Collaborative instead of Adversarial; Governance instead of Government

     There's a pattern to conflicts: each of the opposing parties claims to be right, consciously or unconsciously ignoring their own contribution to the problem, and consciously or unconsciously ignoring the other party's positive attributes. In the gray zone, between these polar opposites sit: reality, mediation & productive, vibrant collaboration. To get here, the consciousness of the players has to rise from the brain stem (reptilian reactivity, primitive emotions) to the pre-frontal cortex (mature judgment, executive function). When ego battles ego, it can be a fight to the death, be it career, family, or actual life - sometimes all three. When the ego is put aside, human beings are capable of living harmoniously and amazing collaborative achievements. Wisdom is hypo-egoic.
     External forms of control, be it from professional disciplinary boards, legal system, or fear of punishment from a metaphysical source, don't work well for today's adults. When one is in a reptilian state of reactivity, one is fully identified with one's own agenda - it can feel like a life or death struggle. One's self-concept feels under attack. One of the 8 key principles of adult education is that "a threatened self-concept diminishes learning."
       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.

     Our behavior - when we're being rational - is mostly controlled from within, by our own conscious and unconscious sense of meaning, values, self-concept & worldview. This conglomerate can be summarized as one's "internal compass" (operating system in computer lingo) in that it has a powerful pervading effect on all aspects of our life, though the details may be largely subconscious ("a life unexamined ..."). Intentional, conscious awareness & upgrading of this internal compass appears to be the necessary path toward wisdom & wise behavior for all, but for us, individually & as a profession, it's a professional obligation.
     Professions being "self-governing" refers to "governance" vs being controlled from the outside by "government". Governance in a profession is akin to an individual's "internal compass." This concept, unlike "government" involves "the notion of internal regulatory processes (that may evolve naturally, even spontaneously, within any complicated set of human arrangements … is – or can be – a benign form of collective autonomy within a set of social arrangements such as organised health care. … the emergent will of the practitioners concerned. … hold those values or visions authentically …  
     Perhaps being ‘left to their own devices’ is the key point here. The assimilation of a particular conception of medicine into the internal processes of governance is something quite different from imposition. It allows the emergence of a particular culture (perhaps, beginning as a counter-culture) that recognises as important certain values and visions such as a careful attention to the patient’s unspoken and spoken wishes alike and that absorbs them organically and authentically, expressing them as part of a self-imposed collective expectation of standards of practice.”
       Evans HM. Affirming the existential within medicine: medical humanities, governance, and imaginative understanding. J Med Humanit 2008; 29(1): 55-9.

     Doesn't (group) governance merely reflect the collective level of consciousness or wisdom of its individual members? And if so, what are we as individuals, as professional organizations, and universities doing to raise our consciousness & cultivate wisdom?

senn_b   www.dpreview.com

Blindspots, Ethics & Evolution of consciousness

     A very self-assured young student had a conflict with an instructor. They were both convinced that the other was unprofessional. The student came to see me shortly after the incident, and was incensed at the instructor. I tried to soften his attitude, to help him behave more professionally at the time as well as in the future. This was part of my follow-up email to him:
     "I was suggesting you consider a softer approach in the future. The direct impact we can have on others' behavior is pretty minimal, while our own attitude sets the tone of our own (and others') lives. The question, 'would you rather be right or happy?' contains a lot. 
     Here's an old story of possible interest:        'A big burly samurai comes to the wise man and says, ‘Tell me the nature of heaven and hell.’ And the roshi looks him in the face and says; ‘Why should I tell a scruffy, disgusting, miserable slob like you?’ The samurai starts to get purple in the face, his hair starts to stand up, but the roshi won't stop, he keeps saying, ‘A miserable worm like you, do you think I should tell you anything?’ Consumed by rage, the samurai draws his sword, and he's just about to cut off the head of the roshi. Then the roshi says, ‘That's hell.’ The samurai, who is in fact a sensitive person, instantly gets it, that he just created his own hell; he was deep in hell. It was black and hot, filled with hatred, self-protection, anger, and resentment, so much so that he was going to kill this man. Tears fill his eyes and he starts to cry and he puts his palms together and the roshi says, ‘That's heaven’."

     And the young man's response? He emailed back that he preferred the following:
     "When somebody hits you, hit'em back harder" - Donald Trump

     Most students studying to become health-care professionals are not adults, but at best "emerging adults". They agree to professional codes of conduct, yet are, for the most part, simply not capable of relating to themselves, others, or ethical codes of conduct the way more mature people can. This is not immorality or amorality, simply an immature set of priorities / capacities, consistent with their immature stage of psychological / consciousness / moral / character development. AND, both dental and medical training have repeatedly been shown to NEGATIVELY impact normal maturation. Don't we need to improve on this?

Garden of Dreams, Kathmandu by Raewyn Bassett PhD   www.raewynbassett.com