"The wisdom of no escape"

     Most of us realize that the problem-solving approach Arnold Schwarzenegger used in his movies was meant to be comedic. "The war to end all wars" (WW I) didn't. And yet, the public continues to support equally useless wars on drugs, terrorism, crime ...

     To (attempt to) eradicate something, it's first demonized - made utterly hateful AND foreign to ourselves individually and collectively to "our tribe", then it's fine to swat it like a mosquito. It's awkward of course when "one of our own" commits a reprehensible act - then we have to "disown" the unfortunate - an outcast, left behind to fend for himself in the wilderness. Most awkward is when we ourselves mess up! Then we have to disown the act - through lying, denial, repression, suppression, avoidance, temporary insanity ... "The system" or one's parents are also handy targets to deflect the blame.

     We each have to take personal responsibility - start looking at our self deeply and honestly. What is our role in this mess? This is infinitely more complex and challenging than diagnosing and treating patients' physical illnesses. Most of us have minimal training in psychosocial matters, and deep self-reflection is uncharted territory for us. Nevertheless, if we wish to fully engage the complexity of our single, short, precious life, then it's worth really serious effort.

     A personal / professional "shipwreck" can suddenly force this inward journey. For this liminal experience to be a productive growth experience, for externally-oriented perfectionists, it's a really good idea to have professional guidance. In Nova Scotia, we have a free, confidential Professionals' Support Program for dentists, physicians and veterinarians, operated by Doctors Nova Scotia. The two fine people behind it are:

Tracy Scott MD  and  Carolyn Thomson MD
Confidential help line: 902-468-8215
E-mail: professionalsupport@doctorsns.com

        Title of today's blog is from the excellent book:         Chodron P. “The Wisdom of No Escape.” Shambhala, Boston, 1991.  

Balint groups - start one!

     One well-established (1950's), but still relatively unknown approach to managing the stresses of professional life among physicians, nurses and other health-care professionals - including students, is participating in a Balint group. There are "regular case discussions in small groups under the guidance of a qualified group leader. The work of the group involves both training and research." http://balint.co.uk/ 
     There are Balint federations in various, mainly European countries, as well as the US. http://balint.co.uk/links/

     "Balint Groups currently serve as a core training modality for professionalism, and are used in training programs in medical, psychological, and caring professions.

Balint groups help clinicians:

• Recognize they are not alone in having challenging interactions with patients
• Develop increased understanding and empathy for patients
• Explore how feelings and thoughts affect the clinician-patient relationship
• Expand their capacity and repertoire for handling difficult situations with patients"     http://americanbalintsociety.org/

     In Canada, there is a longstanding group that meets in Ottawa, and another in Halifax led by Dr Katherine Warren - for psychiatry residents at Dalhousie University.

     So why so few if so valuable?

     "Because it is fundamentally messy and it is threatening, ... people might not want to have to face their own foibles and weaknesses."

     "I think it is a vulnerability thing. In medicine, there's that old idea that you are the expert who's very strong and people struggle with the idea they are presenting difficulties. I think people are often concerned their conduct or skill will be criticized. But that is one of the benefits, to help people with things they are struggling with, to normalize it."

http://www.nationalreviewofmedicine.com/issue/2008/07/5_physician_life_07.html

http://psychiatry.medicine.dal.ca/education/PG_program.htm

     Critical Components of Meaningful Communities: http://www.johnlovas.com/2013/10/what-really-matters-in-community.html