity ... "The system" or one's parents are also handy targets to deflect the blame.

     We each have to take personal responsibility - start looking at our self deeply and honestly. What is our role in this mess? This is infinitely more complex and challenging than diagnosing and treating patients' physical illnesses. Most of us have minimal training in psychosocial matters, and deep self-reflection is uncharted territory for us. Nevertheless, if we wish to fully engage the complexity of our single, short, precious life, then it's worth really serious effort.

     A personal / professional "shipwreck" can suddenly force this inward journey. For this liminal experience to be a productive growth experience, for externally-oriented perfectionists, it's a really good idea to have professional guidance. In Nova Scotia, we have a free, confidential Professionals' Support Program for dentists, physicians and veterinarians, operated by Doctors Nova Scotia. The two fine people behind it are:

Tracy Scott MD  and  Carolyn Thomson MD
Confidential help line: 902-468-8215
E-mail: professionalsupport@doctorsns.com

        Title of today's blog is from the excellent book:         Chodron P. “The Wisdom of No Escape.” Shambhala, Boston, 1991.  

Ethics - black & white??

     Investment advisers, CEOs, clergy, politicians, lawyers, accountants, police, and yes - health-care professionals - lie, cheat, steal, engage in every conceivable means of betraying the public's trust. A real earth-shaker in my area of professional interest was the Sudbø case (below).

     "A stunning admission of fraud from a respected Norwegian oral cancer researcher, Jon Sudbø, M.D., Ph.D., D.D.S., has left the cancer research community reeling. According to statements from his hospital and his attorney, Sudbø fabricated data for 900 patients in a study published in October in The Lancet, which has now retracted the article. He also 'fundamentally mishandled' data for a 2001 article in The New England Journal of Medicine and a 2005 article in Journal of Clinical Oncology.

      Eva Szabo, M.D., who oversees prevention trials for upper aerodigestive cancers at NCI, said in a statement that the institute is reviewing 'the entire portfolio' of oral cancer grants to see which others, if any, drew scientific justification from Sudbø's fabrications. ..."                   http://jnci.oxfordjournals.org/content/98/6/374.full

     Even the liberals among us tend to morph into hanging judges when it comes to serious breaches in medical ethics. We're disgusted and firmly feel that we could never do that! Short of capital punishment, we really want to distance ourselves from such depravity as definitively as possible.

     The problem is that we can't. We are not qualitatively different from these "perps." Each of us has the potential to do anything - from unimaginably horrible to unimaginably wonderful - given the wrong / right circumstances. If we suppress and deny our "dark side," it's much more likely to bubble up as unethical behavior. Health-care professionals tend to be more outwardly oriented than introspective - a real handicap!

         Ethical breaches are disgusting, should bring severe penalties, BUT perpetrators are one of us fallible, at times horrible & idiotic, always fragile, immature yet ever-so-slowly maturing, wonderful creatures.

     “Be kind, everyone is carrying a heavy load.”       Anon

Photo: Colin Bates   http://www.coastalimageworks.com/

 

Healing

     “... an interesting story about how a famous psychologist in Japan cured a young girl after she suffered a nervous breakdown. The girl was from a wealthy family, and the psychologist met her regularly. But he didn’t do or say anything. He just sat with her. One day, as he was sitting with her, the girl peed on the floor right in front of him. He was a very neat gentleman, and he was dressed in a very fine suit. But the moment she did this, he immediately took the beautiful handkerchief from his breast pocket and, without comment, cleaned up after her.

     In time she completely recovered. She later recalled this incident, because she was very impressed by the psychologist’s actions that day. Without any hesitation, he just mopped the floor with his fresh, neat handkerchief. There is no way to explain why she recovered. He didn’t do anything. He only cleaned up after her during this one incident. But she could feel something very soft, gentle, and magnanimous coming from each pore of his body. She really respected him.

     Have you ever met such a person? The moment you meet such people you feel relief just by their presence or their smile. Such people actually do exist in the world. How can we cultivate and nurture this kind of character in ourselves? It is not done through any intellectual process."

     Katagiri D. “You have to say something. Manifesting Zen insight.” Shambhala, Boston, 1998. 

Photo: Colin Bates   http://www.coastalimageworks.com/

CEO syndrome

     Few of us will ever reap the rewards of being actual CEOs - sky-high income, jet-setting lifestyle, prestige. 

     Nevertheless, an alarmingly high proportion of us chose to take on the air of dysfunctional CEOs - harried busy behavior, doing a poor superficial job of projects we've committed to, obsessive cell phone use - an overall lack of caring, balance, focus, priorities, quality of life. 

     "I'm busier than you" and it's variants are common pleas for respect. However, when people we depend on repeatedly fail to deliver, CEO-type excuses become difficult to tolerate.

     We depend on each other completely to do our assigned tasks very well, with great integrity. Civilization depends entirely on each person's civility - like an animal depends on the healthy function of each cell in its body. ALL of us need to fulfill our responsibilities to each other - to life.
     This includes even the smallest aspects of our lives - like throwing trash INTO - instead of beside - the garbage pail, even though there are cleaners for public washrooms. We each OWE civility towards others who use the washroom, as well as the cleaning staff. How we behave, especially when no one can see, accurately reflects our self-esteem - to upgrade the latter, upgrade the former!

Photo: Meowr   www.dpreview.com

Blind Spots - Common & Normal

     Years ago, while driving in heavy Toronto traffic, I looked in the side mirror and without turning to look directly, I quickly switched into the lane to my right. In the process, I cut off a (marked) police car and scared the heck out of one of the policemen. Obviously I had not seen them - they were in my "blind spot." Of course I would have seen them, had I appropriately turned to look directly.

     How many times have we done regrettable things and wondered "What was I thinking?" We now clearly see what was invisible to us then. Most of these blind spots are developmental-stage dependent. We were simply too "young, dumb, and (possibly) full of rum".

     It's so important to realize that we have a huge potential for continued growth as human beings. If we must define ourselves, can it be as a "work-in-progress" or perhaps a verb instead of a noun? Instead of having simplistic "premature closure" about infinitely complex, fluid, ever-changing reality, can we not instead wonder about the mystery of "Who am I?" and "What is this?"

     Our life is "a complex process that includes changes in biological, cognitive, emotional, social, spiritual, and moral dimensions.”

       Parks SD. “Big questions, worthy dreams. Mentoring young adults in their search for meaning, purpose, and faith.” John Wiley & Sons, San Francisco, 2000.

 

Photo: eric87   www.dpreview.com

Job satisfaction

     “We can do no great things, only small things with great love.”         Mother Teresa

      “The success of love is in the loving - it is not in the result of loving. Of course it is natural in love to want the best for the other person, but whether it turns out that way or not does not determine the value of what we have done.”                                           Mother Teresa 

Photo: Colin Bates   http://www.coastalimageworks.com/

 

Authentic communication

     "Communication that is delivered from a skilled and authentic self requires that the self be healthy. Unlike other medical skill-sets, with relationship skills, what you are is as important as what you do. This requires much more than the acquisition of a communication competency. It is no mere cosmetic makeover.

     Transformation of the self – whether as an individual or an institution – is far from easy. … Communication is a core clinical skill. … Senior doctors recognize that their deficiencies in this area contribute to high psychological morbidity, emotional burnout, depersonalization, and low personal accomplishments.

     There needs to be a deep appreciation for the role resistance plays in limiting change. Despite awareness of the problems of communication, why is change within the medical profession taking place at such a glacial pace?"

        Bub B. Communication skills that heal. A practical approach to a new professionalism in medicine. Radcliffe Publishing, Oxford, 2006.

ile d'Orleans in the province of Quebec

Professionalism?

     A profession has been defined as "a collection of expert service providers who have jointly and publicly committed to always give priority to the existential needs and interests of the public they serve above their own, and who in turn are trusted by the public to do so."

     Welie JVM. Is dentistry a profession? Part 1. Professionalism defined. J Can Dent Assoc 2004; 70(8): 529-32.

     Some medical educators have argued that the altruism implied above is unrealistic. Furthermore, health care professionals commonly exhibit avoidance behavior towards existential issues, during training, clinical practice, and not surprisingly, in their private lives.

     Not just health-care professionals, but ALL members of a civilized society must aspire to steadily work towards the ideals of a profession as defined above. Altruism is NOT too much to ask. Every single one of us is RESPONSIBLE for having a lasting positive impact on all of our lives. To embody these basic essential virtues, we all need to grow into FULLY MATURE human beings - a big part of which is approaching (rather than avoiding) existential issues in a healthy manner.

     Should we expect any lower standards of caring from the corner mechanic fixing a school bus' brakes - or a laborer in a third world country assembling smoke detectors - or a dishwasher in a restaurant? Our life, safety and well-being is literally in each others' hands. But our evolution in consciousness is firmly in our own hands.

     "To those whom much is given, much is expected."          John F. Kennedy

     Let us never forget how much society has given and continues to give us health-care professionals, and how much is RIGHTLY expected of us. We owe it to ourselves - and everyone else - to intentionally progressively grow towards the mature human beings we are meant to be.

James Hollis PhD excellent interview (27min)

Mindfulness Course - Highly recommended

     Having taken this mindfulness-based stress reduction (MBSR) course myself, from these two gifted senior teachers, at this same fine venue, I confidently recommend it to anyone who wishes to experience the richness that mindfulness has to offer.
     This course fills up very quickly, so if interested, don't delay registering.

Mindfulness Tools for Living the Full Catastrophe -  

A 5-Day Intensive in Mindfulness-Based Stress Reduction (MBSR)

Teachers: Melissa Blacker and Florence Meleo-Meyer

Repeated each summer in Rhinebeck, New York, USA

http://www.eomega.org/omega/workshops/4b9ff0d51f8c3ea71a113aaae4c2a1c4/?source=ePromo.OM.CS

Wisdom? - in an Information age?

        “In a non-traditional culture such as ours, dominated by technology, we value information far more than we do wisdom. But there is a difference between the two. Information involves the acquisition, organization, and dissemination of facts; a storing-up of physical data. But wisdom involves another equally crucial function: the emptying and quieting of the mind, the application of the heart, and the alchemy of reason and feeling. In the wisdom mode, we’re not processing information, analytically or sequentially. We’re standing back and viewing the whole, discerning what matters and what does not, weighing the meaning and depth of things. This quality of wisdom is rare in our culture. More often, we have knowledgeable people who pretend to be wise, but who, unfortunately, have not cultivated the quality of mind from which wisdom truly arises.”

      Dass R. “Still here. Embracing old age, changing, and dying.” Riverhead Books, NY, 2000. 

Photo: calgalli   www.dpreview.com

At least do no harm ...

     "We are to live so that no harm or pain is caused by our thoughts, words, or deeds to any other being." Patanjali, Yoga Sutras

      “Many people in our society are being driven to addictions because there is no collective container for their natural spiritual needs. Their natural propensity for transcendent experience, for ritual, for connection to some energy greater than their own, is being distorted into addictive behavior.” Marion Woodman

     Is my life, moment-by-moment, clearly reflecting my core values - who I truly am?

Photo: luc verpoort   www.dpreview.com

 

Trust

     "Walls not only keep others out, but keep us in. Yet, we can afford to tear down those walls only if we are willing to surrender to a sense of connectedness deep within ourselves. There is a way in which we create our own reality. Our own inner dynamics are played out in the people and situations that constellate around us. When we come to a place of openness and connectedness within ourselves, our reality without becomes more open and connected. Trust begins to emerge – trust in ourselves and trust in the universe. This is not naivete, but an undefensive posture toward life. It is surrendering to the journey that is uniquely ours.” 

        Woodman M, Dickson E. “Dancing in the flames. The Dark Goddess in the transformation of consciousness.” Alfred A Knopf, Toronto, 1996.

 

Gratitude - everything is a present

     
     Our attitude is much more important than we realize.

108 year old Alice Herz Sommer interview

Meaning, values, action

 
     “The meaning of existence is derived from relationships formed with the self, other people, nature and the universe. These relationships are woven in terms of bonds, feelings and values. So, meaning has to make sense within a system of values. To form a purpose in life, to earn self-respect, to relate satisfactorily to family, friends, and the larger world, one’s value system must be clear. Only then can one judge actions in terms of their wisdom, justice, courage, moderation, whether or not they uphold the respect of self and others, whether they cause pleasure or pain, or are harmful, whether they are creative or destructive.”

      “… one needs to define one’s values system, and one’s behaviour should be compatible with it if one is to achieve cognitive consistency, self respect, purposeful goals in life, and meaningful relationships with family, friend and the larger world.
     If one thinks, feels, or acts in ways which oppose the personal code of values, then there is dissonance causing inner conflict and stress which may lead to maladjustment or psychological morbidity.”

     “… if we can affirm our values, then some things acquire meaning and importance and we discover purpose in living which transcends narrow self interest. Such are the conditions for mental growth and health, which rely upon a values system clarified by reason, warmed by feeling, widened by vision and which compels affirmation and action.”

       Mickleburgh WE. Clarification of values in counselling and psychotherapy. Aust N Z J Psychiatry 1992; 26(3): 391-8.

Photo: Michael Otis   www.dpreview.com

 

The person doing the work

     “Let no one ever come to you without leaving better or happier.”                   Mother Teresa

     “…the best way to become a better helper is to become a better person. But one necessary aspect of becoming a better person is via helping other people. So one must and can do both simultaneously.”                      Abraham Maslow

     “Those who know others are wise,  
     those who know themselves are enlightened.”            Lao Tsu

Wisdom

     “Wisdom is deep understanding and practical skill in the central issues of life, especially existential and spiritual issues.

     Existential issues are those crucial and universal concerns all of us face simply because we are human. They include finding meaning and purpose in our lives; managing relationships and aloneness; acknowledging our limits and smallness in a universe vast beyond comprehension; living in inevitable uncertainty and mystery; and dealing with sickness, suffering, and death. A person who has developed deep insights into these issues – and skills for dealing with them – is wise indeed.”

     Walsh R. Essential spirituality. The 7 central practices to awaken heart and mind. John Wiley & Sons Inc, NY, 1999.

Heart-Mind

      “No matter how sharp your intellect is, don’t forget to filter it through the heart of compassion before you manifest it in the suffering world.”                         Dzogchen Ponlop

     “The practice of medicine ( - all health-care, life itself - ) is an art, not a trade; a calling, not a business; a calling in which your heart will be exercised equally with your head.”    Sir William Osler

     “Anything will give up its secrets if you love it enough.”                  George Washington Carver

Happiness

     “Happiness is when what you think, what you say, and what you do are in harmony.”                   Mahatma Gandhi

      “… bring a simple loving presence into each moment”                   Jack Kornfield

Opportunity

     “Ultimately, our approach to and empathy with our patients and their illnesses are a reflection of our understanding of what it means to be human, of the meaning and value of human life. Although we cannot comprehend or experience the agony of our patients, we can display compassion and alleviate their suffering. In so doing, our values come to life and our work has meaning.”
     Souba WW. Academic medicine and the search for meaning and purpose. Acad Med 2002; 77(2): 139-44.

     “Work can provide the opportunity for spiritual and personal, as well as financial, growth. If it doesn’t, we are wasting far too much of our lives on it.”              James Autry

     “Decreased experiential avoidance and increased mindfulness significantly predicted improved mental health.”
     Moore SD, Brody LR, Dierberger AE. Mindfulness and experiential avoidance as predictors and outcomes of the narrative emotional disclosure task. J Clin Psychol 2009; 65(9): 971-88.

Capacity to Embrace Suffering with Equanimity

     The statement below applies equally to all modern health-care professionals as well as traditional healers and shamans: 
     “Teaching Mindfulness-Based Stress Reduction (MBSR) requires the capacity (- the heart -) to meet our own suffering and that of others with attention, resilience, transparency, and compassion. For most people, cultivating these qualities is both cumulative and non-linear.”
http://www.umassmed.edu/cfm/oasis/index.aspx?linkidentifier=id&itemid=41256

     “Most of us recognize that we human beings may or may not act in a manner that corresponds with what we say our ethics are. But human beings do act in ways that are congruent with what they ultimately trust as dependable and real – what makes sense at the end of the day, what they think they can really count on. We humans act in ways that are congruent with how we make meaning.
     We human beings seem unable to survive, and certainly cannot thrive, unless we can make meaning. We need to be able to make some sort of sense out of things; we seek pattern, order, coherence, and relation in the disparate elements of our experience. If life is perceived as only fragmented and chaotic, we suffer confusion, distress, stagnation, and finally despair.”
     Parks SD. Big questions, worthy dreams. Mentoring young adults in their search for meaning, purpose, and faith. John Wiley & Sons, San Francisco, 2000.

       See also: http://mindfulnessforeveryone.blogspot.ca/2013/07/361-beyond-stress-management-resilience.html
     and: http://healthyhealers.blogspot.ca/2013/06/heart-ensures-you-thrive-not-merely.html
     and: http://mindfulnessforeveryone.blogspot.ca/2013/06/347-training-in-equanimity.html

Laszlo "Les" Lovas   (1915 - 2001)   Self-portrait

Life-long learning

     “… we extend our collective central nervous system to encompass greater swaths of existence. We do so in order to find meaning in belonging to ever richer and deeper realms of reality. Hungarian polymath Michael Polanyi sees man as ‘the innovator and explorer, passionately pouring himself into an existence closer to reality.’”
     Rifkin J. “The Empathic Civilization. The Race to Global Consciousness in a World in Crisis.” Penguin, NY, 2009.

      “implicit in developmental theory is the perception that each succeeding stage, era, or form of consciousness is better in that each represents a capacity to account for more, to handle greater complexity, and thereby provide the potential for greater inclusivity. … a sober assessment of the competencies of mind and soul that social-environmental justice requires. In other words, if justice is a matter of who and what is included or excluded, then just as complex perspective taking is essential to adequate moral reasoning so too the character of one’s composition of the whole of reality (one’s meaning-making) determines what one finds tolerable and intolerable.
     … human beings develop ‘because we need to.’ We recompose purpose, meaning, and (meaning-making) when we encounter the other (other people, other knowledge, other experience) in such a way that ‘we are left with no other choice, short of blocking out what we can no longer block out with any degree of honesty.’ When human development happens well, we embrace a new way of interpreting the world because it can account for things that the old way no longer could. We can acknowledge considerations previously ignored, take more facts into account, and extend hospitality to questions that earlier we could not entertain.
     … requires incessant recomposing of what is true for the self in relationship to a world of others.”
     Parks SD. Big questions, worthy dreams. Mentoring young adults in their search for meaning, purpose, and faith. John Wiley & Sons, San Francisco, 2000.