Why Grandma, What Big Teeth You Have!

     We all normally have multiple sub-personalities - aspects of ourselves we express under different circumstances. During clinical practice, we ideally embody both our scientist-clinician (bio) and wise, nurturing grandparent (psychosocial) selves.
     Phobic patients, even if otherwise mature successful executives, may under clinical situations embody their "fearful child" sub-personality. Clinicians readily understand how stress can make sophisticated adult patients suddenly devolve into whimpering children, and we make appropriate allowances.
     But what happens to us health-care professionals under a lot of stress? Stressors may be severe, multiple, prolonged, yet well hidden, & have little to do with the present clinical situation. Our normally competent professional conduct may suddenly & dramatically devolve into unprofessional behavior, resulting in a sense of loss of control & shame. Should a colleague or patient try to intervene, more shame & aggressive self-defense / denial may ensue.
     Health-care professionals - though perfectionists, are not perfect - "only" human, prone to "melt-downs" like anyone else. Yet we need to maintain exceptional "grace under pressure." 
     “Courage is not the absence of fear, but rather the judgment that something else is more important than fear.” Meg Cabot

     So, first & foremost, we must know & accept our limitations. We must learn how to feel the physical sensations of anxiety in our bodies when things seem to be getting out of control, accept it fully, AND remain calm, rational, professional - as long as we're with a patient. This is something we all can & must train ourselves to do, by ourselves or with the help of counselors. Effective professional help is free, confidential & readily available - AND if needed, we MUST LEARN to make use of it, the earlier the better.
     We are NOT "bad" because we can't control everything in life, we are simply normal human beings, doing the best we can under challenging, constantly changing, complex situations. Since we're not bad, there's no reason to feel shame. Furthermore, feeling shame is isolating - disconnecting us from patients & colleagues. Our ability to remain rational & empathetic - connected within the therapeutic alliance under greater & greater pressures can & should be cultivated. We can & should progressively inhabit & stabilize within our wise, nurturing grandparent sub-personality.

Keith Ladzinski   http://photography.nationalgeographic.com/photography/