Showing posts sorted by relevance for query avoidance. Sort by date Show all posts
Showing posts sorted by relevance for query avoidance. Sort by date Show all posts

Tuesday, 21 March 2017

Avoidance vs Acceptance & Mindfully "Leaning In" with Curiosity


     “A wide range of research reviewed shows that many forms of psychopathology can be conceptualized as unhealthy efforts to escape and avoid emotions, thoughts, memories, and other private experiences.”  
       Hayes SC, Wilson KW, Gifford EV, Follette VM, Strosahl K. “Emotional avoidance and behavioral disorders: A functional dimensional approach to diagnosis and treatment.” Journal of Consulting and Clinical Psychology 1996; 64(6): 1152–68.

     “Elvin Semrad taught us that most human suffering is related to love and loss and that the job of therapists is to help people ‘acknowledge, experience, and bear’ the reality of life – with all its pleasures and heartbreak. ‘The greatest sources of our suffering are the lies we tell ourselves,’ he’d say, urging us to be honest with ourselves about every facet of our experience. He often said that people can never get better without knowing what they know and feeling what they feel.”

       Bessel Van Der Kolk. “The Body Keeps the Score. Brain, Mind, and Body in the Healing of Trauma.” Penguin Books, 2015.

     “The theoretical framework of mindfulness holds that the continual practice of bringing one’s attention to the present moment, and allowing what is in that moment simply to be, eventually leads to a shift in perception in which thoughts and feelings may be observed as arising events. With increased ability to become witness to thoughts, rather than immersed in their valence and content, there follows increased psychological flexibility, enhanced emotion regulation, and reduced rumination.

     An interesting observation in this study was that participation in MBSR was associated with reductions in PTSD symptoms, most strongly among them avoidance. Recent thinking in the field of trauma asserts that avoidance, the effort to escape or hide from traumatic thoughts, feelings, or memories, is the core psychological process underlying the development and continuation of PTSD. Avoidant coping strategies include attempts to suppress intrusive thoughts, to take oneself away from negatively evocative situations, engage in substance use, or through emotional numbing. Therapeutic approaches that prescribe the opposite of avoidance, i.e., acceptance, can serve as a form of exposure and work to alleviate avoidant tendencies. In offering acceptance of the present moment, MBSR may be such a therapy. The mindfulness approach is that through openness, curiosity, and acceptance of the present moment, one’s relationship with negative thoughts is altered. By fostering a greater comfort level with thoughts previously avoided, mindfulness practice allows them to surface and, as such, mindfulness may serve as a form of exposure in its impact on PTSD symptoms. 
     In addition to contributing to a survivor’s ability to be present to his or her own painful emotional experience, mindfulness skills also may enhance one’s capacity to be present in psychological therapy. In this way, mindfulness may potentiate therapeutic work. The exploration of this synergy should be a topic of future empirical investigation. Thus, MBSR may serve as a widely available, potentially cost-effective way for clients to gain a foundation in mindfulness skills.”  
       Kimbrough E, Magyari T, Langenberg P, Chesney M, Berman B. “Mindfulness intervention for child abuse survivors.” Journal of Clinical Psychology 2010; 66(1): 17–33.


 
Courtesy of Buddha Doodles www.buddhadoodles.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

Wednesday, 12 February 2014

Allergy Allert: Penicillin, Peanuts, Wisdom

     We instinctively protect what is most central, valuable & meaningful to our life. We bar most people from going there. In time, we ourselves develop a taboo - a discomfort bordering on disgust - about deep introspection - about going to our core identity.
     There are infinite numbers of ways to (temporarily) avoid having an inner life. Our obsession with "keeping busy" works well, and society seems to admire & reward people who are "SO busy." Without mandatory retirement, many opt to work till they drop - an excellent avoidance technique.
     Unfortunately, fear-based avoidance is a painfully narrow, stunted way of being. See: http://healthyhealers.blogspot.ca/search?q=avoidance and http://healthyhealers.blogspot.ca/search?q=discontents Most people live most of their lives in this early stage of psychosocial development, and because they avoid deep introspection, are ignorant of their own state, and the quality of life they're missing.
      Even those intellectually aware of developmental psychology, mythology, spirituality etc, as well as those who consider themselves religious, may have little or no integration of these concepts into their day-to-day lived experience ie like most people, they continue to instinctively protect / avoid - via "intellectual distancing" or "spiritual materialism" - the core of their life. It's a qualitatively different experience having a PhD in sports physiology compared to being aerobically fit, in fact the two have very little in common. One can be highly intelligent & educated, yet behave like a spoiled child or much worse.

     An intentional, intelligent, regular, life-long meditation (or other spiritual) practice - to rediscover, come back home to, & live our lives from the core of who we are as human beings - seems to be required for us to evolve beyond this primitive instinct-driven avoidant behavior that keeps us from what is most important in our lives.


geerie   www.dpreview.com

Tuesday, 16 December 2014

Emotionally Intelligent Healthcare Professionals?

• Self-awareness and self-management skills. Identifying and self-regulating emotions, managing stress, and evaluating how emotions and behaviors may affect others; assessing personal strengths and limitations; seeking help and making effective use of external resources to achieve personal and academic goals.
• Social-awareness and interpersonal skills. Recognizing feelings and perspectives of others, including those from different cultures and backgrounds; effectively communicating and resolving interpersonal conflicts in constructive ways.
• Responsible decision-making skills. Making ethical decisions; evaluating the consequences of choices, and how virtue (e.g. honesty, justice, compassion, courage) enables us to recognize the needs of others when making decisions; recognizing how individual students can contribute to the well-being of the school and broader community.
- See more at: http://wisdomresearch.org/forums/t/1486.aspx#sthash.NmQwByzS.dpuf
• Self-awareness and self-management skills. Identifying and self-regulating emotions, managing stress, and evaluating how emotions and behaviors may affect others; assessing personal strengths and limitations; seeking help and making effective use of external resources to achieve personal and academic goals.
• Social-awareness and interpersonal skills. Recognizing feelings and perspectives of others, including those from different cultures and backgrounds; effectively communicating and resolving interpersonal conflicts in constructive ways.
• Responsible decision-making skills. Making ethical decisions; evaluating the consequences of choices, and how virtue (e.g. honesty, justice, compassion, courage) enables us to recognize the needs of others when making decisions; recognizing how individual students can contribute to the well-being of the school and broader community.
- See more at: http://wisdomresearch.org/forums/t/1486.aspx#sthash.NmQwByzS.dpuf
• Self-awareness and self-management skills. Identifying and self-regulating emotions, managing stress, and evaluating how emotions and behaviors may affect others; assessing personal strengths and limitations; seeking help and making effective use of external resources to achieve personal and academic goals.
• Social-awareness and interpersonal skills. Recognizing feelings and perspectives of others, including those from different cultures and backgrounds; effectively communicating and resolving interpersonal conflicts in constructive ways.
• Responsible decision-making skills. Making ethical decisions; evaluating the consequences of choices, and how virtue (e.g. honesty, justice, compassion, courage) enables us to recognize the needs of others when making decisions; recognizing how individual students can contribute to the well-being of the school and broader community.
- See more at: http://wisdomresearch.org/forums/t/1486.aspx#sthash.NmQwByzS.dpuf
Self-awareness and self-management skills. Identifying and self-regulating emotions, managing stress, and evaluating how emotions and behaviors may affect others; assessing personal strengths and limitations; seeking help and making effective use of external resources to achieve personal and academic goals. - See more at: http://wisdomresearch.org/forums/t/1486.aspx#sthash.NmQwByzS.dpuf
     Documents listing minimal competencies for graduating healthcare professionals are peppered with references to emotional intelligence (EI). Yet students and faculty alike continue to strongly resist attempts to include EI-related subjects in the healthcare curriculum. Their reasons typically include: 
          • no room in an already packed curriculum; 
          • it's already covered (presumably by parents, places of worship, & earlier education); 
          • not directly applicable to the "science" we teach;
          • outcomes from teaching such "soft subjects" can't be measured; 
          • "we're not training them to be social workers".

     Students continue to gain admission to coveted spots in health-care professional education almost entirely by obtaining high marks on multiple-choice tests (MCTs). Even in science-related subjects, MCTs poorly assess depth of knowledge. How much do we know of these students' self-knowledge, character, psychosocialspiritual maturity? Embarrassed avoidance *** is how admissions & curriculum committees "deal" with these critically important characteristics. Then why are we repeatedly surprised when a proportion of these students "handle their stress" in outrageously dysfunctional ways?
    
      "Ignoring the shadow side of our personalities can only lead to what Freud once called 'the return of the repressed'.”                    Mark Epstein MD


     Comprehensive, integrated Behavioural Sciences curricula could provide students in health-care professions with explicit guidance & practice to intelligently deal with their own & others' emotions - a MUST in order to minimize the frequency & gravity of grossly unprofessional behaviour, not to mention a host of mental health issues, burnout, and suicide. 

     Professionalism includes being explicitly aware of & embodying the highest level of EI and practicing appropriate self-care. Unfortunately, students only take these matters as seriously as their educators.

     *** more on avoidance: http://healthyhealers.blogspot.ca/2014/11/avoidance-is-easier-than-wisdom-hows.html
          fearing introspection: http://mindfulnessforeveryone.blogspot.ca/2014/12/608-fearing-shallows.html
          ethical infants: http://www.johnlovas.com/2013/09/do-we-need-more-nuclear-giants-who-are.html


koasiausad.blogspot.com

Friday, 31 August 2012

Avoidance - very common, but futile

     It's only with continuous, conscious effort that we become aware of the extent to which primitive approach-avoidance instincts dominate our lives. And it doesn't matter how sophisticated we are (read Joan Didion's "The year of magical thinking"), nor does belonging to a religious group make a difference. Do you get hungry and gravitate toward food? Do you seek shelter in a sudden downpour? Of course, but how do you respond to sickness, old age and death?
     Many of us, again regardless of sophistication, intellectual knowledge of the subject, or belief system, nevertheless avoid, suppress, and otherwise fail to deal in a healthy manner with these existential facts. It's scary, so we avoid, simple as that. We keep trying hard to "avoid" what CANNOT be avoided!
     When I was younger, it was as if "old" people were members of a different species - like butterflies with a two-day lifespan compared to my endless decades. Now I look at people of any age - even in their 90's - as being fully alive, like me, but not different. "We are - (ALL) - so lightly here!"

See also: http://healthyhealers.blogspot.ca/2012/11/compulsiveness-of-physicians-dentists.html 
and: http://www.johnlovas.com/2013/01/shine-light-of-awareness-embrace-process.html

Gimli, Lake Winnipeg

Wednesday, 19 November 2014

Avoidance is Easy - but NOT Sustainable

     As with one's personal issues, dealing fully consciously with organizational problems is potentially gut-wrenchingly difficult.
     Can an organization's problems - even theoretically - be unrelated to its members' personal problems? Could an organization possibly remain the same if all its members were replaced by 
1) wise, mature, emotionally-intelligent people; 2) robots; 3) psychopaths?
     Many of us avoid addressing personal and organizational difficulties until the shit hits the fan. The most common vehicle for avoidance is frantic busyness. Cynical demeaning of attempts to address the real issues is another popular way of fearfully avoiding our own incompetence. Timely expert guidance helps thaw the glacial gridlock of psychological rigidity, allowing normal personal & organizational evolution to occur.

     "Ed Deming used to say that 97% of what matters in an organization can't be measured. Only maybe 3% can be measured.
     But when you go into most organizations and look at what people are doing, they're spending all their time focusing on what they can measure and none of their time on what really matters - what they can't measure. Why would we do this? We're spending all of our time measuring what doesn't matter. In fact, it's part of avoiding a lot of the really difficult and important issues, like virtue."
     Peter Senge in "Reflections of a Recovering Management Accountant"                    
www.wisdomatwork.com


Saturday, 11 August 2012

Zen & the Art of Relating to Difficulty vs Avoidance

     “What we repeatedly do becomes what we are. The practice of sitting and breathing to still the mind is the practice of being just what you are – it is enlightened being. Yet it can be hard at times to bend the will to keep the appointment with practice. We humans seem to fear what seems hard and we long for comfort, even though we keep discovering that the greatest treasure is what we find in ourselves at the far end of any really challenging process. But the difficult path is always the path of genuine life: difficulty makes the Way genuine. Meeting with fear of difficulty is an act that sparks with creative energy. Avoiding is finally the more demanding and costly battle. Practice is a commitment to cease choosing avoidance, to refuse to walk through your life as a ghost.”

        Murphy S. Upside-down zen. Finding the marvelous in the ordinary. Wisdom Publications, Boston, 2006.


     See also: http://www.johnlovas.com/2013/01/shine-light-of-awareness-embrace-process.html

Photo: erringtont   www.dpreview.com
 

Sunday, 3 June 2012

What do you really trust?


     "In God We Trust" is emblazoned upon American money.
     Most of us have strong opinions about our own beliefs. Many identify with a major belief system, perhaps attend regular services within that system, and more or less adhere to its rules and customs. This is the extent of "religion" or "spiritual life" for most people.
     What actually directs their lives via thoughts, speech & behavior, their "internal compass", may be very different that what they publicly proclaim, or even privately admit to themselves.

     "The unexamined life is not worth living."             Socrates

     How familiar are we with our "internal compass"? After all, doesn't what we, in the deepest recesses of our subconscious believe about ourselves and how we relate to the universe, guide our every thought, word and action? We may think we believe in, and thus behave (reasonably consistently) according to X, yet anyone who knows us may see a dramatically different picture eg an unhappy, cynical workaholic! Most of us in fact have a profound disconnect between our obvious outer lives, and our hidden (even from ourselves) inner lives.
     In contrast, congruence is when our inner world seamlessly, consciously manifests in our outer behavior. A very select number of wise, fully-integrated people reach this level of being, after a lifetime of dedicated inner work. 
     There's a huge tendency to allow the "momentum of our lives" to carry us along in a trance. Many fear what they would encounter should they do any form of introspection, such as meditation. This fear gives rise to all sorts of uninformed avoidance behaviors. Yet we know very well how essential it is to become consciously aware of our subconscious.
     Our individual specific history contains all the ingredients or inputs (causes & conditions) of our subconscious, so it's  completely natural, normal for each of us, and therefore acceptable - no need for fear, guilt or avoidance. By becoming conscious of this material, the force of its ability to drive our life progressively diminishes, and our ability to make conscious, mature, appropriate choices progressively increases. This clarity of vision, seeing our self-concept and worldview as it is, is the goal of meditation.

"Unity" by artist Andrea Smith   http://www.andreasmithgallery.com/

Sunday, 13 April 2014

Avoidance & the Health-care Professional

     Don't we just love to think, talk about & act on biomedical scientific minutiae - details. After all, compulsiveness is one of our defining characteristics - see: http://healthyhealers.blogspot.ca/2014/04/a-call-for-greater-self-awareness-in.html
     Mention anything about the bigger picture of the psychosocial realm, and most of us become as uncomfortable as young children in a sex-ed class. And those of us who try to initiate mature conversations about the psychosocial "elephant in the room" are avoided as carefully as our elephant. See: http://healthyhealers.blogspot.ca/search?q=avoidance and: http://healthyhealers.blogspot.ca/search?q=Medical+humanities+and+their+discontents
     Trying to avoid life's complexity, constant change & other mind-blowing challenges, is immature, ineffective YET sadly typical, even within healthcare education. Inevitably, it becomes impossible. Like trying to ignore the "oil is low" warning light on our car's dashboard, sooner or later, all hell breaks loose - see: http://healthyhealers.blogspot.ca/2012/09/when-our-whole-world-collapses-around-us.html
     Sooner or later, we have to learn that deep self-reflection & self-awareness is safe, unavoidable and essential. We must get to know & live from our core values, for our deepest most meaningful essence is our actual operating system. See: http://healthyhealers.blogspot.ca/2012/05/time-to-re-set-operating-system.html and:
http://www.johnlovas.com/2014/04/allowing-elephants-to-pass-through.html and: http://www.johnlovas.com/2014/04/core-purpose-philosophy.html 




Saturday, 17 November 2012

Emotional Intimacy - "too busy"?

     Gabbard & Menninger (below) examine the impact of physicians' busyness, compulsiveness and postponing gratification on their marriages.
     "The frequent tendency to use the demands of medical training or practice to justify one's absence or unavailability is a reflection of a significant emotional issue for many physicians, especially men - marked discomfort with closeness and even more marked reluctance to acknowledge this discomfort or deal openly with it. Such tendencies are particularly prominent among those who have compulsive personalities, in which difficulty with the management of strong feelings, both positive and negative, is a central feature."
     Many physicians become incapable of expressing love and nurturance - "the legacy of life-long constriction so characteristic of compulsive personalities.
     ... perfectionism, a susceptibility to self-doubt and guilt feelings, a chronic sense of emotional impoverishment, difficulties managing dependency and aggression, and a limited capacity for emotional expressiveness. ... lead to rigid, emotionally flat, automatonlike styles of relating that are adaptive in medicine but maladaptive in one's personal relationships. The language of feelings may be entirely alien, especially for the male physician.
     ... physicians actually prefer work to family life ... postponement is not so much delay as avoidance - avoidance of intimacy and marital involvement. Work becomes an effective defense against intimacy."
        Gabbard GO, Menninger RW. The psychology of postponement in the medical marriage. JAMA 1989; 261(16): 2378-81.

     See also: http://healthyhealers.blogspot.ca/2012/06/substitute-gratifications.html 
     and: http://www.johnlovas.com/2013/01/shine-light-of-awareness-embrace-process.html


Photo: Tran Cao Bao Long   www.dpreview.com

Thursday, 9 April 2015

Wisdom in Health Care


     "... we are ready for wisdom in health care. ... for leadership that fosters the capacities for wisdom in our healthcare organizations, capacities described in Monika Ardelt’s three-dimensional framework for wisdom (Ardelt M. “Empirical assessment of a three-dimensional wisdom scale.” Research on Aging 2003; 25(3): 275–324). 

     The cognitive dimension includes the capacity to see the deeper meaning of things, to understand complexity and tolerate ambiguity, to avoid over simplification of complex situations. It also includes awareness of the limitations of our knowledge, and avoidance of hubris. 
     The reflective dimension includes the capacity to see things from many perspectives, requiring self-examination, self-awareness and self-insight. 
     Finally, the affective dimension is compassion, and requires transcendence of self-centeredness. Fostering these capacities can be thought of as the wise leader’s virtuous cycle."

Are we ready for wisdom in health care?
By Margaret Plews-Ogan, MD, MS and Gene Beyt, MD, MS
- See more at: http://wisdomresearch.org/forums/t/1362.aspx#sthash.jyMoIpZk.dpuf
 
       Margaret Plews-Ogan, Gene Beyt.  "Are we ready for wisdom in health care?" 
http://wisdomresearch.org/forums/t/1362.aspx#


we are ready for wisdom in health care. Specifically, we are ready for wisdom leadership. What does that mean? We are ready for leadership that fosters the capacities for wisdom in our healthcare organizations, capacities described in Monika Ardelt’s three-dimensional framework for wisdom (Ardelt, 2003). The cognitive dimension includes the capacity to see the deeper meaning of things, to understand complexity and tolerate ambiguity, to avoid over simplification of complex situations. It also includes awareness of the limitations of our knowledge, and avoidance of hubris. The reflective dimension includes the capacity to see things from many perspectives, requiring self-examination, self-awareness and self-insight. Finally, the affective dimension is compassion, and requires transcendence of self-centeredness. Fostering these capacities can be thought of as the wise leader’s virtuous cycle. - See more at: http://wisdomresearch.org/forums/t/1362.aspx#sthash.jyMoIpZk.dpuf

Tuesday, 4 February 2014

Is Avoidance Enough?

     Are we living our life completely passively? Is what we do and whom we do it with simply the left-overs from what we didn't manage to avoid? Is avoidance the main choice we make in our lives? See: http://healthyhealers.blogspot.ca/search?q=avoid
      If so, are we not failing to actively go after what truly matters to us, what really has meaning in our lives. Our brief, precious time must be managed carefully to ensure that it is as deeply meaningful as possible.
     All our lives have a certain momentum (inertia - very much like an addiction). To change it towards a deeper, more meaningful direction requires constant awareness. Mindfulness mediation will continually surprise.



Tuesday, 3 April 2012

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.

Tuesday, 15 April 2014

Competence Navigating Liminality

     The ongoing joke in the British comedy, 'Doc Martin', is that this former surgeon is phobic about blood. Whether his own or his patients', he gags, and often vomits at the sight of blood. He's ridiculed about this, particularly by his former surgical colleagues.
     Sadly, many health-care professionals have a similar visceral aversion to their own & others' inner life, existential matters, the meaning of life etc. Many of us are frightfully incompetent in this liminal arena, and therefore avoid it at all costs - negatively impacting our own, our loved ones' and our patients' quality of life. 
     See: http://healthyhealers.blogspot.ca/search?q=existential
     and: http://healthyhealers.blogspot.ca/search?q=avoidance

     Of course most of us can learn to skillfully, safely navigate our own inner terrain. Meditation practices have been perfected over thousands of years. Mindfulness meditation is evidence-based, tailored to educated professionals, readily approachable, and widely available.

Martin Clunes as "Doc Martin"

Tuesday, 27 January 2015

Basic Values - Trans-situational Goals, Guiding Principles

     "Schwartz sought to identify a comprehensive set of basic values that are recognized in all societies. He defined basic values as trans-situational goals, varying in importance, that serve as guiding principles in the life of a person or group.
     He theorized that basic values are organized into a coherent system that underlies and can help to explain individual decision making, attitudes, and behavior. This coherent structure arises from the social and psychological conflict or congruity between values that people experience when they make everyday decisions.
     values are likely to be universal because they are grounded in one or more of three universal requirements of human existence with which people must cope: needs of individuals as biological organisms, requisites of coordinated social interaction, and survival and welfare needs of groups.
     values ... focus on 
          • attaining personal or social outcomes,
          • promote growth and self-expansion or anxiety-avoidance and self-protection,
          • express openness to change or conservation of the status quo, and
          • promote self-interest or transcendence of self-interest in the service of others."
 
       Schwartz SH, Cieciuch J, Vecchione M, Davidov E, Fischer R, Beierlein C, et al. Refining the theory of basic individual values. Journal of personality and social psychology. 2012;103(4):663-88.


from Schwartz et al 2012 (see text above)
 

Tuesday, 13 March 2012

To Burnout or Engage?

     "The key dimensions of burnout include emotional exhaustion, feelings of cynicism and depersonalization (detachment from the job), and a sense of ineffectiveness and lack of personal accomplishment. Emotional exhaustion refers to feelings of being overextended and depleted of one’s emotional and physical resources. Exhaustion prompts efforts to cope by distancing oneself emotionally and cognitively from work. Depersonalization refers to negative, callous, or excessively detached responses to various aspects of the job and is another distancing mechanism.
     The greater the mismatch between the person and the work environment, the greater is the likelihood of burnout. 
     A better match or fit is associated with greater engagement with work.”
       Kearney MK. et al. Self-care of physicians caring for patients at the end of life: "Being connected... a key to my survival." Jama 2009; 301(11): 1155-64, E1.


     "We tend to approach pleasurable opportunities to promote well-being and survival, and conversely avoid or withdraw from painful experiences as protection from harm. This biological approach-avoid dichotomy underlies all motivational tendencies, forms the basis of emotion and promotes adaptation.
     We're biologically and culturally programmed to seek pleasure and avoid discomfort."
     But life includes not only pleasure, but also pain, as well as uncomfortable periods of growth that take "place beyond one’s comfort zone - in liminality *** - a state of in-between-ness & ambiguity.
     Avoidance of liminality is the basic obstacle to engagement. Mindfulness practice cultivates acceptance of, and the ability to work within, liminality, and should therefore improve engagement."

     Lovas J, Gold E, Neish N, Whitehorn D, Holexa D. Cultivating Engagement through Mindfulness Practice. Poster Presentation, American Dental Education Association annual meeting, March 19, 2012, Orlando, FL.

     *** See: http://www.johnlovas.com/2013/06/liminality-insight-into-emptiness.html

Photo: Brigitte Lorenz   http://www.brigittelorenz-photography.com/

Wednesday, 25 April 2018

Grief as a Solitary Burden


     “Expressing grief has always been a challenge. The main difference between our society and societies in the past is how private we are with it today. Through most of human history grief has been communal. 
     The Pueblo people of the Southwest, for example, have ‘crying songs’ to help move grief along. The Mohawk traditions have the ‘condolence ritual,’ where they tend to the bereaved with an elegant series of gestures, such as wiping tears from the eyes with the soft skin of a fawn. The healers in those traditions know it is not good to carry grief in the body for a long time. 
     But now we’re asked — and sometimes forced — to carry grief as a solitary burden. And the psyche knows we are not capable of handling grief in isolation. So it holds back from going into that territory until the conditions are right — which they rarely are. The message is ‘Get over it. Get back to work.’ 
     Again and again in my practice clients come to me with a depression that is more of an oppression: a result of so many years of sorrow that have not been touched with kindness or compassion or community. You’re left with an untenable situation: to try to walk alone with this sack of grief on your back without knowing where to take it. 
     In traditional cultures people were often given at least a year to digest a major loss. In ancient Scandinavia it was common to spend a prolonged period ‘living in the ashes.’ Not much was expected of you while you did the essential work of transforming sorrow into something of value to the community. The Jewish tradition observes a year of mourning filled with observances and rituals to help the grieving stay connected to their sorrow and not let it drift away. Most people today might get a week of bereavement leave, at best, and then everything should be fine. 
     In this culture we display a compulsive avoidance of difficult matters and an obsession with distraction. Because we cannot acknowledge our grief, we’re forced to stay on the surface of life. Poet Kahlil Gibran said, ‘The deeper that sorrow carves into your being, the more joy you can contain.’ 
     We experience little genuine joy in part because we avoid the depths. We are an ascension culture. We love rising, and we fear going down. Consequently we find ways to deny the reality of this rich but difficult territory, and we are thinned psychically. We live in what I call a ‘flat-line culture,’ where the band is narrow in terms of what we let ourselves fully feel. We may cry at a wedding or when we watch a movie, but the full-throated expression of emotion is off-limits.”
     “The Geography Of Sorrow - Francis Weller On Navigating Our Losses.” The Sun Interview: by Tim McKee, October 2015. https://thesunmagazine.org/issues/478/the-geography-of-sorrow


Christi Belcourt "Medicines To Help Us" christibelcourt.com