Showing posts with label communication. Show all posts
Showing posts with label communication. Show all posts

Friday, 22 July 2016

Social Development & Smart Phones - Part 2


Continuation of the transcript of Sherry Turkle PhD interview by Anna Maria Tremonti, on CBC Radio, Nov 16, 2015


AMT “(The library is) the place you could go and have some solitude, or even talk to people face-to-face.”

ST “Or read a book that didn’t have links that took you from what you’re reading to Facebook, to a game. In any case, the students were having a very hard time concentrating. One student said to me ‘You know I print out all of my assignments, because I can’t concentrate if I just use the tablets.” And then she said to me this really interesting thing ‘Why did they close the library?’ And it’s really a challenge – I just throw the gauntlet down to schools, as they accept give-away packages from Apple and Microsoft that give tablets to everybody in the school and tempt schools to close their libraries, which of course saves a lot of money, why are we closing the libraries?”

AMT “You write ‘We are all the products of conversations we have not had at home, the conversations we have side-stepped with family, friends, and intimates.’ Tell us more what you mean by that.”

ST “The large point I’m making there is that in the years I studied conversation I found that this was not a teenage problem, a millennial problem, a young persons’ problem, it was the adults who were retreating to their phones, it was parents who were texting during breakfast and dinner, it was parents who were giving kids baths and instead of talking to their kids while they were in the bathtubs, were just sitting on the toilet doing their email instead of engaging their children. So I found that in family situations it’s parents who were modeling a way of being with this technology that really excludes their children. And the hopefulness in my book … is I found so many children, let’s say 13, 14, 15 & 16, are saying ‘You know, I think these phones are keeping my family from paying any attention to me. I think these phones are keeping my mother from talking to me in the car – she’s trying to text while she’s driving. We go on vacation and she’s complaining the whole time that the Wi-Fi isn’t strong enough. I want to have a conversation with her and she won’t look up. So I see a generation that raised without enough parental attention. And again, ‘technology makes us forget what we know about life.’ One of the big surprises in my research is finding so many families, so many couples, so many people in relationships of all sorts who found that arguing over text – some called it fighting by text, is how they preferred to air their grievances with each other. And what kept coming out is that they felt that this way of communicating with each other let them feel that they could say their piece, that they wouldn’t be interrupted, that they wouldn’t stop themselves because they felt flummoxed or embarrassed, or they didn’t have to face the person. You know it’s the face of another person you love that both brings that person alive for you, but also silences you in your care for them, makes you anxious, makes you vulnerable. And so without vulnerability, they felt they were better able to express themselves.”

AMT “When you talked about empathy before, this is also about leveling emotion, right - almost flat-lining emotion?”

ST “Yes. You get a chance first of all to edit who you are and how you present yourself. So you become a lawyer in a courtroom rather than someone who’s showing their pain. And that’s more comfortable, but it isn’t necessarily more true. It feels more comfortable too, because you feel you’re getting your argument out, and you’re presenting your best face. But actually, when you’re having an argument, you may not be in your best face, and it may be again that same theme – it may be more important for your partner, your husband, your spouse, your mother, your sister to see that you’re hurt, you’re vulnerable, you’re not in a big, best-face moment. And that may be part of what the argument needs to show. Take a parent & child - if you give your child the feeling that what you want from them is them to tell you the most controlled and edited story of what’s on their mind, and that will help you hear them, they begin to feel that that’s the version of self that is acceptable – this kind of perfect version of themselves. And that really isn’t a good message to give your child. You want to give your child the message that you can tolerate their messiness, and you’ll be OK. Because that’s the child’s greatest fear – that they’re feeling messy, and out of control, and scared, and that it’s so bad that their caretaker – the person they rely on – will dissolve, will disappear, will freak if their truth is known. You have to reassure your child that that’s not case, I can hear this, that’s not so bad, everybody’s like that, that’s being a person. And asking a child to present an edited version, this cleaned-up version, actually I think, has significant dangers.”

AMT “You make the point too that a lot of young people say they don’t know how to have a conversation. They want to learn to have a conversation. I was surprised. That really struck me.”

ST “Yes. Well they haven’t had as much practice as you think. Their families are texting over dinner. Then at school, they have this thing called ‘the rule of three’: let’s say there are 6 at dinner, 3 people have to have their heads up before you feel free to put your head down and text, because everybody comes to the table with their phone and everybody wants to text during dinner. So the conversation in those environments is going to be kept light. It’s going to be kept on topics where people don’t mind being interrupted, going kind of in and out of a conversation. And also you feel less empathic connection with people you’re with.”

AMT “You mention the essential paradox: ‘The very thing we use to connect us, is the thing that disconnects.’”

ST “Well I resolve the paradox by talking about the distinction between connection and conversation, that we’ve satisfied ourselves with mere connection. I don’t want to say that we’re not more connected, but that connection is somehow crowding out conversation. And then sometimes connection can bring us into conversation, and then it’s great. I had a reunion … that never would have happened without Facebook. I’m not anti-Facebook. That was one of the best experiences of my life. That was connection that led to conversation, and that’s what you want. But I think we have to learn the difference between connection and conversation, and make sure we don’t settle for connection, when really what we crave is conversation.”

AMT “So how do we reclaim conversation?”

ST “Well I’m filled with tips. I see this book as a call to arms, because I see us heading in a direction that’s dangerous, so I have many tips. First of all, to keep that distinction in mind. That what you’re looking for is conversation. You’re looking for it because it is the talking cure a crisis in empathy. Sacred spaces for conversation: the kitchen, the dining room, the car – the car I think is ground zero in reclaiming conversation in family; in work, studies show that conversation is good for the bottom line – workers do more, flourish, have greater collaboration, have greater productivity, greater creativity when they’re given both privacy and an opportunity for conversation. I think that in schools, if you’re offered a program where you give up your library but everybody has an Apple tablet and somehow you think you’ve been given it for free, it seems like a great deal – think twice about what the world of that school will look like. Most college and professional schools professors now are moving in the opposite direction – taking phones and laptops out of our classrooms, because that experiment did not work. Our students can’t concentrate (both) on what’s on their laptop, and the dynamic conversations that we want them to have in class. So sacred spaces in high schools where there are no phones, there are no laptops. I don’t think we have to give up our devices – we have to use them more mindfully. They’re not accessories. Maybe that’s my basic message: that these technologies are not accessories. They’re powerful mind tools that can really affect how we think. We should treat them that way.”

Photo: Katrin Koenning & Sarker Protick www.nationalgeographic.com

Friday, 11 March 2016

Ignoring "Soft Skills" & Moral Injury

     "Soft skills" like communication, deep listening, bed-side manner, empathy, professionalism, mindfulness etc are considered a joke in the hidden curriculum and are basically ignored by students & faculty alike in university education: http://healthyhealers.blogspot.ca/search?q=soft
     When students or graduate health-care professionals are caught committing unprofessional acts, everyone is shocked. The dust settles, and "soft skills" continue to be ignored.

     Interesting lessons from the military:
     “If military practice tells soldiers that their emotions of love and grief – which are inseparable from their humanity – do not matter, then the civilian society that has sent them to fight on their behalf should not be shocked by their ‘inhumanity’ when they try to return to civilian life.”

     “… moral injury is an essential part of any combat trauma that leads to lifelong psychological injury. Veterans can usually recover from horror, fear, and grief once they return to civilian life, so long as ‘what’s right’ has not also been violated.” 
       Jonathan Shay. “Achilles in Vietnam. Combat Trauma and the Undoing of Character.” Scribner, NY, 1994.

     Parents spend less & less quality time with their children; schools are forbidden to teach kids basic manners or morals; CEOs, clergy & politicians are progressively losing respect & credibility. These are fundamental violations of what’s right
     Meanwhile rappers, reality stars & dysfunctional sports & movie stars are default role models. Young adults are explicitly exposed to & socialized by the lowest of cultural norms. See: http://healthyhealers.blogspot.ca/2013/01/larger-homes-more-exotic-trips-fancier.html This openly invites people to contravene basic, innate, implicit human codes of conduct, causing moral injury to everyone, victims & perps alike.

     When do we start taking "soft skills" seriously enough to teach them explicitly?

     "Moral Injury": http://healthyhealers.blogspot.ca/2017/01/what-is-moral-injury.html

      "Worldview - Maturity Level - Impacts": http://jglovas.wix.com/awarenessnow#!Worldview-Maturity-Effects/c17jj/56e5715b0cf27db4b02a4011


 

Wednesday, 24 June 2015

Tree, Forest - Which Do We See?

     Traditional aboriginal cultures live Thich Nhat Hanh's "interbeing" - in profound relationship with everyone and everything ("all our relations"). Whereas industrialized people tend to be lost in a sea of seemingly unrelated, meaningless, arbitrary, random factoids.
     Anthropologist Edward T. Hall's 1976 book "Beyond Culture", contrasts the communication differences between such "high-context" and "low-context" cultures. https://en.wikipedia.org/wiki/High-_and_low-context_cultures
     Our education system, up to & including university, is embedded in our culture's communication style. We low-context, "nuclear giants" hotly pursue highly specialized narrow goals, and as "ethical infants," continue to be oblivious of our impact on our shared quality of life.

          "Learn how to see.
          Realize that everything connects to everything else." 

                                                                                              Leonardo de Vinci

     "To Western medicine, understanding an illness means uncovering a distinct entity that is separate from the patient's being; to Chinese medicine, understanding means perceiving the relationships among all the patient's signs and symptoms in the context of his or her life.
     From a biomedical viewpoint, the Chinese physician is assessing the patient's specific and general physiological and psychological response to a disease entity."
       Ted J. Kaptchuk OMD. "The Web That Has No Weaver. Understanding Chinese Medicine." Contemporary Books, Chicago, 2000.

     "In Indian mythology, Indra was a God who attached all phenomena with visible and invisible strands weaving together a universal net. Earth, trees, clouds, mountains, sky, passion, aggression, creativity, women, men, and children, all were connected in Indra's expansive net. At the intersections of these strands, Indra tied dulcimer bells. In that way, as one part of the net was pulled or moved, the bells would ring; when the sound of a bell was heard, awareness of interconnectedness arose becoming another strand of consideration in one's weave. When the bells were ignored, an illusion of separation and independence reigned; the outcome could be destructive, reverberating throughout the net.”
        W. Anne Bruce: "Abiding in Liminal Space(s): Inscribing Mindful Living/Dying With(In) End-of-Life Caring." PhD Thesis, University of British Columbia, 2002, p12


Public Gardens, Halifax, NS

Sunday, 14 June 2015

Different Strokes for Different Folks ...


     “For each different type of person, Hinduism prescribes a different path (yoga). Here I will simply refer to four of the principal ones: 
          (1) Jnana yoga tries to achieve holiness through knowledge, by which is meant not factual information but understanding or vision. 
          (2) For bhakti yogis, feelings are more real than thoughts, so they approach the divine through love and devotion. 
          (3) In karma yoga, salvation comes through work, but work done not for gain but for its own (or God’s) sake. And finally there is 
          (4) royal or raja yoga, comprising meditation and inward exploration. 

     Can the four yogas ever meet, be fully combined? Probably not in the same person. Imagine Socrates and Saint Francis and Gandhi and Siddhartha Gautama meeting at some ethereal pub: they might agree on some common goal, but to reach it they would head off in different directions."

     Even members of the same family can have “such fundamentally different perspectives, the words sail past each other. The intimate conversation between husband and wife or brother and sister can be as mutually incomprehensible as different foreign languages. We need the different and complementary perspectives of the various yogas – and, ideally, of all religions – not only to reach God but to reach each other.”

       Smith H, Paine J. “Tales of Wonder - Adventures Chasing the Divine. An autobiography.” HarperOne, NY, 2009.



Thursday, 14 May 2015

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

Saturday, 21 February 2015

Namaste - the Essential Common Language

     The ideals of our wisdom traditions arose from who we fundamentally are and hope to become as human beings. These ideals are allocentric, ecocentric, transcending individual egos. They constitute our only common human bond. Even atheists are beginning to recognize the central importance of embodying the ideals of our wisdom traditions: Sam Harris. "Waking Up. A Guide to Spirituality without Religion." Simon & Schuster, 2014.
     Human beings also share a fully functional reptilian brain stem, which is limited to egocentric, tribal, adversarial reactivity. Operating at this primitive level of consciousness, people commonly hijack wisdom traditions to serve their agenda of domination, plunder & butchery. 
     Indeed, only a small percentage of people are knowledgeable & deeply committed to embody the full depth of any wisdom tradition, even the one with which they identify. Without this deep understanding, mindless, heartless, needless suffering continues.
     But gently nurturing the deepest, common ideals of wisdom traditions should (theoretically) be safe, practical and beneficial - our global society desperately needs wisdom - see: http://mindfulnessforeveryone.blogspot.ca/2015/01/620-what-is-wisdom.html
     Approaching people with the attitude of Namaste – the core perfect consciousness {Buddhanature, the Holy Spirit, the divine within
, etc} within me, recognizes the core perfect consciousness within you - should be universally helpful. This approach is the complete opposite of prejudice - of “me” vs “the other”. 
     If I can embody Namaste to the best of my abilities, everything should change. I’ve seen this happen repeatedly with heavily-defended people who were expecting to be treated badly. After 5–10minutes of being treated well, they became strikingly relaxed, open and friendly. Not everyone will quickly exhibit an obvious positive response. But embodying Namaste is, I believe, our natural state, while being adversarial or even defended / guarded / amored is a temporary problem to be resolved.
     Namaste is an attitude, level of consciousness, way of being, and as such, is communicated non-verbally. Most people understand, at a deep level, the embodiment of kindness, empathy, & respect. Even if Namaste were abhorrent to someone on an intellectual level (for whatever reason), I strongly suspect it is welcomed by all as a sincere, non-verbal, embodied approach. Namaste embodies the ideals of ALL our wisdom traditions. It is our essential common language, who we actually are.


ju_ju   www.dpreview.com

Tuesday, 21 October 2014

What is the Quality of Our Converations?


     How much thought & care do we put into the quality of what we're about to say? Yet the quality of our conversations reflects the overall quality of our lives - at work, at play, as well as at home.
     This is from Mongolia, roughly 50 years ago.

     “We were all gathered around the oil lamp, and the conversation was quiet, harmonious, unhurried. We took turns speaking. Mother and Father usually reported what had happened during the day. Grandma added explanations and time and again developed them into stories. Nobody interrupted her, nobody interrupted anybody, everybody got rid of what was on his or her mind. And nobody interrupted what they were busy doing, either.
     Everybody listened to the conversation, including the children, who were (playing) … and they loved it. It felt so good to play. Yet the children never lost track of the conversation even though they would not butt in unless they were asked a question. Everybody took part in everything. Sometimes there was a longer pause, but nobody ever rushed to break in. Rather, we would let it last and muse upon it. This way everybody seemed to be getting prepared for the night’s rest.”

       Galsan Tschinag “The Blue Sky.” Milkweed Editions, 2006. 



Friday, 4 April 2014

If Only We Could Better Understand Each Other

     “As for the story itself, it was entitled 'The Dancing Fool.' Like so many Trout stories, it was about a tragic failure to communicate. Here was the plot: 
     A flying saucer creature named Zog arrived on Earth to explain how wars could be prevented and how cancer could be cured. He brought the information from Margo, a planet where the natives conversed by means of farts and tap dancing. Zog landed at night in Connecticut. He had no sooner touched down than he saw a house on fire. He rushed into the house, farting and tap dancing, warning the people about the terrible danger they were in. The head of the house brained Zog with a golfclub.”                    Kurt Vonnegut, Breakfast of Champions
 
numnuts   www.dpreview.com
 

Friday, 14 February 2014

Remembering to RELIEVE Suffering


‘Relieve’ mnemonic helps one remember the key aspects of a Healing-Oriented Encounter:

            Relationship-centered care, built on …
            Empathy & trust, creates a positive environment where the clinician can …
            Listen to a complicated story that creates …
            Insight into a problem that results in an …
            Explanation that is consistent with the patient’s …
            Values, leading to …
            Empowerment & action toward health.

       Rakel D, Fortney L, Sierpina VS, Kreitzer MJ. Mindfulness in medicine. Explore. 2011;7(2):124-6.


Dalhousie University on a crisp winter morning, February 13, 2014

Monday, 4 November 2013

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.



Monday, 30 September 2013

Caring for Unique Individual Human Beings


     "I’m learning that it’s the WAY you communicate and present things that counts, and how to deal with different cultures and personalities. You can have all the right information but if you’re not being listened to, or people don’t understand what you’re saying, or think you care, it makes no difference. So, can I be honest here? In medicine, there is no accounting for differences in people, or how they might feel about something. There is no focusing on the individual. We need to learn more about this." medical student

       Walcher ME. A look in the mirror: Self-development and transformational learning in medical students. Dissertation Abstracts International Section A: Humanities and Social Sciences 2013; 73: 8-A.  
 
 
Shad Bay area, Nova Scotia, early morning, September 28, 2013

Wednesday, 25 September 2013

Professional Competencies - Half Hard, Half Soft


     "Professional competencies in medicine are physician skills defined (by Epstein & Hundert) as the 'habitual and judicious use of 1) communication, 2) knowledge, 3) technical skills, 4) clinical reasoning, 5) emotions, 6) values, and 7) reflection in daily practice for the benefit of the individual and community being served.' Students are expected to graduate with a working knowledge of these competencies in place."
       Walcher ME. A look in the mirror: Self-development and transformational learning in medical students. Dissertation Abstracts International Section A: Humanities and Social Sciences 2013; 73: 8-A.
       Epstein RM, Hundert EM. Defining and assessing professional competence. JAMA 2002; 287(2): 226-235. 

     Of the 7 competencies, how much of our time & effort do we devote to #'s 1, 5, 6 & 7?
    ... "And how's that working for us?"


Sound of Wings by Suezan Aikins   http://www.fogforestgallery.ca/bios/bio_aikins.html

Tuesday, 23 July 2013

We Embody & Teach Our Current Level of Consciousness, for Better or Worse

     "role modeling is the most common form of teaching values, ethics, and the human dimensions of care.
     Unfortunately, the demonstration of undesirable behaviors & attitudes is also effective. Such 'negative role modeling' has been documented to produce unprofessional behavior and even ethical erosion during clinical training. Sometimes referred to as a 'hidden curriculum,' such negative role modeling can be understood as a pattern of behaviors prevalent in a group that runs contrary to the desired & explicitly stated attitudes & behavior of humanistic care. Further, this hidden curriculum undermines the curricular objectives of courses on professionalism, ethics, and 'the art of medicine' that are usually taught during the first two years of medical school.
     Given the pervasiveness of negative attitudes & nonhumanistic behavior, we believe proper role modeling is an important teaching method by which to counter the hidden curriculum modeled by others. 
     How do master clinical teachers develop their teaching skills with respect to the human dimensions of care? In postencounter interviews, the faculty indicated that they use personal self-reflection to develop their teaching skills. Reflective practice has been recognized as an important element of professional development. For the faculty in our study, self-reflection was an iterative process that continued throughout their teaching careers."
       Weissmann PF et al. Role modeling humanistic behavior: learning bedside manner from the experts. Acad Med 2006; 81(7): 661-7.

      It may be safe to assume that those who manifest 'negative role modeling' are much less self-reflective, have minimal awareness of their poor intra- & inter-personal skills, and likely value technical knowledge over communication and other relational ("soft") skills.
     "Physician, Know Thyself!"

fulviavecchia   www.dpreview.com

Friday, 14 June 2013

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

Monday, 10 June 2013

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