Looking in the Mirror: Conditional Self-worth, Perfectionism, Difficulties with Negative Feedback

     Conditional self-worth is associated with psychological distress, while unconditional self-acceptance fosters personal adjustment and well-being. People with extremely high self-esteem are considered vulnerable because they're often characterized by conditional self-acceptance dependent on external evaluations and comparisons to others. 

     Perfectionists find it difficult to unconditionally accept themselves and are preoccupied with obtaining approval and avoiding disapproval from others. Inability to unconditionally accept the self sometimes extends to an inability to accept others.  

     A 2001 study showed that "low levels of unconditional self-acceptance were associated with low self-esteem and elevated levels of self-esteem lability and proneness to depression. ... students with higher levels of unconditional self-acceptance ... were less reactive to negative feedback about their performance ... and tended to be more objective in their personal performance evaluations."

      Three dimensions of perfectionism include: 

          • self-oriented perfectionism - striving for personal standards of perfection;  

          • other-oriented perfectionism - a focus on the capabilities of others. ... associated with hostility and tending to direct blame or punishment toward others, rather than negative self-judgments;  

          • socially prescribed perfectionism - the perception that others have unrealistic standards and perfectionistic motives for one’s own behaviors, and that others will only be satisfied when these standards are attained; related to fear of negative social evaluation, belief in the external control of reinforcement, and need for the approval of others; associated with a wide variety of psychological problems including depression, anxiety, suicidal tendencies, and personality disorders.

       All three have been shown to be linked with low unconditional self-acceptance. Studies consistently show that "low general self-esteem is associated with the perception that unrealistic standards are being imposed on the self."  Also, a contingent sense of self-worth is the antithesis of unconditional self-acceptance.

     This paper concludes that "it is important to foster a greater sense of unconditional self-acceptance among perfectionists, either through preventive efforts or treatment interventions, so that this may serve as a source of resiliency when impossible standards are not attained." 

       Flett GL, Besser A, Davis RA, Hewitt PL. Dimensions of Perfectionism, Unconditional Self-Acceptance, and Depression. Journal of Rational-Emotive & Cognitive Behavior Therapy 2003; 21(2): 119-138. 

     A key component of mindfulness training is unconditional self-acceptance.

See also: http://mindfulnessforeveryone.blogspot.ca/2013/01/271-perfectionism-negative-and-positive.html

Photo: TX Photo Doc   www.dpreview.com

Healing Starts with the Healer

     "There is symmetry between someone’s relationship with the outer world and his or her inner world. All the qualities of the inner relationship with the self will also be reflected in outer relationships. The inner relationship is the basic template for any encounter with the world, and as such is the starting point for all encounters. If one is able to acknowledge herself, she will also have the capacity to acknowledge others. If someone cannot accept himself as a whole and has to neglect some aspects of his personality, then he will not be able to accept others for what they completely are. I call this symmetry the mirror principle because it reflects in both directions. In transforming the attitudes toward the self, one can start to encounter the world in a different way. 

     I believe all healing relationships start in the person of the health care professional. To the Western mind this sounds unexpected because one of the basic assumptions of the Western medical philosophy is the idea that something has to be done for the patient. This often includes the idea that the health care professional has to hold back his or her own personality in a medical context because the patient comes first. The concept that every healing intention starts from a healthy attitude towards the self, or in other words, healing starts by healing the healer challenges that assumption. 

       Schmidt S. Mindfulness and healing intention: concepts, practice, and research evaluation. J Altern Complement Med 2004; 10 Suppl 1: S7-14.

     See also: http://mindfulnessforeveryone.blogspot.ca/2013/11/432-i-try-and-i-try-but-i-cant-get-no.html
       and about self-acceptance: http://healthyhealers.blogspot.ca/search?q=self-acceptance

 

CapturingMoments   www.dpreview.com

A Life Unexamined? - Physician, Know Thyself!

     A healthy, conscious relationship with one's own emotional life - ie self-awareness & self-acceptance - is rare, not just in patient populations, but equally among clinicians. Unconscious emotions continuously manifest themselves, to our detriment, influencing our thoughts, mood, speech, behavior, and our physical & emotional health.
     As mature adults, we owe it to ourselves & those around us to intentionally, intelligently, gently, progressively, cultivate self-awareness & self-acceptance. Mindfulness meditation is an evidence-based way of doing precisely this. Physician, it's time to know thyself! 
     See: http://mindfulnessforeveryone.blogspot.ca/2013/07/373-how-free-is-our-free-will.html

     "When feelings are frightening, conflicted, or deemed unacceptable they generate anxiety & defence mechanisms that act to blanket this anxiety (Fig. 1). This is usually the fate of emotions in children traumatized, abandoned or neglected by loved ones, who then have feelings of love mixed with rage and guilt about the rage. When these mixed feelings are unconscious to the patient, the subsequent anxiety and defences are also outside of awareness or unconscious. In essence, the rage or anger is turned inward into somatic symptoms both to protect the other person from the rage and to serve as a form of self-punishment for having the rage to begin with. Thus, the child develops the pattern of turning anger inward and is thus prone to somatic complaints, including abdominal pain, headache, depression, personality problems and other conditions. When later life events raise the threat of emotional pain and abuse, the rage is ‘turned inward’ into acute or chronic anxiety & somatization. The other person in the relationship is safe from the rage, but the process exacts a high toll for the adult sufferer through the range of symptoms and behaviours required to contain these emotions."
        Abbass A, Lovas D, Purdy A. Direct diagnosis and management of emotional factors in chronic headache patients. Cephalalgia 2008; 28(12): 1305-14.

Fig 1 - Relationship between unconscious feelings, anxiety, & defenses

But Who's Listening?

     Misogyny, sexual discrimination, racism, antisemitism, and all sorts of other social illnesses seem to be, at least partially, communication problems. Progressive attempts to correct these therefore include immersive techniques such as talking circles, restorative justice processes, truth & reconciliation. The understanding behind these is that when we truly see, hear and understand an individual human being, we will naturally treat that person as a unique valuable human being, not as "the other" - something foreign, subhuman.
     We naturally expect people to behave in socially acceptable ways in public, such as in the workplace, educational institutions and health-care facilities. What's not so obvious, is that each of us behaves very differently depending on where we are and the company we keep. Who among us presents the same persona at work, in a place of worship, at a bachelor's party, babysitting, and hiking with an old friend in the back country? So, is one or more of these persona 'real,' and the rest 'fake' - mere acts put on to fool others? 

     I suspect that most of us don't really know, and find such questions that require deep self-reflection uncomfortable - something we rarely do (unless forced on us, occasionally, by traumatic circumstances). Because we're not self-reflective, we have far less conscious awareness of our thoughts, speech or behaviour than we assume. Instead, we instinctively condemn "bad" people, and feel totally different than "the bad guys." We strongly prefer avoiding such topics, and to busy ourselves with other matters - things we're good at.

    But without intentional deep self-reflection, we have minimal self-knowledge & self-acceptance. And if we're not aware of & can't accept our own many imperfections, then we can't really be sincere, full participants in corrective measures like restorative justice. We may be well-intentioned, but we're actually part of the problem! Without owning our own shadow, we simply cannot accept others' shadows. If we can't accept others' shadows, we tend to project our own onto others - see the things we can't accept about ourselves in others - "scapegoating". Scapegoating is expressed through: misogyny, sexual discrimination, racism, antisemitism, etc. These are widespread societal problems in our evolving (not evolved) human race.
     FIRST we must learn to be brave, and intentionally practice self-awareness. The deepest method is meditation; the easiest, most approachable form is Mindfulness. As we come to know & accept ourselves as far-from-perfect human beings with tremendous potential, we learn to be far more understanding with, and helpful towards others.
     All of us can intentionally evolve psychosociospiritually to contribute constructively to civilized society, and in doing so, find personal peace & deep fulfillment.

Gaudi's Park Guell, Barcelona

Basic Concepts: Motivation in Intentional Behavior

     "Any intentional behavior can be classified in terms of the degree to which it is self-regulated versus regulated by forces outside the self, thus indexing the relative integration of action. A general schema for this is presented in Fig 1. This figure illustrates four types of motivational orientations that can be applied to extrinsically motivated (instrumental) behaviors, and leaves a separate category for intrinsically motivated actions which, although clearly self-regulated, do not have to be internalized. While the labels used for these types of motives may be idiosyncratic, the types of motivation to which they refer are identifiable in other theoretical frameworks under different labels, & also are readily observable in everyday behavior. 

     The most heteronomous form of regulation is external regulation, wherein people perform behavior only because they are either coerced into it, or rewarded for it. Here the regulatory impetus to behavior is external in the classic sense of being literally outside the person. When individuals experience their behavior to be externally regulated, they typically feel controlled or alienated, such that when the external regulatory force is absent, so is the behavioral regulation.

      Introjection represents behavior driven by the dynamics of self- and other approval. Behavior regulated through introjection is characterized by "intemally controlling states" and the guilt and anxiety avoidance that accompany them. Thus, while introjection represents a motivational impetus that is intemal to the person (ie is intrapsychic), it nonetheless remains conflictual & external to the self. Introjection therefore can be understood as a form of partial assimilation or integration. 

     A somewhat more autonomous form of regulation is entailed in identification, which involves the acceptance and personal valuing of an acquired regulation. Identification entails greater autonomy insofar as one's behavior is felt to reflect one's conscious values and identity. Because of this the pressure and conflict associated with introjection or extemal control is somewhat ameliorated. However, despite their relative autonomy, identifications can be more or less isolated or unintegrated with other identifications, introjects, or aspects of personal experience. 

     The ultimate form of "assimilation to self" is that of integration, in which various identifications are organized, or reciprocally assimilated, and brought into congruence with organismic experience as a whole. This crucial transformation completes a process of movement from heteronomy to autonomy or self-regulation. 

     Fig 1 represents intrinsic motivation as a separate category, which, as noted, pertains to behaviors that are done for their inherent satisfactions & thus are not a product of internalization. Intrinsically-motivated behaviors (IMBs) reflect a relatively conflict-free & volitional expression of the self, and have an internal perceived locus of causality. Being a prototype of autonomous regulation, intrinsic motivation is placed on the far right side of the continuum to represent a marker against which internalized regulations can be compared in terms of their degree of autonomy. 

     This schema also includes amotivation (impersonal causality) as a regulatory style, which represents the most impoverished state of integration and autonomy in behavioral regulation. Heider referred to impersonally caused behaviors and outcomes as those that are not intentional & not under personal control. People are amotivated when they do not see action as either (a) reliably connected with outcomes (as in helplessness) or (b) viable given perceived incompetence or lack of environmental supports. When amotivated, a person feels neither competent nor autonomous with regard to acting. Because amotivation represents a nonintemalization of regulation, it, like intrinsic motivation, is presented as a separate category in Figure 1."

        Ryan RM. Psychological needs and the facilitation of integrative processes. J Pers 1995; 63(3): 397-427. 

Fig 1 - Regulatory Styles - Ryan 1995

Bad Behavior, Self-acceptance & Interoception

     There's often far more to disturbingly "inappropriate" or "bad" behavior than immorality or poor parenting. Significant trauma enters the equation much more often than we think. "Knowing the difference between right & wrong" and "trying one's best" have very little influence when a posttraumatic reaction is triggered.
     We may suspect, but usually have no idea about peoples' past history, even of those we've known for a long time. Trauma is not something most of us want to revisit, much less share with others.

     “Paradoxically, the more we try to change ourselves, the more we prevent change from occurring. On the other hand, the more we allow ourselves to fully experience who we are, the greater the possibility of change."
       Laurence Heller, Aline LaPierre. "Healing Developmental Trauma: How Early Trauma Affects Self-Regulation, Self-Image, and the Capacity for Relationship.” North Atlantic Books, 2012.


     “…trauma is much more than a story about something that happened long ago. The emotions and physical sensations that were imprinted during the trauma are experienced not as memories but as disruptive physical reactions in the present. 
     … the engines of posttraumatic reactions are located in the emotional brain. In contrast with the rational brain, which expresses itself in thoughts, the emotional brain manifests itself in physical reactions: gut-wrenching sensations, heart pounding, breathing becoming fast and shallow, feelings of heartbreak, speaking with an uptight and reedy voice, and the characteristic body movements that signify collapse, rigidity, rage, or defensiveness.
     …the rational brain cannot abolish emotions, sensations, or thoughts (such as living with a low-level sense of threat or feeling that you are fundamentally a terrible person, even though you rationally know that you are not to blame for having been raped). Understanding why you feel a certain way does not change how you feel. But it can keep you from surrendering to intense reactions (for example, assaulting a boss who reminds you of a perpetrator, breaking up with a lover at your first disagreement, or jumping into the arms of a stranger.) However, the more frazzled we are, the more our rational brains take a backseat to our emotions.
     The fundamental issue in resolving traumatic stress is to restore the proper balance between the rational and the emotional brains, so that you can feel in charge of how you respond and how you conduct your life. … 
     Recovery from trauma involves the restoration of executive functioning and, with it, self-confidence and the capacity for playfulness and creativity. 
     If we want to change posttraumatic reactions, we have to access the emotional brain and do ‘limbic system therapy’: repairing faulty alarm systems and restoring the emotional brain to its ordinary job of being a quiet background presence that takes care of the housekeeping of the body, ensuring that you eat, sleep, connect with intimate partners, protect your children, and defend against danger. 
     The neuroscientist Joseph LeDoux and his colleagues have shown that the only way we can consciously access the emotional brain is through self-awareness, ie by activating the medial prefrontal cortex, the part of the brain that notices what is going on inside us and thus allows us to feel what we’re feeling. (The technical term for this is ‘interoception’ – Latin for ‘looking inside.’) Most of our conscious brain is dedicated to focusing on the outside world: getting along with others and making plans for the future. However, that does not help us manage ourselves. Neuroscience research shows that the only way we can change the way we feel is by becoming aware of our inner experience and learning to befriend what is going on inside ourselves.”
       Bessel Van Der Kolk. “The Body Keeps the Score. Brain, Mind, and Body in the Healing of Trauma.” Penguin Books, 2015.

"Not Good Enough" Runs our Lives

     I'll never forget an instructor in first year dentistry - Dr. S. Each time I'd show him something I had just finished working on, he'd look at it for 30 seconds or so with a disgusted look on his face, then inevitably say "Ehhhh, do it over again." What he meant of course was "not good enough!"
     Like Dr. S, our parents likely meant well by repeatedly urging us to improve on various activities - HOWEVER - after a steady diet of this, doesn't a distinct impression form that WE are not good enough? And what do we do about this deep sense of insufficiency? WE STRIVE for ACCEPTANCE, which deep down we know we can't ever achieve, because ... we're simply "not good enough." 
     So we sense that we're perpetually running after (praise, acceptance) some elusive "must have" thing - like the fake rabbit that's always just out of the reach of the hounds on race tracks. Is this at least partly why some of us will "never retire"? At the same time, we're running from criticism, rejection.
     Maybe "not good enough" not just runs, but ruins lives. Is there any wonder why self-acceptance is a critical part of various psychotherapies?

Simulated Town, Palestine - Adam Broomberg & Oliver Chanarin

Taking Care of Ourselves More Wisely

"Sometimes I go about with pity for myself
and all the while Great Winds
are carrying me across the sky."             Ojibeway wisdom

     "Be still... drop in deeper... listen.... sense into these 'Great Winds' that carry you...."                                    WisdomAtWork.com

     It's normal & healthy to look after ourselves. But don't we at times flip-flop between self-neglect & overindulgence? 
     Consider the ideal grandparent. Doesn't she wisely nurture her beloved grandchild? Nurturing means providing whatever's needed to maximize the probability that a person, animal, plant or project will flourish, thrive. 
     Wise nurturing has at least three components: unconditional love, experience & patience.
     Experience requires not just time, but also quiet, patient, honest self-reflection - intentionally, humbly learning from our mistakes, as well as things that went well; always guided by the open question, 'What will nurture us, others & our environment in the long-run?'
     Unconditional love is very rare! It must come, first & foremost, from ourselves! We must generate this precious, vital nurturing energy through self-acceptance, self-compassion - recognizing ourselves as being human beings, instead of mythical superheros. Unconditional love is the one & only source of the essential energy that unleashes & fuels our full human potential.
     All this requires patience, for we need to listen deeply to re-connect with our authenticity. Authenticity is easily drowned out by noisy distractions and the roller-coaster artificial highs & lows of our adrenaline-junky lives. Wisdom waits patiently as we slowly realize that we're fed up with noise, and that we're much, much more than thrill-seeking children. 
     Wisdom awaits - AND - life is short.

Psychological Health & Maturity - Increasingly Integrated Adaptation to & Engagement with Reality

     "Allport described the characteristics of psychological maturity as an adaptive set of seven functions: 

     a) self-extension: authentic & enduring involvement in significant life activities, such as work, family life, or community service; 

     b) dependable ways of relating warmly to others, such as tolerance, empathy, trust, and genuineness; 

     c) self-acceptance or emotional security: the ability to regulate & live with one’s emotional states; 

     d) realistic perception & appraisal: seeing the world as it is in contrast to being defensive or distorting reality to conform to one’s wishes; 

     e) problem-centeredness: resourceful problem solving; 

     f) self-objectification: self-awareness allowing a person to know oneself with insight and humor; and 

     g) a unifying philosophy of life, allowing comprehension and integration of one’s goals and values. 

     According to Allport, a healthy person is constantly striving toward unification of personality by integration of all aspects of his/her life."

 

       Cloninger CR. Healthy personality development and well-being. World Psychiatry 2012; 11(2): 103-4.

 

Homes in North End Halifax Nova Scotia

 

Healers, Drugs, Machines, & their Relative Value

     "It is the non-judgmental, non-condemning, and non-manipulative atmosphere between doctor and patient that will permit the most open, and therefore, the diagnostically and therapeutically most meaningful communication between them."  
       Ornstein PH. The family physician as a 'therapeutic instrument.' The journal of family practice 1977; 4(4): 659-61.

      So the ability to accept patients as they are is critical for optimally engaging with them in therapeutic alliance. Of course acceptance of others must be preceded by self-knowledge, self-acceptance, tolerance for ambiguity, and other mature, highly evolved human characteristics.
     We know that "emerging adults" are, at best, 'getting there'. We also know that medical & dental training negatively impacts psychosocial maturation.
See: http://healthyhealers.blogspot.ca/2012/07/soft-skills-undervalued.html 
and: http://healthyhealers.blogspot.ca/2012/11/emotional-intimacy-too-busy.html

     So are we graduating the best healers ('therapeutic instruments') possible? Ensuring student wellness & quality of life during training is an excellent, logical place to start. How much trust (curriculum time & course weight) do we actually have in drugs & machines compared to the human agent of healing? 
     Promoting (rather than disrupting) our students' health & healthy maturation remain critically undervalued educational missions.

Two Levels of Consciousness

     We’ve all experienced – and vividly remember – occasions when we were fully present, totally engaged in any of a wide variety of situations: while relaxing, caring for or loving a person or activity, including work. Such experiences stick with us because they stand out as qualitatively different from everyday life. 
     During such “wisdom” experiences, we’re intimate with whomever or whatever we vividly share the present moment. Self-talk fades away - our noisy, anxious self-concern having subsided. We become unconditional friendliness, kindness, peace, gentleness, patience, acceptance, equanimity, perseverance, stillness, silence & timelessness.

     How do wonderful “wisdom” experiences come to an abrupt end? Doesn’t “self talk” predictably burst onto the scene insisting that we “don’t have time” and must get back to focusing on our fears, worries & anxieties? So our noisy ego, anxious self-concern, our stressed-out “everyday mind” quickly & easily drowns out the peace & wonder of our innate wisdom. 
     Everyday mind so dominates, that we (mistakenly & to our detriment) assume that this primitive, fear-based, survivalist level of consciousness or operating system is literally who (& all that) we are. And it’s distressingly easy for most of us to remain trapped – by default – in this distorted, unrealistic, unhelpful, unhealthy state of mind. 

     “My mind is like a bad neighborhood, I try not to go there alone.” Annie Lamott
 
     Psychotherapists describe everyday mind as a real mess: 
     “an innumerable swarm of disconnected impulses, thoughts, reactions, opinions, and sensations, which are triggered into activity by causes of which he is totally unaware.”
     “a disconnected, helpless collection of impulses and reactions, a being of disharmonized mind, feeling, and instinct." 
       John Welwood ed. “Awakening the Heart. East / West Approaches to Psychotherapy and the Healing Relationship.” Shambhala, 1983.

      Wisdom is a completely natural, inherent, accessible part of our consciousness, intelligence, or operating system. Yet sadly, we're barely aware of it, don’t know how to intentionally access it, and don’t really trust it! And since most of us feel at least somewhat stressed most of the time, our stressed-out everyday mind becomes our default identity.

     "What we experience is our state of mind projected outward." Gerald G. Jampolsky MD

     “Wellbeing is not found by calming the mind, changing our thoughts, or adjusting our attitudes, but by actually shifting into a level of mind that is already calm and alert.”
       Loch Kelly. “Shift into Freedom. The Science and Practice of Open-hearted Awareness.” Sounds True, 2015. 

Therapeutic Presence, Self-knowledge, Self-acceptance

To optimize our therapeutic presence, we need to "work through unfinished business or issues that keep us stuck. We cannot expect our clients to develop any further than we have in our growth process. The idea that we can help our clients to resolve their issues and lead a healthier life simply by using proper techniques is misleading. … techniques will have minimal impact if they are facilitated by someone who is detached or absent. To develop and sustain this quality of presence, therapists must commit to working through their own issues so that those issues will not interfere in the therapy process and so that therapists will be clear and open vessels who are accessible and attuned to the client, without personal interference.
     Presence opens up the potential for happiness and joy now. If we are ruminating or expending mental and emotional energy on past hurt or future longings, we miss the preciousness of this moment. This level of present-centered attention demands constant attention to care for and to bring ourselves back to this moment, where the treasures of contentment, experiencing, openness, and inner peace are possible.”
       Geller SM, Greenberg LS. Therapeutic presence. A mindful approach to effective therapy. APA, Washington, DC, 2012.


     See also: http://mindfulnessforeveryone.blogspot.ca/2013/03/293-presence-therapy-healing.html

Photo: Figsbury   www.dpreview.com

Serving More Wisely

     In our time of workaholism, substance abuse, materialism & other severe imbalances, secondary traumatization, burnout and suicides, we need a MUCH healthier perspective on life.

     "… an important teaching by Dr. Rachel Naomi Remen: ‘Helping, fixing, and serving represent three different ways of seeing life. When you help, you see life as weak. When you fix, you see life as broken. When you serve, you see life as whole.’ Remen explains that helping is based on inequality: ‘When we help we may inadvertently take away from people more than we could ever give them; we may diminish their self-esteem, their sense of self-worth, integrity and wholeness. When I help I am very aware of my own strength. But we don’t serve with our strength, we serve with ourselves. We draw from all of our experiences. Our limitations serve, our wounds serve, even our darkness can serve. The wholeness in us serves the wholeness in others and the wholeness of life.’" 
       Joan Halifax. “Standing at the Edge. Finding Freedom Where Fear and Courage Meet.” Flatiron Books, 2018.


     “Listening is the oldest and perhaps the most powerful tool of healing. It is often through the quality of our listening and not the wisdom of our words that we are able to effect the most profound changes in the people around us. When we listen, we offer with our attention an opportunity for wholeness. Our listening creates sanctuary for the homeless parts within the other person. That which has been denied, unloved, devalued by themselves and others. That which is hidden.... 
     Perhaps the most important thing we bring to another person is the silence in us, not the sort of silence that is filled with unspoken criticism or hard withdrawal. The sort of silence that is a place of refuge, of rest, of acceptance of someone as they are. We are all hungry for this other silence. It is hard to find. In its presence we can remember something beyond the moment, a strength on which to build a life.” Rachel Naomi Remen MD

     “… the spiritual is inclusive. It is the deepest sense of belonging and participation. We all participate in the spiritual at all times, whether we know it or not. There’s no place to go to be separated from the spiritual, so perhaps one might say that the spiritual is that realm of human experience which religion attempts to connect us to through dogma and practice. Sometimes it succeeds and sometimes it fails. Religion is a bridge to the spiritual - but the spiritual lies beyond religion. Unfortunately in seeking the spiritual we may become attached to the bridge rather than crossing over it.” Rachel Naomi Remen MD
 
     "I am reminded that death, like love, is intimate, and that intimacy is the condition of the deepest learning.
     I am reminded, too, of the simplicity of the true teacher, and the power of story to include us in a web of connection far more profound than the superficial things that divide us.
     Ultimately, death is a close and personal encounter with the unknown. Many of those who have died and been revived by the skills of science tell us that the experience has revealed to them the purpose of life. This is not to become wealthy or famous or powerful. The purpose of every life is to grow in wisdom.” Rachel Naomi Remen MD

     “mindfulness concerns freeing oneself from misperceptions, thinking patterns, and self-imposed limitations that impede creativity, clear seeing, and optimal mental and physical health. Moreover, from both the Eastern and Western view, every individual has the intrinsic capacity to be mindful, and with intention and practice, mindfulness can garner strength and stability. In this sense, the greatest potential of mindfulness may emerge when one consciously decides to pursue mindfulness not as just a ‘tool’ in the proverbial toolbox, but as a way of seeing oneself and the world, or a conscious way of being and interacting.”
        Jeffrey Greeson, Eric L. Garland, David Black. “Mindfulness - A Transtherapeutic Approach for Transdiagnostic Mental Processes.” in Amanda Ie, Christelle T. Ngnoumen, Ellen J. Langer, eds.
 “The Wiley Blackwell Handbook of Mindfulness
.” John Wiley & Sons, 2014. 

Who me?

Does the following describe you?

• Type-A driven perfectionist?

• Know how to be seen to know enough?

• Sense of acceptance derived from external praise for ability & performance (don’t feel inherent self-worth)?

• Perfectionist, compulsive, need to be in complete control, emotionally fragile?

After a bit of self-reflection, it's right on the money for me!

Most of us hardly think of ourselves - we're so busy. But isn't at least some of the lack of balance in our lives due to compulsively chasing after, and running from stuff?

As a group, we’re dangerously prone to avoid and delay seeking help for our own problems due to denial & fear of ridicule from colleagues.

Fredrickson RE. Nova Scotia Dentist. Aug/Sept 2005.

The personality type described above is common to physicians and dentists, but likely common to most of us in the caring professions. Bob Fredrickson MD, the author of the above paper, was in charge of Nova Scotia's Professional Support Program, which helps physicians, dentists and veterinarians who require confidential personal assistance.

Canadian Provincial Physician Health Programs:

http://www.cma.ca/living/provincialphysicianhealthprograms#ns

Fear of Death - even among Healers

     "Consistent evidence suggests that physicians who treat terminal patients experience many difficulties. The contact with terminal patients reminds them that death is a universal human phenomenon and thereby evokes their own concerns about dying. Because they are unable to keep these patients alive, as is the mission of their profession, they tend to develop feelings of general hopelessness and personal failure. Moreover, it is emotionally wrenching to absorb the loss and separation implicit in the deaths of people one has cared for. These difficulties may lead to psychological exhaustion, impair their professional functioning, and affect the physician’s attitudes toward death in general and their own death in particular.
     Exposure to the death of significant others somehow leads one to a greater acceptance of death, both as a universal phenomenon and as a personal event. This possibility is supported by our finding that increased age was related to less fear of personal death. 
     Fear of death, and not acceptance, is behind the reduced reporting (of death anxiety by some physicians eg surgeons). While such 'repressors' admit to less death anxiety on self-report measures, they produced stronger physiological reactions (assessed by galvanic skin responses) to the threat of shock than 'sensitizers'. Repressors are not 'low anxiety' individuals, but, on the contrary, are highly vulnerable to anxiety-arousing stimuli."
       Hamama-Raz Y, Solomon Z, Ohry A. "Fear of Personal Death among Physicians." Omega 2000; 41(2): 139-149.


     "... death was one of the prominent aspects of dukkha motivating the Buddha-to-be to set out on his own quest for awakening. ... for the Buddha, the decision to 'renounce the world' and undertake the life of a wandering ascetic was, then, an attempt to resolve the existential problem of 'being toward death' ... his goal was to conquer death within life.
     Having reached the deathless through full awakening, one is no longer affected by the mortality of one's own body or that of others'."
       Analayo. "Mindfully Facing Disease & Death: Compassionate Advice from Early Buddhist Texts.” Wisdom, 2016.

 

Visitors by Robert Pope   http://robertpopefoundation.com/