Current "Bad" Behavior, Past Trauma & Empathy

     It's stunning how well-educated, professionally-successful people can behave completely inappropriately from our perspective.
     How can this be? It's not possible to have a balanced overview of, or proper perspective about a situation if one  viscerally feels in mortal danger. It is now a life-or-death emotion-directed struggle, reason has fled (executive function / mature judgment). This brain-stem-led behavior does not arise from stupidity or evil, though the consequences can easily be both. Such people who fight tooth-and-nail for their "rights", insisting that they're "right" (when in fact they may be partially or wholly wrong), very likely had traumatic childhoods (insecure or disorganized attachments): http://healthyhealers.blogspot.ca/2012/12/everyones-doing-their-best-under.html plus a variety of other traumas about which we truly know little or nothing.
     Nobody gets up in the morning and decides to behave unreasonably or foolishly - there are valid reasons, though not necessarily current ones, therefore appearing irrational. It's really useful AND practical to try to understand such strangely disruptive behavior, and try to mediate instead of sliding into heavy-handed, adversarial mode.
     We understand all of this when a patient behaves irrationally, BUT when a colleague behaves "badly", OUR judgment can become compromised, and WE can can overreact & easily become punitive!
     Our colleagues, & we ourselves, deserve just as much empathy as our patients.

Nita Zeqiri, National Geographic   http://photography.nationalgeographic.com

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