Why Grandma, What Big Teeth You Have!

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

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

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

HYPNOSIS Workshop in Newfoundland - October 24-27, 2013

The Canadian Federation of Clinical Hypnosis:  Atlantic Division

Autumn Workshop

October 24^th to 27^th  2013

Marble Inn Resort, Steady Brook, Corner Brook, Newfoundland

Oct.  24^th to 26^th, 2013 --  Introductory Workshop

A 20-hour approved basic and experiential workshop.

Aim: to acquire the skills to use hypnosis within your area of clinical expertise.

Oct 27^th  --  Intermediate / Advanced Workshop

This workshop will explore the use and place of Hypnosis in Anxiety and many of its manifestations --- Panic attacks, Phobias, PTSD and Hypnobirthing.

Faculty Clinicians: have extensive clinical experience in hypnosis.

Aim: To demonstrate the role of hypnosis in the treatment of Anxiety in many of its manifestations. 

To provide evidence for clinical techniques, and practical demonstrations of different techniques.

Requirement for this course is a previous introductory course.

Registration for these workshops is open to any Health Care Practitioner who has a valid license issued by a Provincial Licensing Body.

A detailed brochure will be available by early September.

For more information please contact below.

Dr. Ian Simpson

Box 2108, RR1 

Corner Brook NL. A2H2N2

Email:   iansimpson@bellaliant.net

Armand Huet DeGrenier, Ed.M, C.A.G.S., F-CHSNS

Phone daytime: (902)-543-9376, Phone evening: (902)-677-2243

Email:  novaquest@eastlink.ca

Beautiful Newfoundland   http://www.canadabbhosts.com/NF.htm

Empathy - a Basic Human Competence?

     "Employers prizing empathy in high-paying jobs stretch far beyond the predictable 'compassion sector' organizations such as hospitals, clinics and foundations. They also include global heavyweights in the fiercely competitive worlds of tech, finance, consulting, aerospace and pharmaceuticals. Say hello to Microsoft, Dell, Symantec, Mars, Barclays Capital, McKinsey, Raytheon, Thermo Fisher Scientific, Pfizer and Abbott Laboratories. ...
     At a dinner this week, Eric Openshaw, head of Deloitte's U.S. technology, media and telecom practice, mentioned that 60% to 65% of white-collar productivity involves sorting out exceptions. That's a big number for situations where the routine rules aren't sufficient. Addressing that challenge calls for people who can use both their heads and hearts." 
     George Anders "The 'Soft Skill' That Pays $100,000+" http://www.linkedin.com/today/post/article/20130626195513-59549-empathy-and-jobs-that-pay-100-000?trk=mta-lnk

S Yeh   www.dpreview.com

Sense of Belonging - through - Embracing Vulnerability

     Subjects in my study divided into 2 groups: "people with a sense of worthiness, a strong sense of love and belonging, and folks who struggle for it, folks who are always wondering if they’re good enough. Only one thing separates these two groups – those with a strong sense of love and belonging believe they’re worthy of love and belonging. These are kind of wholehearted people, living from this deep sense of worthiness - what they had in common was a sense of courage.
     The original meaning of courage - derived from coeur meaning heart - was to tell the story of who you are with your whole heart. So these folks very simply had the courage to be imperfect. They had the compassion to be kind to themselves first, and then to others, because as it turns out, we can’t practice compassion with other people if we can’t treat ourselves kindly. And they had connection as a result of authenticity. They were willing to let go of who they thought they should be, in order to be who they were, which you absolutely have to do for connection.
     The other thing they had in common is they fully embraced vulnerability. They believed that what make them vulnerable made them beautiful. They didn’t talk about vulnerability being comfortable, nor did they really talk about it being excruciating, (as I heard talked about in the ‘shame’ interviews) they just talked about it as being necessary. They talked about the willingness to say ‘I love you’ first. The willingness to do something where there are no guarantees. The willingness to breathe through waiting for the doctor to call after your mammogram. The willingness to invest in a relationship that may or may not work out. They thought this was fundamental. 
     The definition of research is to study phenomena for the specific goal of controlling and predicting. My mission to control and predict has turned up that the way to live is with vulnerability and stop controlling and predicting.
     When we hold a perfect little baby in our hand, our job is not to say 'look at her, she's perfect, my job is to keep her perfect, make sure she makes the tennis team by 5th grade, and Yale by 7th grade.' That's not our job. Our job is to let kids know 'you're imperfect, and you're wired for struggle, but you are worthy of love & belonging."        Brene Brown PhD 

Optimism is Realistic - Persevere!

     Remain curious & open to how & when success inevitably unfolds. Michaelangelo saw the angel in the marble and carved until he set him free. Each of us has within a seed of wisdom awaiting full expression - tirelessly nurture that seed.

     "Realistic Optimism - an awareness and acceptance of a limiting situation or physical handicap, and the belief that you can succeed despite the limitation; not letting the limitation keep you from performing
 

     Perseverance - continuing in the face of difficulties, delays or obstacles
 

     Handling Pressure - ability to execute what was practiced in important situations."

 

       Barton GB. Career success and life skill development through sports. PhD Thesis, Boston University, School of Education, 2011.

Lecha   www.dpreview.com

Towards a Qualitatively Better Quality of Life

     “The rapid growth of the coaching field over the past ten years reflects a hunger and yearning for new ways to address deep, perplexing issues inherent in human life. How can we respond with kindness and skill to the constant, rapidly changing flux of circumstances in our lives? How can we reduce rather than contribute to harm and suffering? How can we live in ways that are not just productive and efficient, but are also meaningful and fulfilling? 
     Our hunger can never be satisfied by better, faster, increasingly efficient ways of doing more of what we’ve been doing all along. It can only be fed by addressing its source: the deep human longing to be fully who we are.
     In order to develop ... we need to move beyond horizontal accommodation toward vertical transformation.”            Pamela Weiss   http://www.appropriateresponse.com/


     “Everyone has the ability to cultivate a certain kind of intimacy with what’s deepest and best in ourselves. And you can’t do that if you’re rushing through your moments to get to better moments.
     Mindfulness is a practice – as a concept, it’s only the doorway.”           Jon Kabat-Zinn

Anne Bastedo   http://www.serenityimages.ca

 

Cultivating Heart

     “Always do what you are afraid to do.”    Ralph Waldo Emerson

     “Opportunity is missed by most people because it is dressed in overalls and looks like work.”      Thomas Alva Edison

     “From now on practice saying to everything that appears unpleasant: You are merely an appearance and NOT what you appear to be.”      Epictetus

     “I wanted to change the world. But I have found that the only thing one can be sure of changing is oneself.”       Aldous Huxley 

Dr. Tom Boran, descending the 33 story Fenwick Tower for Make-A-Wish http://www.makeawish.ca

Basic Essential Life Skills Need to be Re-introduced

     Society's escalating obsession with comfort, convenience and ease is dramatically reducing our competence to handle normal daily life. Parents, the education system, and organized religions are collectively failing to prepare children to assume basic adult (never mind leadership) roles.
     We need to formally re-introduce training in basic essential life skills! This means striking a healthy balance between the current extreme of rewarding people for having a pulse, and the old-fashioned abusive marine boot camp.

     By skillfully*** encouraging people to "go the extra mile," they "practice calling up emotional reserves until they trust that they have a stockpile of conviction. ... building heart ... is a preventive public health strategy that can inoculate against the potentially negative effects of stress and trauma. (With skill and will, this could become) an essential tool in the primary prevention of stress-related disorders ... and a critical skill that promotes having an optimal life. In addition ... heart can be developed after exposure to traumatic stress. Heart is critical to overcoming*** the sense of devastation and helplessness that develops from traumatic experiences.
     ***when training heart in (those) previously traumatized, it is critical to monitor their tolerance of the training to avoid overwhelming their reduced capacity to handle stress."
       Bell CC, Suggs H. Using sports to strengthen resiliency in children. Training heart. Child Adolesc Psychiatr Clin N Am 1998; 7(4): 859-65.

     See also: http://healthyhealers.blogspot.ca/2012/04/capacity.html

Anne Bastedo   http://www.serenityimages.ca

"Heart" ensures you Thrive, not merely Exist, despite Life's Inevitable Adversities

     "Heart (is) the characteristic that causes a person to be firm in his or her beliefs and to have determination to accomplish goals. Examples of heart can be found in many accounts of people who have overcome hardships and become successful. In studying the supermarathon Mexican Tarahumara kickball race and the Alaskan Iditarod 1049-mile dogsled race, researchers have explored the relationship between endurance and extreme motivation, which is believed to develop heart. In addition, of individuals who have been injured in accidents who have become disabled in some way, some become embittered and consumed with the tragic events that regrettably altered their lives, whereas others seem to find ways to compete in sports, secure meaningful work, and move ahead with their lives. What is the difference between those who thrive and those who simply exist? The difference is the indomitable warrior spirit or heart that brings forth courage, strength, and resilience."
     There's a great need to cultivate heart for all of us "as a primary prevention strategy to prepare (us) to face adversity. Heart can be developed by using sports (as well as mindfulness practice) as a vehicle."
       Bell CC, Suggs H. Using sports to strengthen resiliency in children. Training heart. Child Adolesc Psychiatr Clin N Am 1998; 7(4): 859-65.

     See also: http://healthyhealers.blogspot.ca/2012/04/capacity.html

matematto   www.dpreview.com

What We Each "Bring to the Table" is Ourself - Hopefully a Wise, Mature one

     After 38 years in health care, 30 of it as a full-time faculty member at a dental school, I'm struck by the dominant influence of every single "player's" personality and psychosocial history ie "baggage." 
     Yet, every one of us likes to believe - or at least wants others to think - that we're the poster child for normality, balance, maturity, logical thinking, etc - that all our decisions are "evidence-based" - the ultimate stamp of legitimacy.
     A somewhat funny, but often true sentiment: humans use their prefrontal cortex less for executive decision-making, than to fabricate excuses for foolish behaviors. The more rigidly a person clings to the idea that they're logical, impartial, objective, and ... trumpets please - "evidence-based" - the more seriously deluded they are, and tragically, the more rigidly avoidant they are of self-reflection, introspection, mindfulness training, or any other ways of gaining psychological flexibility, maturity, and ultimately - wisdom.
     Maturity, and especially wisdom, are RARE but attainable states to work towards. Every one of us is "a work in progress." Each of us is in a very weak, vulnerable position to be harshly judging others. Humility is simply being "evidence-based" IF we see ourself clearly & objectively! And such clarity of vision, particularly about oneself, requires methodical introspection - a science of the mind - meditation.

     More about wisdom: http://healthyhealers.blogspot.ca/search?q=wisdom

Graham McGeorge   http://photography.nationalgeographic.com/photography/

We Teach Who We Are

     All of us teach - patients, colleagues, family and friends. Each of us teaches constantly, by how we say every word, and how we perform each action.

     "A teacher in search of his/her own freedom may be the only kind of teacher who can arouse young persons to go in search of their own."     Maxine Greene

     "And this freedom, this ripeness of self, is the indispensable element in all true teaching, simply because it speaks so compellingly to those who hunger to be free - that is presumably all."     William Arrowsmith

     "Of the many attributes associated with transformative teaching, the most crucial ones seem to concern the teacher as a person. For it is essential to success within that tradition that teachers who are trying to bring about transformative changes personify the very qualities they seek to engender in their students. To the best of their abilities, they must be living exemplars of certain virtues or values or attitudes."     Philip Jackson

       Higgins C. Human conditions for teaching: The place of pedagogy in Arendt's Vita Activa. Teachers College Record 2010; 112(2): 407-45.

Michelle Finucane   http://photography.nationalgeographic.com/photography/

Comfortably Numb? Aging & the Fossilizing Mind

     "‘medical educators (human beings in general) are relatively unsophisticated at distinguishing between formative struggles that advance learning and adverse struggles that distract [from] or impede learning’. 
     To transform a transition from a threat to a learning opportunity, medical education (all educators) should assist (all) students and doctors in developing the coping skills they need to effectively deal with the challenges presented by new environments."

        Teunissen PW, Westerman M. Opportunity or threat: the ambiguity of the consequences of transitions in medical education. Med Educ 2011; 45(1): 51-9.

The child is grown
The dream is gone
I... Have become comfortably numb                       Pink Floyd - Comfortably Numb

Self-understanding, Healing Yourself - THEN You Can Help Others

     Celebrated performance artist Marina Abramovic, currently performing in Toronto, on the positive role of suffering & the road to real happiness:

     “Do you think that every ancient civilization’s sacred rituals ‘abused’ the body in order to become a shaman, or in order to go from childhood to puberty – when they send the kids into the forest & they have to survive in order to learn what loneliness means, what it means being in the wild, what it means getting food for yourself, or hundreds of other rituals where you almost have to face clinically dying in order to create a different state of consciousness? Why are we doing this? Why call this ‘abuse’? Suffering is good for us, IF we see the context, IF we see the concept, IF we see the idea behind it. We suffer because we are just temporary on this planet – the moment you’re born, you’re going to die. Just general human suffering that’s expressed in so many ways – the suffering of loneliness, the suffering of not being loved, not understanding the world, not understanding what the purpose of your life is, there are so many different ways. Just that kind of suffering - every human being has this.
     Pain is another obstacle – we’re so afraid of pain. But what I’m doing in my life, I’m staging painful experiences in front of an audience and using the energy of the audience I’m going through this experience in front of them and actually seeing how I can push my mental-physical borders. If I can do it myself, they can do it in their own lives. That’s the way I’m doing it. I don’t see this as abuse.

       Jian Ghomeshi: Do you think that the pursuit of happiness - that Americans have held to such a high standard – do you think that’s folly?  

     No, it’s so wonderful. Right now, you’re facing me, and I’m the happy person in this moment. It took me 40 years to come to that point that I actually feel happy. It’s been such a long journey, but it’s really about fully understanding yourself. You see the concept of happiness is not about having more cars, and having more money in the bank, and then go and take drugs, and drink like hell, and then suicide because you can’t deal with yourself. Happiness comes from fully understanding your own being – and this is such a long journey. And all these things, at least in my work I’ve been doing was going towards this transformation where actually you come to that kind of knowledge. And you come to that kind of knowledge, that type of happiness, you actually come to that point where you can help others to understand that."

       Marina Abramovic interview by Jian Ghomeshi on CBC Radio - starts precisely @ 0:25:35/1:09:03 see: "Eroding gay rights in Russia, Artist Marina Abramovic, Inventor Mick Ebeling 06/12/2013" http://www.cbc.ca/q/episodes/

     See: http://healthyhealers.blogspot.ca/2012/03/approach-avoidance-dichotomy.html

     A true artist shows society what it can't see on its own.

Udayan Sankar Pal   www.facebook.com/UdayanSankarPal

Obviously Suffering Colleagues

     How often have you seen a colleague clearly suffering, yet, there was no way of connecting with her/him deeply enough to be of meaningful help?
     Ego, rigidity, professional boundaries, cynicism, fear - a whole host of barriers mitigate against health-care professionals being human with each other. So our colleagues who suffer, tend to do so alone, isolated - the worst case scenario - as any of us advise our patients!
     It's essential to face the fact that most of us completely lack the ability to examine, never mind share, what is deeply meaningful to us. Our entire lives we've focused attention outwards - towards solving others' problems. Such an exclusively outward orientation is terribly unhealthy - incompatible with normal maturation and a rich, meaningful life.
     We all must learn to bravely look deeply within - to rest in awareness of our inner world and learn to integrate our inner and outer lives. This is absolutely basic maturation - growing up as an evolved human being. 
     Cynical cracks about "navel gazing" carry the same gravitas as schoolyard bullies' pejoratives regarding "book-learnin'".

     See: http://healthyhealers.blogspot.ca/2012/03/approach-avoidance-dichotomy.html

FYE-PHOTOGRAPHY   www.dpreview.com

Priorities, Competencies, Time-poverty, Life-stage, Maturation

     Prioritizing various aspects of our life is a complex matter. It involves deliberate, conscious decisions AND - far more than we like to admit - primitive subconscious approach-avoidance reflexes.
     We all naturally gravitate towards (approach) our strengths, so we tend to get increasingly good at fewer & fewer activities, avoiding the less impressive aspects of our lives. Avoidant behaviour leads to an unbalanced life.
     The pace of life seems to be progressively speeding up. Many of us have trouble saying "no", be it to a text message during dinner with our family, or yet another exciting new project. And we like to do things right. So most of us suffer seriously from "time-poverty."
     How to behave appropriately at different ages / life stages - acting one's age - seems to be a complete mystery! Kids aren't ready for school when it's time to enter school, not ready for university, not ready for work, not ready to retire, not ready to be old, & of course not ready to die. Though there's a definite, timeless, universal pattern to human life, people don't seem to have a clue! Isn't it time to take a close look at this?
     Humans - individually & as a society - can mature in a normal, healthy manner. ALL parents, teachers: in our schools, universities etc, and ALL the various counselors must learn, embody, explicitly teach, continuously nurture and ensure that we all GROW UP! - "Leave no child behind!"

     See: http://mindfulnessforeveryone.blogspot.ca/2013/04/316-fear-reactivity-mindfulness-mature.html
     and: http://mindfulnessforeveryone.blogspot.ca/2013/04/313-being-stressed-out-is-optional.html
     and: http://www.johnlovas.com/2012/04/time.html

idanbh88   www.dpreview.com

Educators & Administrators: A Threatened Self-Concept Diminishes Learning!

     Though we learn to avoid SOME of our teachers' unskilful habits, we inevitably retain & embody some of them. When as pathology residents (in the early 1980's) we presented cases, we knew that we'd be mercilessly, public humiliated if we didn't present all of our facts correctly. 

     When trained through intimidation - AND MOST OF US WERE - student-centered learning is a completely foreign concept. So most of us over the age of ~35 have NO IDEA how fragile our current students' egos are compared to our own crusty, heavily-armoured egos.
  
     "Educational research has shown that emotions and cognition are interactive. Excessive anxiety decreases our ability to process information. As a result, a negative learning environment, however it is created, limits a student’s ability to process, synthesize, and retain information. Learning requires a receptive mind; negative emotions interfere with our cognitive functioning. Therefore, a threatened self-concept diminishes learning. In terms of medical education, this means that high expectations should be accompanied by a positive learning environment and support until residents have gained a measure of mastery over the new material. Positive assessments should never be seen as the result of favoritism or of effort alone in the absence of actual achievement. The corollary is that negative assessments should not be seen as unfounded or lacking in constructive advice. Residents may forget what we said, but they will never forget how we made them feel."
       Pinney SJ et al. Orthopaedic surgeons as educators. Applying the principles of adult education to teaching orthopaedic residents. J Bone Joint Surg Am 2007; 89(6): 1385-92.

     Shame severs Relationships - see: http://www.johnlovas.com/2013/06/from-shame-to-wholeheartedness.html

My former Chief of Pathology - on a benign day.

FerruginousHawk   www.dpreview.com

Transformational Learning, Like Aging, is NOT for the Faint of Heart

     Growing pains, out with the old - in with the new, shedding old skin, re-inventing oneself - one continuously transforms into a completely new person. At sub-atomic, atomic, molecular and even cellular levels, our bodies constantly change, shedding dead cells by the billions, producing equal numbers of new ones to replace those lost, loosing old intercellular connections and forming new ones in the process of learning (neuroplasticity). Constantly learning how to deal effectively with the emerging environment -  moment-by-moment evolution.
     Without even being consciously aware of it, we're undergoing constant, continuous change. Our body automatically adapts to the continuously changing environment. Our mind can also do this - unless fear of discomfort & liminality stops us - because inertia is more comfortable than growth & adaptation. But to survive & thrive, we need to intentionally, intelligently, creatively, embrace change.

     "The emotions of anxiety and depression accompany the very difficult process of dis-integration, re-constitution, and re-integration that is transformational learning."

       Green L. "Transformative learning: A passage through the liminal zone. in: Psychoanalysis and education: Minding a gap." Karnac Books, London, England, 2012. pp199-216.

     See: http://healthyhealers.blogspot.ca/2012/03/to-burnout-or-engage.html
 

Erez Marom   www.dpreview.com

Common Conversation vs Meaningful Communication

     "If other people are going to talk, conversation becomes impossible."

               James McNeil Whistler, American-born artist (1834-1903)
               Globe & Mail June 4, 2013


     Jokes aside, we've had serious communication problems for a long, long time. The loudest, brashest folks continue to be heard, despite the fact that they invariably have the least worthwhile things to say. 
     There's a serious need to cultivate listening skills individually and in groups - we may need to learn from our aboriginal brothers & sisters to sit in circles and pass the talking stick. 
     The productivity of our meetings would surely improve if EVERY person was given the chance to fully express herself without being cut off, shouted down, passed over, or otherwise ignored.

Steve Geer   www.dpreview.com

Mindfulness - MUCH MORE than a Clinical Intervention or Object of Study

     "‘Mindfulness’ is not only to be understood as an abstract idea or concept but also embodied and experienced as a practice. The great risk of the engagement with mindfulness in the West, whether through Buddhist Studies or Psychology, is that it is taken as an object of study, to be written about, rather than as something to do or be." 

 

        Stanley S. Intimate distances: William James’ introspection, Buddhist mindfulness, and experiential inquiry. New Ideas in Psychology 2012; 30: 201–211.

 

Vincent Quint   www.dpreview.com