On Easter: Separate and Unite

Sheil Easter 2019

What does Easter mean to you?

It occurred to me as I sat in the second pew today, coming to church on Easter labels me.  I declare myself Catholic on this occasion, in this place.  I separate myself, in a sense, from all who are not Catholic or Christian, from all who do not celebrate.  You might consider that I do this every Sunday at church, or every time I say I’m Catholic.  But on Easter it feels more intense, because this mass is all about the definition of Christianity—He died for us—we hold this to be true (I still have questions about that, actually) and that is what makes us Christian.  I apply this label to myself by my attendance at this mass.

I generally dislike being labeled, because of the assumptions that inevitably and automatically accompany labels of any kind.  You are Catholic, therefore you must be pro-life and thus anti-woman (I am pro-choice).  Your church is full of pedophiles and those who abet them; your religion, and you as an extension, represent the worst kinds of repression of the reality and diversity of human expression (if you think this please read about Father James Martin).  You are Chinese, you must be so smart and have a Tiger Mom (I am so smart but I don’t attribute it to being Chinese, and my mom is not Amy Chua).  You are a doctor in executive health, you must have done it for the money (this one slapped me recently, and I still seethe a little over it).

I have attended my church for 28 years this fall, starting my freshman year in college.  I was confirmed here, my children were baptized here, and I would have been married by the priest here, had it not been New Student Week that year.  I have so many friends here, from the couple who sponsored me for confirmation to the woman who ran the nursery where both of my kids played, to the director of the prison ministry who has kept the pencil record of my kids’ heights on the wall in his office.  I return to this community not for the ‘body and blood’ mass parts, which I could get at any Catholic church.  It’s how the people here put their faith into action that I admire—seeking connection across diversity, holding space for differing viewpoints and discoursing with respect and compassion.  Next month there will be a dialogue on the Ten Commandments led by our pastoral associate and a Northwestern campus rabbi, entitled, “The Big 10.”

I consider myself not religious at all, rather faithful and spiritual, and this is where I practice.  So while I separate from non-Christians this Easter, I unite with this particular Catholic tribe.  And let me be clear: separating into tribes is a GOOD thing.  Humans are wired for belonging and shared identity.  Support from those we identify with and relate to is essential for survival and thriving, especially in chaotic and uncertain times like now.

But it is in exactly such times when we must be wary of over-identifying with those we perceive as similar to ourselves.  Separating (or sorting, as Bill Bishop calls it) ourselves by religion, ideology, profession, or any other in-group carries risks for us all.  As I looked around the chapel today, I saw a widely diverse group.  Most people were white, many at least a generation older than I.  But there are always college students here, bringing balance, which I love.  I see also families like mine, our children growing up as members of the community, making it a whole of many assorted parts.  No doubt we are not all of one political persuasion, and we each have our own reasons for whatever opinions and positions we take.  We must not assume that just because we attend the same church, in this little building or the Catholic church of the world, that we are all the same, or wholly different from those outside of our church or faith.

As we unite as Christians this Easter, then, separating ourselves from ‘non-believers,’ what is the best object of our spiritual focus?  When we think of ourselves in terms of this religious tribe, how does it impact our identity and relationships in the tribe of humanity?

What are we called to do with this faith of ours, how are we meant to best manifest it here on Earth?

I hear Brennan Manning’s words in my mind all the time, like a warning:

The greatest single cause of atheism in the world today is Christians who acknowledge Jesus with their lips and walk out the door and deny Him by their lifestyle. That is what an unbelieving world simply finds unbelievable.

By the end of mass, I decided that if I choose to accept this ‘religious’ label, oversimplified and overgeneralized as it is, then I must represent it well.  I must not personify the corruption and hypocrisy that so many identify with Christianity—I must demonstrate the opposite.  My faith in action must be driven first and always by love, and never by fear, never by suspicion.  If I can pull this off, then separating myself as Catholic or Christian serves wholly to unite me with all of humanity, because that is what my faith, and what I believe the best of all faiths, calls us all to do.

Wide Open Spaces

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What to write on vacation?  Depends on the schedule, no?  Happily, on my Rocky Mountain escape this week, time lolls wide open.  How rare and precious to have these days with no commitments, no agenda, and a true feeling of detachment!  Wow.  How refreshing, nourishing, relaxing, and challenging.  No patients to see, meetings to attend, immediate work crises to solve.  I feel at once liberated and anxious—as if I enjoy the bright Colorado sun now, but there must be some black cloud looming over the ridge to the west.  *sigh*

The LOH retreat positively saturated me last weekend—mind, body, and soul.  I had Hippie Zealot Conference High, for sure.  And as so often happens, synthesizing learnings and insights proved challenging off the mountain and in real life, especially with only four intense days of re-entry before leaving again for spring break.  But now I have time and space—physical and mental—to process, hallelujah!

It never ceases to amaze me, the cosmic collision of ideas and insights that simultaneously shape my personal and professional development.  It’s like I feel the universe’s Michelangelo, Van Gogh, and Einstein hands sculpting and unifying my consciousness at all levels—it’s awesome!!

Weeks prior to LOH, my own coach Christine and my coach friend Donna each independently introduced me to the work of Jennifer Garvey Berger, expert in adult development and leadership coaching.  She incorporates ideas of complexity and systems, central tenets of LOH training, in her philosophy.  I started listening to her book, Changing on the Job, the week before LOH started.  My friends came to Berger’s work separately (they don’t know each other, which I intend to remedy soon), and the temporal overlap of their new learning with my own makes my heart leap—my friendships are, without question, divinely inspired.  The central learning for me so far is recognition of my current and aspirational states of development as a person in all aspects of life.  I look forward to acquiring and practicing more skills for growth—it is a lifelong process!

Two weeks ago, while searching links for my Thank You post to Ben Zander, I came across Rosamund Stone Zander’s book, Pathways to Possibility, the follow up to their co-authored book, The Art of Possibility, still my favorite book of all time.  I started PtP days before LOH; the synergism of ideas almost overwhelmed me.  I finished it last week and holy cow, this is advanced practice personal development.  The stories we tell, the ones that rule our relationships and lives, can be so deeply entrenched that even when we recognize their dysfunction, revising them feels almost impossible.  In my personal life, I recognize intellectually that I hold onto some seriously destructive stories—ones that cause chronic and palpable suffering not just for me but those closest to me.  I lose circulation in my figurative hands, my emotional grip on these stories is so tight, and I still refuse to let go of them.  It is positively frustrating and fascinating.  I know this stubborn intransigence has untoward effects on my leadership capacity and style at work, however indirectly, because I firmly believe that ‘how we do anything is how we do everything.’  It just kills me—like a padlocked steel door in the long hallway of self-awareness, behind which live insight and psychological freedom—I know I have the key somewhere, I just can’t find it yet.  I will return repeatedly to integrate the practices in this book, like I do to AoP.  And, I get better every year at holding myself with a little more compassion.  We’re all here doing our best; I am no exception.  Nobody is better supported in this work of self-discovery than I.  So I journey on mostly joyfully, surrounded by fellow wayfinders, working on ourselves for the benefit of us all.  Onward!

Spring break writing

I started this post with at least two other ideas to write about, but I’ll hold off.  I have four more days here in the mountains.  More time and space to think on, manipulate, and start to apprehend all of these ideas and learnings of late.  My thank you cards, washi tape, journal, and laptop are spread out over the coffee table.  My favorite movies play on DVD and cable as pleasant and entertaining background ambiance.  What a gift and a blessing are time and space.  May I savor these days with deep and sustaining gratitude.

This Is My Hogwarts

Sylvan Dale Lodge

My friends, I belong.  This weekend marked the beginning of a ten month training program in communication, leadership, connection, and creativity.  9 of us made it to Colorado after the bomb cyclone (Patrick, we missed you—can’t wait to meet you in May!) to launch Cohort 11 of Leading Organizations to Health (LOH).  Our teachers, Tony Suchman and Diane Rawlins, led us through three days of introspection, skills acquisition and practice, and formation in community.  It all happened at the Sylvan Dale Guest Ranch in Loveland, surrounded by mountains, river, wildlife, and a rich history of family and hospitality.

We are training in relationship-centered care and administration, helping one another embody our best relationship tendencies, so we may help our organizations function at higher levels of connection and effectiveness.  It’s too exciting!

I walked into the lodge at Sylvan Dale, saw the vaulted ceiling with the icicle lights, and immediately thought of Hogwarts.  I came to this place, called by something to the Why of my soul, to be with others like me.  We are here to train, to hone our skills for good.  Within the first session I realized I can totally be myself in this crowd.  Here, I’m no longer a lone voice focused on relationships ahead of everything else, no longer the only one who cannot help seeing how the nature of our relationships permeates every interaction, every decision—and how we recreate them in every moment.  No more self-editing and explaining, tip-toeing around what matters most to me.  I can fully inhabit my relationship convictions here, in this space and among these new friends.  I feel an ease of purpose and values in this group that I come to, like a deep well, to fill my bucket and irrigate my garden of personal and professional growth.  Here, I am not a black sheep.

I now have 9 new people-nodes to connect and integrate into my existing relationship webs—a new and emerging system.  We share stories with common themes, new insights, and mutual support.  These ten months we will form and evolve as individuals as well as a community.  It’s a type of love, really…  At least that’s how it feels to me.  Hooray!

 

 

Thank you, Mr. Zander

Zander Cheng

Dear Mr. Zander, I met you almost 10 years ago and you transformed my life.

You and Ms. Zander gave the keynote address at the second ever Harvard conference on coaching in healthcare.  I was one of only a handful of physicians in attendance.  You discussed the central tenets of your book, The Art of Possibility.  I could not wait to get my copy signed, and you also graciously agreed to a photo.  I have since read and listened to your book at least a dozen times, and every time I gain something new and relevant.  The names of the practices ring in my consciousness on a regular basis:  Give the A, Rule #6, Be a Contribution, Lead From Any Chair, and Be the Board.  I describe the practices and their benefits, still, to anyone who will listen.

Zander book sig

Back in 2015 I boldly contacted the Boston Philharmonic to see if you could speak at the American College of Physicians Illinois Chapter Meeting.  You actually spoke to me on the phone and considered coming!  I was honored.  Though it did not work out (I knew it was the longest of long shots), it amazed me that someone as sought after as you would personally take a phone call from a random, unknown doctor in Chicago.  Later that year, when I attended the Harvard Writers conference (the birthplace of this blog), I had the honor of observing a master class where I witnessed you love some young musicians into their best selves.  They believed in themselves because you saw them, loved them, and believed in them.  That is the best thing any teacher can do for a student.

Throughout these last ten years, I have continued to seek, study, and attempt to apply learnings from authors, teachers, and mentors like you, people who see the world as broken as it is, and also the hope of humanity’s strengths and connections.  There is no shortage of people trying to help us all be better, for ourselves and one another, and no more urgent time or need for this teaching than now.  I count myself beyond fortunate to have benefited from your influence and inspiration so early in my life and career, to have you as my model.  No doubt I am only one of thousands, if not tens (hundreds?) of thousands, whose lives you have transformed for the better.  I wish you an ever broader and higher platform from which to reach countless more people and organizations.  I wish you peace, health, and joy in all your endeavors and relationships.

Please know how much you have meant to so many.

Sincerely,

Catherine Cheng, MD

 

“People Don’t Care…

Lily Pad Lake trail weather coming

…how much you know until they know how much you care.”   –Teddy Roosevelt (the most common attribution—but at this point, who knows?)

Friends, I had a great conversation on Facebook this week that really made me think!  I have pasted it below so you can decide what you think of it—please share your impressions, as my own have evolved as I reread it.

I initially shared an article by Ozan Varol entitled, “Facts Don’t Change People’s Minds.  Here’s What Does”.  In it he outlines steps to help others and ourselves change our minds rather than dig in:

  1. Make it psychologically safe to admit they (or we) were wrong before—stop shaming one another for our diverse beliefs
  2. Disentangle ourselves from our beliefs—hold them loosely rather than in identity-defining death grips
  3. Practice empathy
  4. Exit our echo chambers

I thought this was all pretty good, and my friend agreed that the method is effective, and also ‘morally ambiguous.’  At the end of the conversation my understanding of his perspective (again, please see for yourself below) is that he opposes ‘tricking’ people by manipulating their emotions into agreeing with us, while ignoring facts and evidence.  I agree with this opposition, and I also see this article as not actually suggesting we do this.

Basically it got me thinking:  It’s not that we can either argue/convince with facts or we can’t.  It’s that we have to make a personal, emotional connection before someone in opposition can be open to our facts and evidence.  This is not an either/or proposition.  It is both/and, as most things are.

After the two-day thread concluded I felt an urge to listen again to Never Split the Difference, a book on negotiation by Chris Voss, a former FBI hostage negotiator.  Funny how that came up…  In it he references Daniel Kahneman’s book, Thinking, Fast and Slow.  Kahneman describes two aspects of mind, System I, our intuitive, limbic, subconscious mind, and System II, our rational, logical, cognitive mind.  Voss’s and the FBI’s most successful negotiation strategies are founded on the understanding that System I is the primary driver of human behavior and action, though we would like to think otherwise.  This reminded me of Jonathan Haidt’s analogy of the mind as an elephant (System I) and a rider (System II).  He also posits that though we assume the rider steers the elephant, really the elephant goes where it wants and the rider rationalizes the path.

None of this is meant as a negative judgment on humanity or to say that we are not the super-intelligent, creative, and highest order creatures we claim to be.  It is simply the reality of how our minds work, a consequence of evolution for individual survival and tribal living.  When confronted with someone I perceive as an enemy (someone who shames me, threatens my sense of self and belonging, even if unintentionally), why in the world would I open my mind and experience to her point of view, even it would benefit me in practical terms?  Under threat of attack (of my ideas, beliefs, and identity), the elephant will stampede and trample, not stop, put its snout to its forehead, and consider thoughtfully.  But if my own tribe member, whom I already trust implicitly and with whom I feel relaxed and open, encourages me to change our usual path to the water hole because she has found one that bypasses the lion pride, I am far more open to the idea.

Similarly, if we consider ‘changing our minds’ as analogous to behavior change, we see how knowing the facts and evidence is definitely not enough to change anything.  I know I should eat less if I want to lose weight.  I know added sugars and simple starches are not healthful staples for my diet.  I know that eating late wrecks my metabolism.  So why do I still eat big, yummy brownies at 10PM?  Some days I can muster the motivation to head off self-sabotage; other days not so much.  I stress eat, especially when I’m sleep deprived.  So now I’m also listening again to Chip and Dan Heath’s book Switch: How to Change Things When Change Is Hard.  They propose a three-pronged approach to behavior change at the individual, organizational, and societal levels:  1. Direct the Rider (know the facts and have them ready to present).  2. Motivate the Elephant (find meaning for motivation).  3. Shape the Path (make it easy, remove obstacles).  All of these articles and books reflect the same reality: we are emotional beings who think, in that order.

Of course changing people’s minds, especially about emotionally charged and controversial ideas, is hard!  And of course facts and evidence are crucial and we absolutely should not ignore or abondon them!  And, we would all benefit from practicing a little more generosity, patience, empathy, kindness, and charity in our approach to one another—whether we’re trying to change minds or not.

 

*    *   *   *

CC

Friends, please read.
Applies to vaccines, politics, family conflicts, and relationship communication in general.

 

JM

I’m a total believer in the successfulness of this philosophy as a general rule, and I also find it Machiavellian and morally troubling. A great many people have a severely limited ability to understand the facts they believe. They can hold contradictory views easily and they prize simplistic notions of tribal loyalty, common sense vs actual knowledge and nostalgia for a past that never existed. Until we prize critical thinking as a a skill, we won’t display it as a people. And of course, this article correctly but tragically argues that since we don’t, and since we all just walk along blasting confirmation bias all over the place, it’s pointless to attempt persuasion with critical thinking skills and one should instead seek to trick people into doing what’s right through revisionist personal histories (you aren’t responsible for your past failures in critical thinking) and personalized sales pitches (who cares about the principled notions of the greater good or what’s just! Let’s talk about you and your family’s short term best interests!)

 

CC

Thanks, Jonathan. I wonder what you think of this post that I wrote, then?https://catherinechengmd.com/…/talking-to-the-opposed…/

 

JM

In this article you don’t have a clearly stated goal. So while I gather that you support vaccination, you don’t seem too bothered by patients who opt not to vaccinate. I see this as raising a question. If you learned that a parent was deliberately harming a child you wouldn’t casually suggest the idea that next year you revisit the benefits of not abusing kids. You’d act. You’d report. You’d get authorities involved. You’d protect the kids, even against the parents wishes. And you would do it now. So as I said, it raises the question: how bad is it to not vaccinate? Your article implies that it’s not that bad. In fact, you give two examples of outcomes: one of a child who gets autism and one of a child who gets whooping cough. Can you see how this implies balance in the perspectives? Are these views equally valid? Sympathy towards the emotional struggle of making the right decisions for kids should not be conflated with sympathy for endangering children -both one’s own and others in the community. Is there reasonable doubt about whether vaccines cause autism or not? That’s not only testable but actually repeatedly and widely tested already. Let me state it in reverse: I currently vaccinate but if verifiable scientific evidence started raining doubts about whether vaccines caused autism, I would want my doctor to tell me ASAP and explain it emphatically and with little regard to my previously erroneously held belief.

 

CC 

Thanks for your feedback, Jonathan. I actually do state a clear goal: “my primary objective is actually to cultivate our relationship.” Of course I think it’s harmful to both the child and the community to not vaccinate. I am absolutely bothered by non- and anti-vaxxers (as evidenced by multiple posts on this page). And I also have to take into account the likely outcomes of my actions. My goal is to get everybody vaccinated, no question. But demanding it now, as if it’s really the same as witnessing a parent beating a child physically, is not often productive. I have learned in multiple relationship settings that chasing agreement and acquiescence gets me the opposite result. In this case, taking the long view and strategy, with a soft front, works.  Just this flu season, I estimate my ‘conversion’ rate at about 60-70%, which I assess as successful. And I did so while maintaining and strengthening the physician-patient relationship, which is even better. And for those who continue to defer vaccination, at least they are still with me and I have more chances to continue the conversation and eventually make an impact. To me that’s worth a little waiting in the short term, which could be long term waiting and making people dig in harder against, if I came at them too aggressively.

 

JM

all that sounds great. My comments were only about that article, not your actions.

 

CC

Huh, okay… The article I wrote speaks directly to my actions, so I am not sure what the distinction is? Regardless, I respect your opinion so I hope I have your confidence in me as a physician and a steward of public health.

 

JM

you do!
—next day—

CC

 I’m beating the dead horse! Feel free to ignore. Here is an article along the same lines, which I saved at the time it was published. Interesting to read it again now.https://hbr.org/…/how-to-build-an-exit-ramp-for-trump…

 

JM

Yup. Same deal. Machiavellian. Ends justify means. Critical thinking is not taught or valued so let’s ditch it in favor of methods that are effective at achieving the desired result. That may actually achieve the most social good in the end. But it’s still morally ambiguous. When does an elephant in the room become so large that you simply can’t claim not to have seen it? Must we always pretend that it’s reasonable to have thought it was a grey desk to give people an out? These articles seem to say yes. They might be right. I’m just not happy about it.

 

Oh, and I do apply this to “both sides”. There is a position I’ve heard espoused on the Left that argues that holding people accountable for stupidity is a form of prejudice. <insert shock face emoji here> It’s apparently “ableist”. And that it’s inappropriate to expect people to all be able to reason and know things. Any things. That one leaves me speechless. It seems more about a race to decry the most possible prejudices than an attempt to help improve our world. Virtue signaling. I’M SO WOKE! I’M EVEN MORE WOKE! I WOKE UP WOKE!

 

CC

Thank you for engaging, Jonathan! Your perspective is so interesting to me, I don’t see it these strategies as nearly as manipulative as you see them. To me, they are enlightening paths of empathy, leading to clearer and more compassionate, understanding communication. Underlying the methods I see an implication that we all may be more open-minded than we know, if given space and connection to explore alternative perspectives to our own. The methods themselves are simply a way to uncover and allow that openness, and thus possibility for change and growth, to emerge. If one practices these strategies with NO commitment to a particular outcome, but simply for the sake of continuing a conversation or relationship–an exchange of perspectives for mutual understanding and respect–if we all practiced this we all might end up changing, little by little, for the better, and better together.

 

JM

We’d be more open to dialogue in the non-judgmental world you describe. But, while it’s popular to embrace profound egalitarianism as positive, that is a disaster in practice. Not every viewpoint should enjoy the same privileges. For instance, slavery is a viewpoint. Might makes right is a viewpoint. The Nazis had a viewpoint. Should these all be engaged with with respect for a differing worldview? I don’t think so. Determining your actual reason for why not is key. It’s because we believe deep down in hierarchies. Even egalitarians tend to believe that egalitarianism is BETTER than non-egalitarianism. There is a Buddhist parable in which the student asks: “If we meet bandits on the road, and they try to kills us, how are we to act compassionately as our noble truths dictate?” The teacher answers “You must cut them down with your sword, compassionately.”

 

CC

I agree with everything you write here. But is this not a tangent? Do any of these articles or any of my comments claim that all viewpoints are equal? This conversation is not about ‘profound egalitarianism’ and its merits or lack thereof. Being slightly more open minded and empathetic toward our fellow humans (which is the point of these articles, in my view) does not equal throwing away all forms of morality and ethics, absolving ourselves of any and all judgment, or elevating slavery, xenophobia, and genocide to anything remotely acceptable. So I’m curious. When you encounter people whose opinion or whatever is opposed to your own, how do you engage? What are your objectives when you interact with them on these topics? For instance on this thread–why are you still here? You go first and then I’ll tell you mine. 

 

JM

Firstly, I’m arguing from the edges. Is an approach sound? You can test it by how it handles just such situations. The articles discuss a successful methodology for achieving a change in position. You can describe that most generously as sympathetic openness combined with non-confrontation. That is presented for its effectiveness. When I engage with people with differing opinions, it matters greatly what the opinions are. I evaluate them based on the soundness of the facts and theory underlying them. When more sound than my own, I change my views. When less sound, I can safely place them back in the bin of the disproven, false or less effective. I’m typically delighted to be convinced of a new position. I don’t view all positions as being basically equal. I view positions as very often being hierarchical. Some are intrinsically better than others. That means when I change position for just reasons, I am improving myself and the world at large. My engagement here is based on the warmth of our relationship and the desire to see higher truths recognized wherever possible -the ultimate purpose of information exchange. If the real purpose of the articles is to “be suuuuuuper nice before and while presenting your logic” then that’s just “getting more bees with honey than vinegar”. I don’t disagree. But some part reads to me like an acceptance of tribalism. In other words, this system doesn’t increase the likelihood of the “right” answer or the just answer. Just the answer of the person most effectively using the technique.

 

CC

THANK YOU, I understand you much better now!! I very much appreciate what you wrote here, and I wholeheartedly agree, especially with the self-improvement part. You have elevated my point of view and I will refer back to this conversation often now! So on my end, I engaged because I noticed myself feeling defensive and I wanted to understand what I was feeling a need to defend against. Now I don’t feel defensive at all, and I am so glad we continued the exchange! Big hugs, old friend! 😀

 

Theory and Practice

ben ski

Does anyone become a great skier or volleyball player by just reading books and watching videos of other people doing it?  Of course, not.  And even if you have the best coach, with the most knowledge and expertise, you still have to get out on the trail or the court and do it yourself, find your own groove, create your own style and habits that work for you and your team.

I realized this over the past week, as once again I found myself calling forth everything I have learned about leadership from books and observations of other leaders.  Leading people is hard, and I often feel at the same time that I do it well and that I totally suck at it.  I worry that because it feels mentally and emotionally exhausting, I must be doing it wrong—like if I really knew what I was doing it would just be easy.  But that is perfectionism and fixed mindset talking, I’m pretty sure.

Knowing theory is key, no question.  If you don’t understand in advance what it will be like to stand up on skis (they don’t stop themselves and if the tips are pointed downhill that is exactly where you will slide), you will fall and risk injury to self and others a lot more than if you are prepared with a few pointers in advance.  It’s the same with leadership.  Remembering how it feels to be led well, versus poorly, allows me to have empathy for those I lead.  Mastery of, or at least proficiency in, some key communication tools such as reflective listening, nonjudgmental questioning, and objective feedback, makes the skills easier to access under stress and pressure.  Holding core values and principles in front, and exemplifying them, rather than just professing them, earns trust and credibility.

I wrote to a mentor recently, “I find myself repeating language from the books, inventing analogies and using examples from the team’s lived experience to show how the theories apply.  Words like empathy, curiosity, generosity, non-judgment, deep breathing, and ‘How fascinating!’ exit my mouth a lot, as well as, ‘It’s all about relationships!’ People must see me as a broken record…”  He reminded me that we need these mantras to keep ourselves focused and also to repeat out loud and invite accountability in our actions.  I wholeheartedly agree.  Maybe I will take a misstep here or there (no maybe—it will happen!).  It won’t be because I’m not trying or I don’t care—it will be because I’m human and we all make mistakes.  It’s because I’m out there practicing.

When I think back to high school volleyball practice, residency, personal training, and the early days of parenting (hell, every day of parenting), it’s not the easy days that stand out in memory.  It’s the hard days, the days when I really struggled, but came out having grown, even in a little, in my learning.  It’s the days when I can say, hey, I know better now, and I will do better next time—bring it.

So yes, leading well is hard.  It’s exhausting.  It costs inordinate amounts of energy, self-awareness, -monitoring, and -control.  It makes me hypervigilant of my words, posture, and actions.  Theory and practice go hand in hand; they are the twin pillars of learning, application, and success in all realms.  I will keep reading for theory (I highly recommend Legacy by James Kerr and Big Potential by Shawn Achor).  I will keep showing up every day ready to do my best in practice.  I feel confident in the trust and credibility I have already earned, and that people can see that I’m honestly doing my best, for all of us.

 

Synthesis and Integration: Self and Other Focus

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Hey friends, how was your week?  Learn anything new and interesting?  Anneal any new ideas to existing frameworks in your already complex world view?  I did!  And it came in another big wave after my presentation on Friday.

I wrote last week about how I put together a new presentation.  For the first time, I added the idea of medicine as a complex adaptive system to a talk I gave to physicians at various levels of training and practice.  The objective of the presentation was for people to understand the scope of physician burnout, and leave with some ideas of how they could not only cope better themselves today, but also influence the system and move it toward a healthier, more compassionate state in the future.

As usual for my talks, I focused first on personal resilience.  Many physicians push back at this idea, and rightly so, as many medical organizations have instituted physician wellness programs aimed mainly at ‘fixing’ the doctors with yoga and meditation classes, while allowing the system that burns them out to continue its toxic trends toward over-regulation, loss of physician autonomy, and driving metrics that lie outside of, or even counter to, our core values.  I worried that my talk would be taken as just another attempt to tell physicians we aren’t good enough at self-care.

Thankfully, the feedback so far has been positive and I have not heard anyone say they felt berated or shamed.  I hope it’s because in addition to tips for self-care (eg 7 minute workout, picnic plate method of eating), I talked about how each of us can actually help change the system.  In a complex system, each individual (a ‘node’) is connected to each other individual, directly or indirectly.  So, difficult as it may be to see in medicine, everything I do affects all others, and everything each other does affects me.  This means I can be a victim and an agent at the same time, and the more I choose one or the other (when I am able to choose), I actively, if unintentionally, contribute to the self-organizing system moving in one direction or another [URL credit for image below pending].

Nodes in Complex System

My primary objective in every presentation is to inspire each member of my audience to claim their agency.  Before that can happen we must recognize that we have any agency to begin with, then shore up our resources to exercise it (self-care and relationships), and then decide where, when, and how that agency is best directed.

 

In 5 years of PowerPoint iterations, including and excluding certain concepts, I have always incorporated David Logan’s framework of stages of tribal culture.  Basically there are 5 stages, 1-3 being low functioning, and 4-5 high functioning.  The tribal mantras for the first three stages are, respectively, “Live sucks,” “My life sucks,” and “I’m great”.  Stage four tribes say, “We’re great” and in stage 5 we say, “Life’s great.”  The gap between stages 3 and 4 is wide, as evidenced by the traffic jam of people and tribes at the third stage.  In my view, the difference is mindset.  In the first three stages, most individuals’ implicit focus is on self, and subconscious mindset centers around scarcity and competition.  Victims abound in these cultures, as we focus on recognition, advancement, and getting ours.  We cross the chasm when we are able to step back and recognize how our mutual connections and how we cultivate them make us better—together—we see the network surrounding and tied to our lone-node-selves.

This week I realized that crossing the stage 3-to-4 chasm relates to two frameworks I learned recently:

The way I see it, in Logan’s tribal culture structure, one initially works toward self-actualization, essentially achieving it when fully inhabiting stage 3, “I’m great.”  But crossing to stage 4 requires self-transcendence, as described by Abraham Maslow, by recognizing a greater purpose for one’s existence than simply advancing self-interest.  In the same way, through stage 3 we live in what the Arbinger Institute describes as an ‘inward mindset,’ and we cross to stage 4 when we acquire an ‘outward mindset’, which is pretty much what it sounds like.  Essentially in stage 3 we mostly say, “I’m great, and I’m surrounded by idiots,” and in stages 4 and 5 the prevailing sentiment resembles, “We’re great, life’s great, and I’m so happy to be here, grateful for the opportunity to contribute.”

An astute colleague pointed out during my talk on Friday that we do not live strictly in one stage or mindset in serial fashion.  Depending on circumstances, context, and yes, state of mind and body (hence the importance of self-care!), we move freely and maybe often between stages, sometimes in the very same conversation!  The goals are to 1) look for role models to lead us to higher functioning stages more of the time, and 2) model for others around us to climb the tribal culture mountain with us, spending more and more mindset and energy at higher and higher stages.

The problem is the system, and we are the system.  So, onward.  Progress moves slowly and inevitably.  It will take time, energy, and collective effort.

We’ got this.