Readiness to Evolve

     The stories we continuously tell ourselves, about ourselves, form a seemingly stable self-image, giving rise to a false security AND inertia. "That's who I am" - is a mirage, a deluded attitude, the "autopilot" that flies our "momentum of our life." At some level we know that a solid self-concept is untenable because everything is obviously constantly changing, including our opinions and even our memory of past actual events.

     We retain a heroic death-grip on our fossilized self-concept (ego) because few of us are adequately informed about the normal evolution of human consciousness, self-transcendence, hypo-egoic states etc. See: http://mindfulnessforeveryone.blogspot.ca/search?q=self-transcendence  
     Even fewer among us know & trust that we have agency over this process, and an even smaller proportion regularly practice to promote this process. See: http://mindfulnessforeveryone.blogspot.ca/2014/02/500-changes-ambivalence-progress.html

     "Change readiness (is) defined as an individual’s 'beliefs, attitudes, & intentions regarding the extent to which changes are needed and the (the individual's and) organization’s capacity to successfully undertake those changes.'

     ... social psychologists have defined attitudes as 'evaluative summary judgments that can be derived from qualitatively different types of information (e.g., affective & cognitive).'

       Rafferty AE, Jimmieson NL, Armenakis AA. Change readiness: A multilevel review. Journal of Management. 2013;39(1):110-35.

Peggy's Cove, Nova Scotia

 

Our Open Heart-Mind Works Best

     Just for fun, try this experiment: start monitoring how you feel as often as you can. Suppose your state of being is on a continuum between: 
          1) being relaxed, at home, in control, open-hearted, loving, generous, profoundly at peace,
          2) being afraid, out of your element, out of control, closed-hearted, angry, greedy, disturbed.

     After a bit of practice, or perhaps you can already do this, you'll physically feel where you are on this continuum between 1 and 2:
          1) being essentially in the open wise, evolved elder, saint or mystic mode, making full use of your prefrontal cortex or heart-mind;
          2) being in the closed fearful-child-lost-in-the-woods mode (brain stem reactivity).

     With some practice you might begin to notice that the farther we are towards the fearful-child pole, the more we & those around us suffer, because our judgment is severely impaired, and therefore our performance & behavior deteriorates. But as we learn to become aware, as early as possible, that we're starting to slide down towards this extreme, we learn not to go with this downward momentum, and recover "our better judgment".
     Positive biofeedback is more powerful for most of us. Noticing how when our mind and heart areas feel relaxed, open & warm, everything goes well, people respond so positively is a real eye-opener.
     Can we ourselves learn to directly control our state of being - where we are on this continuum, REGARDLESS OF EXTERNAL CIRCUMSTANCES, thereby improving our quality of life AND that of all those around us? Can we? "Whether you think you can, or think you can't, you're right!" Henry Ford

     Meditation practice is a powerful way of intentionally opening up to, processing & transcending difficult aspects of our lives. See: http://www.johnlovas.com/2014/02/meditation-is-powerful.html

"Les" Laszlo Lovas   1915-2001

Disruptive Behavior by Physicians & Other Health Care Professionals

     "Disruptive physician behavior represents a threat to public health by negatively impacting the safe & effective care of patients. Disruptive behavior also undermines effective staff retention, increases malpractice risk, & jeopardizes patient safety specifically related to the culture of avoidance that ensues. Maladaptive role modeling perpetuates this cycle to the detriment of the empathy, wellness, & overall professionalism of medical students, residents, & allied health professionals.
     Despite a mandate from the Joint Commission to have policies in place to define disruptive physician behavior and intervene when it is identified, many academic institutions, hospitals, practices, & licensing boards are grappling to develop effective means for handling these vexing difficulties. Some are unaware of available resources & feel reluctant to intervene, and some might even believe that disruptive physicians are incapable of change. Sadly, many of these physicians’ behaviors are tolerated until a crisis emerges, such as a patient injury or staff complaint, at which time disciplinary action ensues.

     The American Medical Association defines disruptive physician behavior as 'personal conduct, whether verbal or physical, that negatively affects or that potentially may negatively affect patient care.' This includes but is not limited to conduct that interferes with one’s ability to work with other members of the health care team. However, criticism that is offered in good faith with the aim of improving patient care is not to be construed as disruptive behavior. 
     Disruptive physician behavior may be verbal (foul language, intimidating language, belittling or demeaning words) or nonverbal (facial expressions or other body language, throwing things). The behavior also may be aggressive (see above), passive (chronic lateness, failure to write chart notes), or passive-aggressive (hostile or inappropriate notes, or derogatory comments about colleagues or institutions)."

       Samenow CP, Worley LL, Neufeld R, Fishel T, Swiggart WH. Transformative learning in a professional development course aimed at addressing disruptive physician behavior: a composite case study. Academic medicine : journal of the Association of American Medical Colleges. 2013; 88(1): 117-23.

Massimo Bassano   http://photography.nationalgeographic.com

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

Metacognition - a Grand Evolutionary Achievement

     "Human beings possess the striking reflexive capacity to hold mental states about mental states, that is, to engage in thinking about thinking. This has been heralded as a grand evolutionary achievement of our species and its kin, and its social & psychological significance may scarcely be exaggerated. Daily life is replete with complex determinations about the reliability of our own thoughts, feelings, and beliefs as well as attributions about the thoughts, feelings, and beliefs of others around us. For centuries, philosophers have speculated about the dependability of self-knowledge and about the problems inherent in drawing inferences about the contents of other minds. Contemporary psychologists, too, have devoted considerable theoretical and research attention to the topic of metacognition, which recently cracked the 'top 100 topics' of psychological research.

     Although a good number of edited volumes on the subject now exist, there is no consensually agreed on definition of metacognition. ... the term 'has been variously referred to as "cognitive monitoring", "executive processes", "self-communication", and "knowledge about knowledge"'. Typically, metacognitive researchers investigate mental processes whereby individuals 'control' and 'monitor' their own mental activity." 

 

     Jost JT, Kruglanski AW, Nelson TO. Social metacognition: an expansionist review. Pers Soc Psychol Rev. 1998; 2(2): 137-54. 

 

Dalhousie University, February 13, 2014

 

Insight, Self-reflection, Psychological Mindedness, Evolution

     Meditation practice has long been known to bring about profound mental-health benefits.

     "The non-reactive, detailed, systematic, and impartial observation of one's own cognitions & emotions through the technique of meditation can be a source of personal insight & self-understanding. ... even among patients with little psychological mindedness, approximately 20% 'with a wide range of psychophysiological disorders, who joined stress reduction & relaxation programs involving mindfulness meditation, became interested in psychotherapy for further expansion of self-understanding.' Within this framework, they refer to meditation as a 'psychobiological form of introspection.'"
       Shapiro DH. A preliminary study of long-term meditators: Goals, effects, religious orientation, cognitions. Journal of Transpersonal Psychology 1992; 24(1): 23-39.

     "our perception, cognitions, & emotions related to our ordinary experiences can be distorted or biased to varying degrees. Depending on certain dispositional factors, these biases are sometimes pathological, but exist on a spectrum and may therefore be present without any clear psychopathology. Within this framework, mindfulness is described to reduce such biases through specific forms of mental training that develop meta-awareness of self (self-awareness), an ability to effectively manage or alter one’s responses & impulses (self-regulation), and the development of a positive relationship between self & other that transcends self-focused needs and increases prosocial characteristics (self-transcendence)."
       Vago DR, Silbersweig DA. Self-awareness, self-regulation, and self-transcendence (S-ART): a framework for understanding the neurobiological mechanisms of mindfulness. Front Hum Neurosci. 2012; 6: 296.

ARClark   www.dpreview.com

 

Between a Rock & a Scary Place! - Self-concept & Worldview Upgrades

     We have an aversion to, & frankly doubt we can upgrade our self-concept & worldview (SC&WW): http://healthyhealers.blogspot.ca/2014/02/if-it-aint-broke-upgrading-self-concept.html When someone else gives us advice about this critically important, yet taboo territory, we get mad at them!: http://mindfulnessforeveryone.blogspot.ca/2014/02/494-we-know-were-heading-wrong-way-when.html And our current societal tendencies of scientific reductionism, materialism, consumerism & cynicism make the wisdom traditions - the traditional gateways to SC&WW - unintelligible & virtually unapproachable.
     We're in a real pickle, because life deals all of us at least one, but usually multiple "shipwrecks", where our whole life - including SC&WW - falls apart. 

     We have only 3 options when shipwrecked: 
     1) remain cynical & miserable; 
     2) rebuild without skills; 
     3) rebuild with skills - I prefer this third option. 

     Jon Kabat-Zinn's Mindfulness-based Stress Reduction (MBSR) program, is a widely-accepted & evidence-based way of gently, skillfully approaching, upgrading & when necessary, rebuilding our own SC&WW.  Each of us has to start - slowly - from where we are now. The learning is experiential, not theory / dogma-based.

Dalhousie University February 13, 2014