Predicaments & Problems Differ QUALITATIVELY ... Know the Difference

     Dealing effectively with life's predicaments - existential issues, whether we recognize it or not, is perhaps the most important determinant of our quality of life from middle age & onwards. Carl Jung had a lot to say about this: http://healthyhealers.blogspot.ca/search?q=Jung
     A recurring fundamental error in health care, & life in general, is mistaking predicaments for problems.
     Problems, such as a splinter in the thumb, can & should be solved via relatively quick, simple, often mechanical solutions.  
     Predicaments, such as chronic pain & other existential issues, differ qualitatively from problems. 1st we must recognize that these are NOT problems, but predicaments. 2nd, that effective management requires nothing less than a life-time's maturation toward wisdom. 
     "Wisdom" is completely absent from most health-care & even most liberal arts curricula, therefore, predicaments are generally poorly managed. A healer must take the journey for herself first, only then can she become a useful guide for patients to do the same.

        Hollis J. “Finding Meaning in the Second Half of Life.” Gotham Books, NY, 2005.

        Hollis J. "What matters most. Living a more considered life." Gotham Books, NY, 2009. 

 

Elena Shumilova  http://www.flickr.com/photos/75571860@N06/11874722676/

We Love to be Competent, be in Control, have Agency ...

     Most of us are "control-freaks", yet much of the time, we know we're "winging it" - "flying by the sear of our pants". Most of what we do is NOT evidence-based. Heck the vast majority of the agents to which we routinely expose our patients (our families & ourselves) has never even been tested for biocompatibility! With thousands of new chemicals coming on the market monthly, proper biocompatibility testing cannot be done! Does anyone think we should perhaps slow things down a tad?
     Clearly some quality control is essential, and at the same time, we need to realize that we have at best limited control, and with this combination, perhaps help re-orient humanity towards a saner course. The serenity prayer comes to mind: http://healthyhealers.blogspot.ca/2013/07/psychological-health-sense-of-control.html

Rudy Pohl   http://www.flickr.com/photos/rudypohl/sets/

Psychological Health & Sense of Control - an Expanded Understanding

     “… one component of psychological health historically has been defined as the individual’s ability to have a positive sense of instrumental control, efficacy, and competence.
     (Shapiro conceptualized) four different modes of control: positive assertive, positive yielding, negative assertive (overcontrol), and negative yielding (too little control). Psychological health involves reducing the negative modes (overcontrol & too little control) and increasing & developing the two positive modes of control (positive assertive & positive yielding). Results have shown that a sense of control from both positive modes can affect both physical and emotional well-being; that meditation increases the yielding, accepting mode of control; and that the longer a person has meditated, the more this mode increases. Independently, Rothbaum and Weisz were developing the concepts of primary control (change the environment) and secondary control (change the self to fit the environment).
     Both of these models have applicability to stress management and psychotherapy. They offer a version of the R. Niebuhr (Serenity) prayer by suggesting that individuals can learn not only the dominant mode of instrumental control prevalent in Western psychology, courage to change what can be changed, but also the sense of control through yielding and acceptance that can come from meditation (as well as other techniques) – to accept what cannot be changed. Further, the self-exploration of meditation, alone, or in combination with Western therapy, can be helpful in ‘gaining the wisdom to know the difference.’ Finally, depending on the context and belief system about the nature of the universe, meditation can facilitate positive yielding & accepting, either within secular assumptions about the nature of the universe and/or from religious assumptions in which one lets go, surrenders, and trusts control to a benevolent Other, or the essential ‘isness’ of the universe.”

       Shapiro DH. Examining the content and context of meditation; A challenge for psychology in the areas of stress management, psychotherapy, and religion/values. Journal of Humanistic Psychology 1994; 34(4): 101-135.

Nguyen Anh   www.dpreview.com