"Shoulds" or Common sense?

     When kids starting to drive their parents' car are told to keep an eye on the engine oil & brake fluid levels, tire pressure, etc - they consider it nagging. If they follow the advice, it's out of obligation, guilt, morals, trying to be good. On the other hand, if the engine seizes (lack of oil), it's considered terrible luck, or cosmic punishment for disobedience. Childish right?
     I suggest that ALL of the "moral" codes ("shoulds") regarding thought, speech and behavior found in the wisdom traditions are of the exact same nature as making sure the car engine has sufficient oil to run smoothly. The founders and refiners of the wisdom traditions had very mature accurate insights into how things actually work: how humans relate to each other and the universe, the causes of suffering and its release, and thus, how we can choose to live the deepest, most meaningful lives.
     The 16-year old doesn't know and cares less about the car (big picture), he's blinded by the urge to get to the party quickly (short-term, self-centered goal). Nevertheless, all the causes and effects that make the car operate (laws of nature) must be in place for it to work properly. Only when we understand the workings of the car fully, do ideas like "bad luck" and "punishment" fade.
     All of us in health care are highly trained in biomedical science. Most us have inadequate training or interest in the psychosocial and spiritual dimensions of life, even as it pertains to fully caring for our patients. Thus, when (not if) the biomedical approach fails to keep our patients, our loved ones, and ourselves from aging, sickness and death - we immaturely think: bad luck, tragedy, "unacceptable"!
     The biomedical is a small part of the overall picture, which has HUGE psycho-social-spiritual dimensions. Our avoidance of the latter is fear-based - plain old ignorance due to lack of training. If we investigate deeply how the universe works, we CAN begin to live a full, balanced life. Life becomes more understandable - even joyful, as our knowledge AND wisdom matures.

Photo: Geza Radics   flickr.com/radicsge

Wisdom - is it valued today?

     Recently, a sequence of white-collar criminals have been convicted of intentionally robbing countless elderly people, some of whom were immediate family members, of their entire life savings. Clearly, very intelligent, well-educated people can, and do cause tremendous human suffering due to an utter lack of wisdom.

     "The world has achieved brilliance without wisdom, power without conscience. Ours is a world of nuclear giants and ethical infants." General Omar Bradley, commander of US ground forces, Normandy invasion, WW II 

     “The intuitive mind is a sacred gift and the rational mind is a faithful servant. We have created a society that honors the servant and has forgotten the gift.” Albert Einstein (1879-1955)

     “Education's purpose is to replace an empty mind with an open one.” Malcolm S. Forbes

      “School instead creates closed minds, filled to the brim.” Rudyh

     “Faced with the choice between changing one's mind and proving that there is no need to do so, almost everyone gets busy on the proof.” Galbraith's Law

     “Great spirits have always encountered violent opposition from mediocre minds.” Albert Einstein

     “Discipline divorced from wisdom is not true discipline, but merely the meaningless following of custom, which is only a disguise for stupidity.” Rabindranath Tagore

      “No problem can be solved from the same consciousness that created it.” Albert Einstein

 

     "We need to change the mindsets not just the problem sets”. Jean-Lou Chameau, Dean of Engineering at Georgia Institute of Technology

     "A human being is part of a whole, called by us the 'universe', a part limited in time and space. He experiences himself, his thoughts and feelings, as something separate from the rest - a kind of optical delusion of his consciousness. This delusion is a kind of prison for us, restricting us to our personal desires and to affectation for a few people near us. Our task must be to free ourselves from this prison by widening our circles of compassion to embrace all living creatures and the whole of nature in its beauty." Albert Einstein

      "Try not to become a man of success but rather try to become a man of value." Albert Einstein

      "The true value of a human being can be found in the degree to which he has attained liberation from the self." Albert Einstein 
 
     “Education has taken the easier, quicker route. It leads students rapidly and relatively smoothly — in the wrong direction. That wrong direction is illustrated by the high-stakes systems of testing that have come to dominate the UK as well as the US. It is not that high-stakes testing is, in itself, necessarily bad. It is that what the tests measure, to a large extent, doesn’t matter all that much in the long run. What matters is not only how much knowledge you have, but how you use that knowledge — whether for good ends (as for Mahatma Gandhi or Martin Luther King) or for bad ones (as for Adolf Hitler and Joseph Stalin). In this article, we argue that what matters most of all is the development of wisdom.”
      Sternberg RJ, Reznitskaya A, Jarvin L. Teaching for wisdom: what matters is not just what students know, but how they use it. London Review of Education 2007; 5(2): 143-58.

     What can I do to cultivate wisdom?

  

Photo: Andre Gallant   http://www.andregallant.com/

Philosophy of life - deep enough?

     "When I state the proposition clearly that life is suffering and that the purpose of life is not happiness, (my students) actually experience that as a great relief. And the reason I think they experience that as a great relief is that they already know it. Even if they wouldn't necessarily articulate that, their experience has taught them that life is complex and tragic and difficult.

     And the problem with the public portrayal of the ideal state of humanness as happiness is that it makes all of these young people feel ashamed of their own suffering. They feel that if they're suffering, and if they find their life tragic in its essence, then that means that there's something wrong with them, and instantly that makes it impossible for them to communicate anything real about their own tragedy. 

     ... Suffering is not some unfortunate thing that disrupts an otherwise perfect existence, or that suffering is an accident that may befall some people. ... suffering is at the heart of being a human." 

     "... because life involves suffering, if your philosophy is shallow and meaningless, when you suffer, you'll become resentful, and hostile, and self-critical, and then you'll become cruel and destructive.
     Not only is there a necessity for your own mental health to forthrightly confront the deepest questions of life, but if you don't, then you remain a danger to yourself, and more importantly to others."

        "Say No To Happiness" Frank Faulk's (~54 min) documentary on CBC Radio's "Tapestry" May 27, 2012 
http://www.cbc.ca/tapestry/

Photo from IMS website: http://www.dharma.org/

Good enough?

     We were all used to being the smart one in the class. Then all of a sudden in our professional training, we were surrounded by high (over) achievers, and we started doubting ourselves - am I smart enough to be here? I've seen very bright, very successful dental as well as medical students, even residents, express serious doubts if they "had the right stuff" to finish their programs. And it doesn't end on graduation. Self-doubt continues to haunt many of us in the health professions.

     Those of us who appear (even to ourselves!) to be the most "bullet-proof" may well be the most rigidly armored, and therefore, most susceptible to crumble when the winds of circumstance blow hard.

      “The truth is what one really needs is not Nobel laureates but love. How do you think one gets to be a Nobel laureate? Wanting love, that’s how. Wanting it so bad one works all the time and ends up a Nobel laureate. It’s a consolation prize. 

     What matters is love.”                 George Wald, Nobel prize winning biologist from Harvard

     "Be kind - everyone carries a heavy burden."

      “an oasis – a gathering place where travelers rest, learn, and tell their stories. … where people can put down the burden of pretense and share what it really means to be human.” 

     Lesser E. “Broken open. How difficult times can help us grow.” Villard, NY, 2005.

Photo: everaldo   www.dpreview.com

Your "to-do" list

     "you only have one life to live, and as you will find out sooner than later, it goes by pretty quickly. Happiness should not be given short shrift. It should not be overlooked on your life's to-do list. It's just too damned important. And one way to make sure you at least give yourself a shot at getting a little piece of it, is to follow your heart."

     Eugene Levy, Canadian comedy icon, convocation speech at Dalhousie University, May 23, 2012

Self-concept & Worldview & Crises

     “The change from storm & winter to serene & mild weather … is a memorable crisis which all things proclaim.” Henry David Thoreau

      “In the physical sciences, dramatic shifts to very different ways of thinking are common. In fact, they are regarded as essential.”
      Ramo JC. "The Age of the Unthinkable. Why the New World Disorder Constantly Surprises Us and What We Can Do About It." Little Brown & Co, NY, 2009.  

    

     Is our worldview / self-concept something solid we can hold onto and depend upon - OR - but a provisional model (paradigm) in a rapidly changing world? The more we identify with it as a solid, unchanging "me", "who I am", the more powerfully it colors our perception and influences our thoughts, speech & behavior. Our worldview / self-concept is the operating system (OS) of our life. Yet how conscious of it are we?

     Do we actively avoid examining our OS? Do we "keep busy" with work and distractions? Do we pursue "mindless fun", proclaiming "this is as good as it gets" - while "I can't get no satisfaction" plays in the background? Does being quietly by ourself provoke anxiety? And in the company of others, do we quickly fill silent moments to avoid dreaded "dead air"?
     My Dad, who lived for almost 86 years, witnessed his parents, 3 younger sisters, and all of his closest friends grow old, get sick, and die. Such traumas ("shipwrecks") can & do cause "the world as I knew it", including "who I thought I was", to disintegrate, numerous times within a lifetime. 
     “To undergo shipwreck is to be threatened in a total and primary way. … what has dependably served as shelter and protection and held and carried one where one wanted to go comes apart. What once promised trustworthiness vanishes." Lesser E. “Broken open. How difficult times can help us grow.” Villard, NY, 2005.

     Afterwards there are 2 options: shrivel up, cynical, vengeful & miserable OR construct a new, broader, more inclusive model of reality that can contain what just happened.
     "When we have been through a trial and survived it – or better still, transformed its terrors into revelations – then we begin to approach other adversities with a different attitude. Change and loss may still knock us off the horse, but soon we are back in the saddle, stronger & wiser than ever. As life progresses, and we continue to transform and refine our consciousness, we gain more insight and humility, greater strength of character, and deeper faith in the meaningfulness of life." Lesser E. “Broken open. How difficult times can help us grow.” Villard, NY, 2005. 

     PROACTIVELY studying one's worldview / self-concept is uncommon (avoided) in our society. Yet the millions of people who meditate, do precisely that - specifically to achieve greater & greater clarity about reality - how things actually are.

     Which works better, avoiding or facing reality? Is becoming a competent swimmer reasonable when only the timing & number of shipwrecks is unknown?

Photo: Veltchev   www.dpreview.com

Dealing with Trauma & Adversity

      "The greatest and most important problems of life are all fundamentally insoluble. They can never be solved but only outgrown (accepted & transcended)."          Carl Jung 

 

     “traumatic life experiences can be conducive to the development of (personal) wisdom, a notion prominent in concepts such as post-traumatic growth, stress-related growth, or growth through adversity. After negative experiences such as accidents, life-threatening illness, or the death of a close other person, many people report self-perceived increases in aspects of personal growth such as compassion, affect regulation, self-understanding, honesty and reliability, spirituality, and self-reported wisdom itself. While such self-perceptions of growth may be delusional, it seems plausible that personal wisdom is fostered by the experience of fundamental changes that ‘force’ individuals to grow by challenging them to reorganize – but not completely destroy – their assumptions about life and priorities.”

     Staudinger UM, Gluck J. "Psychological wisdom research: commonalities and differences in a growing field." Annu Rev Psychol 2011; 62: 215-41.
 

     “There are at least two ways to picture a broken heart, using heart in its original meaning not merely as the seat of the emotions but as the core of our sense of self. The conventional image, of course, is that of a heart broken by unbearable tension into a thousand shards—shards that sometimes become shrapnel aimed at the source of our pain. Every day, untold numbers of people try to ‘pick up the pieces,’ some of them taking grim satisfaction in the way the heart’s explosion has injured their enemies. Here the broken heart is an unresolved wound that we too often inflict on others.
     But there is another way to visualize what a broken heart might mean. Imagine that small, clenched fist of a heart ‘broken open’ into largeness of life, into greater capacity to hold one’s own and the world’s pain & joy. This, too, happens every day. Who among us has not seen evidence, in our own or other people’s lives, that compassion and grace can be the fruits of great suffering? Here heartbreak becomes a source of healing, enlarging our empathy and extending our ability to reach out.” 

     Palmer PJ. "The politics of the brokenhearted. On holding the tensions of democracy." Fetzer Foundation, 2005.
 

     “When worldviews change, new possibilities can emerge, even within the same set of circumstances. Worldview transformation … is a fundamental shift in perspective that results in long-lasting changes in people’s sense of self, perception of relationship to the world around them, and way of being.”  

     Schlitz MM, Vieten C, Miller EM. "Worldview transformation and the development of social consciousness." Journal of Consciousness Studies 2010; 17(7-8): 18-36. 


      "The most intense conflicts, if overcome, leave behind a sense of security and calm that is not easily disturbed. It is just these intense conflicts and their conflagration which are needed to produce valuable and lasting results."             Carl Jung

     In Nova Scotia, dentists, physicians and veterinarians can call a free, confidential Professionals' Support Program, operated by Doctors Nova Scotia:

Confidential help line: 
902-468-8215  or  1-855-275-8215 (toll-free)
E-mail: professionalsupport@doctorsns.com

Photo: winerston   www.dpreview.com

 

Constant sense of dissatisfaction?

     Did you know that you can write comments?

     One of you commented re the May 16th blog "Time to upgrade the operating system?": "Listening to my mental dialogue, I seem to be driven by a script that demands that I “work, work, work” or “do, do, do” to “get it all done” so that I can be satisfied.

     In listening to my body, I detect physical sensations of unease (I am wondering whether this is what Buddhists refer to as “suffering” or dissatisfaction) which trigger the mental script above and cause further tension.

     Therefore in my, rudimentary, observation the physical and the mental seem to collude to create an almost constant sense of dissatisfaction. Ironically, it is this sense of dissatisfaction that drove me to graduate school followed by medical school. However I am starting to realize that the satisfaction that I am looking for may have to be cultivated directly, independent of achievement.

     Any further thoughts?"

     My response: "You express yourself very well and your experience is, I'm pretty sure, widespread in industrialized countries, perhaps particularly among health-care professionals. 

     A LOT of working / doing fails to bring us satisfaction, so we persevere and do MORE (in quality / quantity) of "what doesn't work". If one replaced the socially-approved, and in fact encouraged, excessive "working" with socially-stigmatized excessive drinking, eating or gambling, it immediately becomes obvious. There's an addictive quality to it. Work (alcohol, food, gambling) alone, regardless of the quality / quantity, cannot provide the happiness we seek. Robert Wright wrote: "The essence of addiction … is that pleasure tends to dissipate, and leave the mind agitated, hungry for more." Gerald May, a psychiatrist who worked in addictions for 25 years, wrote that we are ALL legitimately addicted to multiple "substances" eg work, chocolate, etc.

     Most of us seem to need to fully experience dissatisfaction with our own addictions before we can transcend them ie we don't need to stop working, eating (or even drinking etc in moderation), but do need to re-balance by looking for what brings deep meaning and direction to our lives.

     The wisdom traditions offer well-traveled road maps to living a deep meaningful life. These offer complete WAYS OF LIFE ie not simply an add-on to tweak our current unsatisfactory way of life. Wisdom traditions are many and varied: Taoism, (non-dual) Yoga / Hinduism, Buddhism, Kabbalah, (non-dual) Christian mysticism, Sufism. You will become a better, more empathic, balanced physician in the process.

     I read about these paths for 30 years before embarking on one of them with increasing seriousness. The various wisdom traditions each appeal to different personality types and perhaps historic times. Also, availability of respected teachers is a consideration.

     You're in an excellent place and time - there are infinite possibilities for living a very rich and rewarding life!"

     Any further thoughts?

Photo: Auntie Ginzy   www.dpreview.com

Using "effort" wisely

     "'Do no harm' is the guiding precept for health care professionals. The definition of 'harm' is key in this context, particularly as the distinction between physical, mental and emotional pain or distress merges in such programs as MBSR (Mindfulness-Based Stress Reduction) ie one could have chronic pain or an incurable illness, but reach a place of acceptance and calm; or perhaps a deeper emotional pain may be experienced for the first time. As well, the definition of 'harm' can be open to interpretation, depending on the capacity of both the participant and the instructor to remain present to their experience. In this context, the individual's perception of the experience and the instructor's skill in perceiving what is going on at multiple levels are crucial (eg if an instructor allows a participant to remain with his pain in order to gain some insight, or perhaps encourages a participant to not 'push' himself so hard, yet never allows him to move through an experience - then is 'harm' being done?).

     Dobkin PL, Irving JA, Amar S. "For whom may participation in a mindfulness-based stress reduction program be contraindicated?" Mindfulness  2011; DOI 10.1007/s12671-011-0079-9

     A 20-year-old marine and a mature gardener likely have very different takes on the word "effort". The wise use of effort is a subtle art in both mindfulness meditation as well as in the growing family of mindfulness-based interventions - see:

http://mindfulnessforeveryone.blogspot.ca/2012/05/127-non-striving.html

as well as

http://mindfulnessforeveryone.blogspot.ca/2012/05/130-stable-awareness-or-trance.html

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

Time to upgrade the operating system?

     Most of us got to where we are by being goal-oriented (over) achievers. We clearly assumed that getting to where we are would make us happy. And yes, we can feel satisfaction about our career and the fact that we've helped many patients along the way and have provided well for our families. So why do many of us feel dissatisfied?

     Meditation teachers uniformly advise that the "gaining mind" - precisely the goal-oriented, striving operating system that we have identified with over most of our lives - makes true contentment impossible! And how do most of us handle our dissatisfaction? By trying to suppress, avoid or medicate it into our subconscious. We "try to keep busy" - as if this were a noble and intelligent thing to do.

     Someone once said that the first half of life is a mistake. Certainly to the extent that we mutate into single-minded achievement machines, it is a colossal mistake. Many of us can't extricate ourselves from this "doing" mode - we become our function, forgetting who we are as human beings.

     So what's the alternative to "if only I can achieve (or avoid) X, THEN I'll be happy"? It's switching over to a less surgical, more gardener-style of thinking. Doing what needs to be done, in the present moment, and being satisfied with the process itself. No expectations, no anxieties about results, having done all one can to nurture an organic process. This shift in one's modus operandi is definitely not instant, but certainly more congruent with the second half of life - when it's time to cultivate wisdom.