All Hail Your Dark Side

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What triggers you?

I don’t mean your pet peeves (please, stop using “there’s” when speaking about anything in the plural).  I mean what gets under your skin and affects you viscerally, really hijacks you?  I’m talking about the thing that escalates you so fast or intensely it’s like an out of body experience—you know you’re overreacting, you know it’s irrational, and yet all you can do is sit by and watch it unfold, powerless to control or direct it.

I had the pleasure of self-witnessing two such episodes recently, and it’s all so fascinating I had to write about them!

Bad Mom

A leader whom I deeply respect has asked me twice, in separate conversations, in slightly different words, how I manage my time.  The second time his words were, “How do you prioritize?”  Interestingly, I immediately altered his question in my mind to What do I prioritize?  I answered easily both times about strategies for handling emails, task lists, time with family, workouts, etc.  But after the second time I started to worry.  What’s behind this questioning?  Is he worried for me about something here?  Does he think I’m neglecting my family for work, and/or my clinical duties for all the extracurricular stuff?  Does he think I can’t handle it?

Over the next several days I had to chuckle with that sly, knowing expression when I realized it didn’t really matter what he was thinking.  The question, repeated, was a stealth trigger for my Bad Mom fear.  It wasn’t that I worried about his concern for my work life balance.  It’s that I was worried for it, and that I secretly question, more than I like to admit, whether my kids really feel loved enough by me.  This despite my previous blog post claiming that I actually don’t question it!  Blaaaaahahaha, how cosmically ironic!  Looking back, the article that incited that post was pretty much the same trigger, and it has taken me this long to see it (better late than never).  How fascinating!

In my defense, I really do think I’m a good mom—mostly.  But like being a good leader, it’s definitely not always easy, and that I question my competence/proficiency/mastery does not necessarily detract from my real, ever developing, occasionally flourishing skillset.  Thanks to this new awareness of the Bad Mom Trigger, I have adjusted my strategies and tools, and rebalanced, for now, time and energy between work and home.  I look forward to receiving more lightly the signals for future opportunities to readjust.

Canned and Rote

Last year I was leaving an evening work gathering.  A nice man saw me departing, got out of his seat, and approached me, apparently to introduce himself.  He said he had heard my ‘shtick’ something something something—I did not really hear anything else, as my abhorrence of that word had made me stop listening.  I think I was polite, and I exited with as few words exchanged as possible.

Readers of this blog know how much I admire Brené Brown.  Followers of Brené also know that her work is always evolving, new theories testing, refining, and building on prior ones, always with deeper and more meaningful understanding and application in relationships.  So I was deeply offended when I heard someone refer to her presentations as ‘shtick’ and ‘spiel.’  These words feel dismissive, mocking, and pejorative to me.  I have only heard them used in a disrespectful way about a speaker or their speech.  But why should I be so offended on Brené’s behalf?  She knows the value of her work; she does not need me to defend her.

Of course, as usual, it hit me later:  I identify with Sister Brené, so I took these words personally.  To me, shtick and spiel are how we describe presentations, and thus people, who stopped learning and growing long ago.  We utter these words and roll our eyes at having heard it all before—nothing new here, folks.  David Litt has said that when preparing a presentation ask yourself, what is the one thing you want someone in your audience to tell their friend about your speech the next day?  If the words ‘shtick’ or ‘spiel’ appeared within a hundred yards of someone describing my work—if someone thought I had not prepared but just shown up with canned, stagnant drivel—I would be mortified.  I pride myself on constant learning, self-awareness, and self-improvement.  I want every audience to feel that my presentation was uniquely relevant to them, that I worked hard to meet them exactly where they needed me.

I understand that everybody may not see or hear these words the way I do.  I can respect that and monitor/manage my reactions from now on.  But wanna trigger me?  Tell me you heard my spiel.  Go ahead, I dare you.

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Debbie Ford and Your Dark Side

OH it’s all so funny, the things that trigger us.  Because if we don’t laugh we will absolutely cry.  Or pick fights with our spouses that last weeks on end.  That’s what happened to me when I read The Dark Side of the Light Chasers about 10 years ago.  I was young yet in my adult development journey, and I had a few (just a few) more emotional hang ups than I have now.  On page 69 of the paperback edition she lists negative words like greedy, liar, sleazy and freak, and suggests an exercise:

Take a few minutes and identify any words that have an emotional charge for you.  Say out loud, “I am _____.”  If you can say it without any emotional charge, then move to the next word.  Write down the words that you dislike or react to.  If you are not sure that the word has any charge for you, close your eyes for a minute and meditate on the word.  Repeat it to yourself a few times out loud and ask yourself how you’d really feel if someone you respected called you this word.  If you’d be angry or upset, write it down.  Also spend some time thinking about words that are not on this list that run your life or cause you pain.

I didn’t get through the whole book back then, so I don’t know what she wrote about ‘embracing your dark side,’ ‘reinterpreting yourself,’ and ‘letting your own light shine.’  But I think I have figured it out for myself, at least a little bit.  It’s about self-compassion, acceptance, growth mindset, forgiveness, connection, learning, and joy.

Every light casts a shadow, and we need both light and dark for balance in life.  I’m learning to hold it all a little more lightly (ha! Pun!).  Debbie Ford felt too heavy for me ten years ago.  I’m looking for a new book this week.  Maybe I’ll pick hers up again and see how it feels.  …Makes me a little nervous, actually.  I wonder what I’ll find this time?

The Status of Women, 1999-2019

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What happens for men when women speak Feminism?

I intend to ask this question to more men in my life from now on.  What do you hear as Feminism?  Where do you think it comes from?  What do you think women are trying to accomplish by talking about equity and representation?  What moves a man to ally with women in this movement?  What keeps him from doing so?  What are the risks, costs, and benefits for us all when he does and does not?

AP QUICK HITS THE 99ERS S SOC FILE USA CA

Women in Sports

The US Women have just won their fourth World Cup Soccer title, kicking balls and ass, I like to say.  What an accomplishment, and how far they’ve come since winning the first ever Women’s World Cup in 1991, the year I graduated high school.  I don’t follow soccer, but as an American woman, this victory carries meaning for me.  At halftime this morning I read about Brandi Chastain, the 1999 US World Cup champion midfielder who famously, spontaneously, took off her jersey in unadulterated celebration after firing the winning penalty kick in double overtime against China to win it all.  The New York Times featured her story yesterday, commenting on the evolution of our perceptions and treatment of female athletes over these 20 years:

In that pivotal moment of arrival for women’s team sports in the United States and around the world, viewers saw Chastain removing her jersey and twirling it like a lariat, spinning around and falling to her knees, pumping her arms in exultant triumph. What resulted was perhaps the most iconic photograph ever taken of a female athlete, a depiction of pure spontaneous joy.

It was a moment of freedom and liberation, Marlene Bjornsrud, a longtime women’s coach and an influential sports executive, once told me. She called it a “casting off the burden of everything that kept us down and said, ‘You can’t do that because you are a woman.’ It was a moment that screamed, ‘Yes, I can.’”

Title IX was signed into law by President Nixon in 1972, one year before I was born.  So I took it for granted that girls could play sports just like boys in school—not every sport, but most.  I also took for granted the inherent assumptions about women in athletics—that we cannot be as fast, as strong, or as competitive as men.  I have so much more appreciation now for icons like Billy Jean King, Martina Navratilova, and Pat Summitt. I think about the WNBA, and women coaching in the NBA, NHL, and NFL, and I marvel at how far we have come.  Take a look at this timeline of women’s sports in the US to get a fuller perspective.  I know many will say we have a long way yet to go.  But today, let us joyfully celebrate all that we have accomplished already.  Wahoo!! [fist bump and dancing woman emojis]

 

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Journal of Bone and Joint Surgery, January 2012

Women at Work

I’m thinking about the culture of orthopaedic surgery.  In the twenty years since I graduated from medical school, I see more and more women in this field (as well as other surgical specialties), which makes me proud.  While women comprise only 5% of practicing orthopaedic surgeons, 15% of American orthopaedic residents are now women, which is roughly double the percentage in 1999.  But what’s it like to be a woman in orthopaedics?  How do these women present, perhaps differently, at work compared to in their personal lives?  Is it truly safe for them to be themselves as surgeons?  The American Orthopaedic Association held their annual meeting recently.  My orthopod friend returned from the conference and commented that the rare women leaders in his field seem ‘fierce’ and ‘tough’—but in a good way?  It struck him to wonder if they are just like that in general, or do they have to be that way to navigate their male-dominated specialty.  He wondered how they would be seen if they displayed sensitivity and emotion, “because a man can be seen as sensitive and kind” and not only does it cost him nothing, his social status is likely to be elevated because of it.  My friend was not sure this is the case for his female colleagues, and he seemed both empathetic and powerless at the idea.  Looks like gender parity may take a bit longer in medicine than in sports.

At work in general, women’s status varies considerably.  But research points to common issues such a 22% pay gap and too few women in leadership (5% of US corporate CEOs), though these are improving.  One need not look far for abundant evidence that having more women on the corporate team improves earnings and morale.  Much is also written on strategies for improving gender equity at work.  Two of my favorites are exit interviews and work-life balance initiatives for all employees, not just women.  But as I wrote last week, it’s not just about including women as participants in the workforce.  It’s about truly appreciating the diversity of experience, biology, and contribution that women bring to any group they serve.

 

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Women and Men

There is no way I can do justice to this topic in the remainder of this post.  So let me just share some ideas and resources I will continue to explore in the months and years to come.

I asked at the beginning what happens for men when women speak Feminism.  A corollary question is what happens for all of us when we hear the words ‘toxic masculinity’?  My guess is men get defensive and women get aggressive.  Personally I love the phrase because it’s so incisively descriptive.  But it can also be a flashpoint phrase, one that immediately incites conflict and emotional hijack.  Let me be clear: toxic masculinity does not imply that men and manhood are toxic by nature.  Quite the contrary, the phrase refers to a culture of expectations of men that is just as toxic for men as it is for women.  Male surgeons may well benefit from being sensitive and kind, but not too much so, lest they be seen as weak.  This is a vast oversimplification, by the way; the history and complexity of toxic masculinity are explored articulately here.

Readers of this blog know how much I love Brené Brown.  Her explanations of how shame (where toxic masculinity is born) manifests and organizes around gender—and why it is toxic for both men and women–are the most poignant and real.  Read her first hand comments to Ms. magazine here, and a stay-at-home dad writer’s interpretation of them here.  If you seek a nonjudgmental, objective, and real-life exploration of the complex dynamics between men and women, read The Gifts of Imperfection and Daring Greatly.  Sister (she’s not old enough to be Aunt) Brené’s books are the most accessible form of evidence-based, all-around relationship advice I have ever read, and I’m so grateful for her.  From the Ms. Interview:

What role do you think vulnerability played in the #MeToo movement?

Know what I love about the #MeToo movement?—and, me too—I thought until I was 25 or 30, that sexual harassment was just the price of entry.  The greatest casualty of trauma is the ability to be vulnerable. So this #MeToo movement is re-defining and re-claiming vulnerability, and putting vulnerability in the context it belongs in, which is power and courage. 

 What gives you hope?

The thing that scares me about the world today is the same thing that gives me hope. I believe we’re witnessing white male power over. It’s making its last stand right now. And it’s scary because last stands are dangerous, and people get very backed into a corner. I think this is the last stand, and that we’re going to see a shift, mercifully, from white male power to inclusive power with it too. And I think from that paradigm, we can do anything, change anything, and be anything. 

And it’s not just women who can claim agency against misogyny and sexism.  Men who identify as feminists serve as allies for gender equity and respect.  But men can also help themselves and each other break free from the restraints of machismo and chauvinism.  Movements like The Good Men Project and Evryman give men a forum for honest, vulnerable emotional expression and connection.  Just like women surgeons and corporate executives, all men need inclusive spaces where they can feel true belonging, where they are free to be all of themselves—hard emotions and all—for all our sakes.

Men I admire in this space include Nate Green, Ozan Varol, and David Brooks.

* * * * *

To lift my spirits here at the end of this long post, I’m listening to a song on repeat: Woman, Amen by Dierks Bentley.  It’s such a shining anthem of a man’s unabashed love and appreciation for his partner.  I can also imagine modifying the lyrics and hearing Faith Hill singing about her man Tim McGraw.

Thanks for reading to the end, friends.

Our relationships kill us or save us, and we really need to be better at taking care of each other, locally and globally.  We, men and women alike, are all in this together, inextricably, in sickness and in health, forever.

Only Love can save us.  Let’s get on it.

 

Attune and Attend, Conclusion

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Two posts ago, I related my friend’s experience of feeling unseen and dismissed during a visit to establish care with her new primary care doctor.  I blamed the doctor for not listening, for not exercising his relationship power with enough responsibility.  Last week I described how I see medicine as a complex system, in which each of us is both a contributory and affected member.  I alluded in both posts to forthcoming ‘solutions. ‘

If you have read the last two posts, what were you expecting here, in the last installment?  Quite honestly, the closer I came to writing, the more nervous I got, as if I had promised to deliver some groundbreaking algorithm for instantly fixing physician-patient relationships and our healthcare system at large.  Um, no, sorry.  Hopefully what I write will still be useful.

Events these past weeks have really highlighted for me the profound importance and vulnerability of relationships in a system.  At my kids’ school, a veteran and beloved teacher was terminated suddenly.  No students, staff, faculty or parents were given any warning.  Communication was sparse and poor, and few if any in the community saw evidence of a plan for instruction and emotional support of students in the aftermath.  Students, faculty, and parents alike have raised questions and concerns, all, in my opinion, met with evasion and deflection.  Worst of all, the administration repeatedly refused to acknowledge or own the profoundly negative impact of their actions on their relationships with the school community—a community which they proudly claim to steward.

Once trust has been violated and relationships damaged, the road to recovery looms long and ardent.  Apologies—sincere and heartfelt—serve a necessary and vital role in repair, but they are only the beginning.  We all make mistakes.  But too few of us own up to them and take full responsibility, especially when we have hurt others.  In a medical or educational community, I think we focus too much on scientific and objective decision making, and too little on relationships.  That is to say, we manage the former very intentionally and critically, and the latter only in passing.  This is how, for instance, a surgeon ends up saying to patients, “I can’t help you,” when surgery is not a viable treatment option.  We can always help.

In recent months I have listened to and read myriad resources that point me to some simple (and not easy) guideposts for relationship cultivation and repair.  I have listed the guideposts and their references below.  None of them will surprise you.  You may even roll your eyes and think them cliché.  And yet, all of us in all of our overlapping systems and tribes could do a little better at these practices—physicians and patients, teachers and students, leaders and those they lead.  Which one will you attune and attend to now?  What else should be on the list?

 

Curiosity

By its nature, curiosity makes us open and willing to see more, learn more, and understand more.  What if we got more curious about other people’s feelings and their origins?  What if we did that for ourselves?  Why, for instance, do I get angry when I perceive someone trying to tell me what to do without asking first what I’m thinking?  Could they be motivated by something other than a desire to control and oppress me?  How else could I respond if I thought they were trying to help me solve a problem, if I interpreted their actions as caring rather than interfering?  Check out the distinctions between diversive, epistemic, and empathic curiosity described by Ian Leslie below.  Then the next time you feel conflict coming on, consider these questions (asked in a truly curious tone):

What is this about?

Huh, what else?

Curious, by Ian Leslie

The Art of Possibility by RS and B Zander

Rising Strong and Dare to Lead by Brené Brown.

Kindness

Smiling at a stranger, extending a hand to shake, holding a door, saying hello—small acts of kindness go such a long way.  They benefit not only the recipient and the actor, but also bystanders and witnesses.  Kindness is a primary currency of connection, and reserves can be infinite.  We should never underestimate the potential tidal waves of global benefit from our dropping a pebble of kindness in the waters of humanity.  When a stranger holds the door or my patient asks about my kids, in that moment I feel seen.  I connect with you, my kind counterpart.  My heart lifts ever so slightly, and I am grateful.

A Year of Living Kindly, blog and book by Donna Cameron

Forgiveness

Forgiveness can feel infinitely harder than small acts of kindness.  Will my friend forgive her doctor?  Will I forgive my kids’ school administrators?  What good does it do to carry around grudges, does that get us what we want?  Where else can we direct the energy we expend holding so tightly to resentment?  Could we use it instead to ask, honestly, “What is this about?” or to utter a kind, compassionate word?  Can we see people as people, flawed and trying their best, rather than objects, obstructions, annoyances, and unworthy?

TED Radio Hour, Forgiveness

Leadership and Self-Deception and The Anatomy of Peace by The Arbinger Institute

Accountability

When I hit and dent a parked car, I should leave a note owning my mistake and offering to make up for it—even if I slid on ice, or my child was crying in the back seat, or the other person’s car was parked poorly.  If someone damages my car, I expect the same.  The more we can all/each take responsibility for our own part in any conflict or situation, no more and no less, the better off we will all be.  The key here, when we show up to others, is to do it without qualification.  It’s not, “Yes, I hit your car, but…”  It’s, “I hit your car.  I’m sorry.  How can I make it right?”  I may think you were also in the wrong, but pointing that out in the middle of an argument will not help you own your part, which I need you to do for us to connect and heal.  You may never own your part, and I have no control over that.   But perhaps my example will influence you or others over time.  Humans tend to reciprocate, and mutual exchange of accountability can heal many relationship wounds.

7 Truths About Accountability That You Need to Know”, Inc.com

Humility

Nobody knows everything, even experts.  And certainly when meeting another human, we cannot possibly know all that has shaped their beliefs, values, and emotions, both in the past and in the moment.  In medicine we have never known more than we do today, and it seems to me that for every new piece of knowledge we acquire, we also discover a hundred new things we didn’t know we didn’t know.  So what gives me the right to assume I have all the answers—that I have nothing to gain or learn by asking curiosity questions?  Why should I feel the need to appear all-knowing?  The opposite of humility is arrogance, and we all know how hard it is to be around people like this.  Turns out students and leaders alike, who practice humility, succeed more than their less humble peers.  Makes sense—humility connects us to others, while arrogance separates.  It’s vulnerable, though, and that can be uncomfortable.  But if we have already cultivated our relationships with curiosity, kindness, forgiveness and accountability, perhaps humility can come a bit more easily.

“The Benefits of Admitting When You Don’t Know” by Tenelle Porter

Empathy

In the end, I believe empathy will save us.  It is the bedrock on which the other skills are built.  Google dictionary defines empathy as “the ability to understand and share the feelings of another.”  It will save us because this is how we truly connect to one another.  But it’s not enough to just have the ability to understand and share others’ feelings.  In order for empathy to connect us, we also need to effectively express that understanding and share the emotions actively.  Active empathy allows us to take another person’s perspective.  It keeps us out of judgment and blame.  It helps us recognize others’ emotions by recognizing our own familiar experiences—empathy is how we relate.  It is the medium of relationship.  Some people possess the gift intuitively.  And it can be learned!  Medical training programs across the country have taught doctors how to be more empathic.  Patients of more empathic physicians do better.  And, physicians themselves do better, too–we feel less burned out and more fulfilled in our work.  We all do better when we connect.

Watch a cartoon and hear Brené Brown explain the importance and benefits of empathy.

“How to Teach Doctors Empathy” by Sandra Boodman

The Empathy Effect by Helen Reiss, MD

 

Please forgive the length this time, friends.

What did you think?  In your next encounter with your doctor or your boss, what do you anticipate?  What do you fear?  How does it feel?  What is that about?  Which of these skills could help?  How will you acquire/hone it?  What help do you need?  What will be better if you achieve it?

What else should be on the list?

Grudges and Boundaries

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Has someone wronged you recently?  Long ago?  (How) Does it still affect you?  Are you a grudge holder?  Does someone hold a grudge against you?

Last night I gathered with good friends and this topic came up—we go deep, my friends and I.  Of course, it started me thinking and wondering:  What does it mean to hold a grudge?  When I hold a grudge, what do I actually do?  What is the motivation?  What are the consequences?  When/how/why does it resolve, if ever?  As we talked, it felt straight forward at first.  Everybody knows how it feels to hold a grudge—but how do you describe or define it?

Google dictionary defines it:

Grudge: /ɡrəj/

noun

a persistent feeling of ill will or resentment resulting from a past insult or injury.

“she held a grudge against her former boss”

synonyms: grievance, resentment, bitterness, rancor, pique, umbrage, dissatisfaction, disgruntlement, bad feelings, hard feelings, ill feelings, ill will, animosity, antipathy, antagonism, enmity, animus;

informala chip on one’s shoulder

“a former employee with a grudge”

verb

be resentfully unwilling to give, grant, or allow (something).

“he grudged the work and time that the meeting involved”

synonyms: begrudge, resent, feel aggrieved about, be resentful of, mind, object to, take exception to, take umbrage at

“he grudges the time the meetings use up”

 

The more we thought about it the worse it felt to me.  I’m reminded of the saying that hatred hurts the hater more than the hated.  Grudges feel like dark clouds hanging over my consciousness, chilling my soul, or at least casting a cold shadow on my joy, freedom of emotion, and possibility for connection.  My friends and I contemplated the utility of grudge holding.   What good does it do, what need does it meet?  I think it’s protective—a defense mechanism, a way of not being vulnerable again—armor, as I believe Brené Brown would call it.

I asked my friends last night, “So is it holding a grudge, or is it setting a boundary?”  I wondered if they are the same or different.  After all, both make you behave differently toward the other person.  But I think it matters whether and how we judge the other person.  When I hold a grudge, I judge the whole person based on the bad thing (I perceive) they did to me.  I may generalize from my own negative experience and write them off as wholly selfish, ignorant, narcissistic, and unworthy of my compassion and empathy.  Perhaps I start to depersonalize them, make them into an abstraction right in front of my eyes—dehumanize them.  Does that seem like an extreme description?  Even so, doesn’t it still describe the feeling?   When I hold a grudge, I do not—cannot—like or even relate to the person.  I avoid them, don’t want to be in the same room with them.  I don’t trust them.

I listened to The Thin Book of Trust by by Charles Feltman (referenced by Brown in her book Dare to Lead) this past week.  He describes four distinctions of trust:  Sincerity, Reliability, Competence, and Caring.  He suggests that when we find someone else untrustworthy, it’s likely that they have disappointed us in one or more of these elements.  I have assumed for a long time that the person I hold a grudge against simply does not care about me or my well-being.  Feltman suggests that of the four distinctions, this may be the hardest one to overcome when violated.  My story about this person is that they don’t care about me, therefore they are categorically untrustworthy.  So I feel justified in denying the validity of their point of view, minimizing their achievements, and casting them as the permanent villain in my story.

Yuck.  That perspective does not align with my core values.

So what can I do?  Maybe rather than holding a grudge, I can simply reorient myself to our relationship.  Instead of harboring bitterness and ill will, can I instead learn, synthesize, and integrate some new information?  When I’m wronged, maybe I can say, with curiosity more than resentment, “How fascinating!”  Maybe I can take care of my own feelings, connect with people I do trust, and regroup.  Then I can decide how I want to present to this person hereafter.  I can set some new boundaries.

Rather than dismiss the person as uncaring in general and holding this against them, I can do other things.  First, I can withhold judgment on their caring and make a more generous assumption.  For example, I feel un-cared for by them, but perhaps their way of expressing caring is different from how I receive it.  I can look for alternative signs of caring.  Or perhaps they truly don’t care about me, but I need to work with them anyway, so I had better figure out a way to do it—are they at least sincere, reliable, and competent?  How must I attend to myself, so I can honor my core values, get the work done, and not get hurt (or at least minimize the risk)?  Second, I can set clear boundaries in our relationship.  I can point out behaviors that I will not tolerate, and call them out if they happen.  I can set realistic expectations about agendas, objectives, methods, and contact.  I can give honest and direct feedback with concrete examples of words or actions that require attention and remedy.

Many thanks to my thoughtful and engaging friends who stimulate these explorations.  I can feel my grip on the grudge loosening already.

Honesty and Integrity

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NaBloPoMo 2018:  What I’m Learning

Last day!  I’m feeling a little elated.  Not sure if it’s Day 30 relief and success, the abnormally large caffeine load I had today, or my awesome breakfast date…

I wish you all to have a friend like Donna.  She is one amazing woman.  A leadership coach, wife, mom, and fellow cosmic journeyer, I count myself infinitely lucky to know her this time around on earth.  I bet we’ve known each other longer than that, though.  We met in this life about 9 years ago.  I can count on one hand the number of people I remember propositioning for a coffee date on our first meeting, and Donna is one.  We meet every two or three months to commune, share, and grow.  I consistently experience two or three separate intellectual and spiritual epiphanies each time.

Today was no exception, and possibly even an exponentially positive anomaly.  Like I said, I’m caffeine loaded and coming off a 30 day freestyle writing challenge—I was primed!  The conversation was so profound I had to type out some notes afterward, as I sense future writings to spring therefrom.  Day 30 was the perfect day to meet her!  I have synthesized and integrated deeply this month thanks to this daily blogging discipline, and sharing with Donna was the quintessential culmination of it all.  I now share with you my favorite segment from our egg-and-toast-laden love-in.

I described a values exercise I did reading Dare to Lead by Brené Brown.  From a list of over 100 words including accountability, courage, faith, openness, respect, and truth, I had to choose two core values, or think of two of my own.  Brown writes:

The task is to pick the two that you hold most important.  …almost everyone…wants to pick somewhere between ten and fifteen.  But you can’t stop until you are down to two core values.

Here’s why:  The research participants who demonstrated the most willingness to rumble with vulnerability and practice courage tethered their behavior to one or two values, not ten…  and when people are willing to stay with the process long enough to whittle their big list down to two, they always come to the same conclusion that I did with my own values process:  My two core values are where all of the ‘second tier’ circled values are tested.

Values list

Dare to Lead, page 188

I listened to this book twice before I received my hard copy from Amazon.  I could. not. Wait!  In anticipation of doing the exercise, I thought the whittling process would take a long time—that I would agonize over it.  But as I skimmed the pages approaching the list, in a cosmic flash, I realized my two: Honesty and Integrity.  It was one of those ‘you just know’ moments, but I had to check in.  Really?  Was I sure?  How did I know?  How could I prove it?  I turned the page and scrutinized every word, comparing it in importance to these two.  Accountability?  Yes, but not as much.  Equality.  Fairness.  Gratitude.  Learning.  Openness, Optimism, Stewardship, and Wholeheartedness:  all important, but not nearly so much as Honesty and Integrity.  I was done.  As surely as I felt self-actualized in seventh grade, I am sure these are my core values.  A few days later, I was describing this moment to another thoughtful and astute friend.  She mulled for a moment and said, “Yes, I agree, I see these as your core values, too.”  Wow, I cannot think of a higher compliment.

Today when I told Donna, her first response was, “Honesty and Integrity… What is the distinction between the two?”  What a great question!  I had a vague, intuitive idea, but had never taken the time to think it through.  As happens so easily when I’m with Donna, and as a person who talks to think, the answer poured forth after only a few seconds.  I used a real life example:

Let’s say my friend asks me, “Does this dress make me look fat?”

Honesty compels me to answer truthfully.  Yes.  Honesty keeps me from lying.  That is outside of my core values, no can do.

Integrity helps me choose my words.  This dress does not flatter your figure the way a different style would.  We are here to choose the dress that makes you look positively stunning and we will not leave until our mission is accomplished!  Integrity frames my response in line with all of my other, ‘second tier’ values: kindness, diplomacy, empathy, love, loyalty, and all the rest.

Thus, Honesty tells me what I cannot do.  It gives me constraints and standards.  Honesty is the guardrail, the floor for my code of conduct.  Integrity then tells me what I can and must do.  It defines the realm of possibility, meaning, and purpose—the Why, How, and What.  How can I be the best friend, mom, doctor, wife, speaker, and leader?  It is the accelerator and steering mechanism that keep me in the lane of who I am.  Or, Honesty is the launch pad; Integrity creates the universe of potential.  I swear I got goosebumps.

Phrases that recur often in my speech and writing are “walk the talk” and “lead by example.”  I always ask myself if I exemplify these, and they are the yardsticks by which I measure all those who lead me.  One cannot do either without Honesty and Integrity at work all of the time.  Brené Brown calls integrity “living into our values rather than just professing them.”  Hallelujah.  I feel the most at home, confident, and grounded when I know I’m living deeply in my Honesty and Integrity.  When I’m outside of these, I feel viscerally uneasy.  I cannot tolerate it, or I can only with great suppressive efforts to manage the dissonance.  I lose sleep; I get irritable and restless.

Practicing Honesty and Integrity is not always easy, though.  Facing the ugly and disappointing truths about myself and my dysfunctional patterns, and then holding myself to a higher standard of conduct—internal benchmarks of behavior and relationship—these aspirations create stress and tension on multiple levels of consciousness.

In the end, though, I know that as long as I hold these two values in front, they will light my right path.  I know I will make mistakes.  There will be times when my behavior absolutely does not exemplify these values.  I wanted to write a blog post right after my A-ha! moment reading the book.  But I was afraid someone would recall a time they witnessed the opposite of these values in my actions, and call me out on it.  But I’m not afraid anymore.  I’m not perfect.  And I’m striving every day.  That’s good enough, because it is my best.  Honest—I swear on my Integrity.

 

 

Living Large in Seventh Grade

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NaBloPoMo 2018: What I’m Learning

Did you know that Abraham Maslow never represented his hierarchy of needs as a pyramid?  I didn’t either!  To be clear, I have not read the paper I just linked; it was linked in a different article I read today, describing more about Maslow’s work than I have ever known before.  It’s in Scientific American, entitled, “What Does It Mean to be Self-Actualized in the 21st Century?” by Scott Barry Kaufman.

Especially later in his life, Maslow’s focus was much more on the paradoxical connections between self-actualization and self-transcendence, and the distinction between defense vs. growth motivation. Maslow’s emphasis was less on a rigid hierarchy of needs, and more on the notion that self-actualized people are motivated by health, growth, wholeness, integration, humanitarian purpose, and the “real problems of life.”

I was intrigued by this piece because I remember so clearly when I first learned about Maslow’s Hierarchy.  It was in seventh grade, and I can’t remember anymore the class or context.  I just recall that it made so much sense, and I felt such a swell of joy at the possibility that something so complex could be distilled and explained so simply.  It would have been fair to predict at that time that I would go on to become a psychologist.  The boy I had a crush on that year (and all through high school, actually) asked me where I saw myself on the pyramid.  I remember looking at the tiers and thinking, very clearly, oh, I’m at the top.  I felt a little sheepish, afraid I would be seen as bragging, but it was the honest answer, and I said so.  “Bullshit,” was his reply.  I can’t remember our verbal exchange thereafter, but I think I was able to convince him that I really felt like I was ‘there.’  And I left that encounter feeling both a bit more self-aware and also proud that I had stood my ground and defended a truth.  You could also have guessed I would later entertain a brief interest in law school.

Kaufman has revisited Maslow’s work, including his hierarchy of needs, and evaluated the components in the context of modern life.  Reassuringly, 10 of 17 of Maslow’s self-actualization characteristics still stand up to ‘scientific scrutiny,’ (not sure how he measured this).  He names the ten characteristics in the article, and you can ‘take the quiz’ to see how self-actualized you are today.  I love quizzes like this.  I have done the Myers-Briggs at least 5 times.  Others I love are Gregorc Mind Styles, Insights Discovery, and the Gallup Strengths Finder.  The most useful ones tell you what you already know about your strengths, and also offer advice and insights on how to manage your blind spots.

But the most interesting aspect of Kaufman’s article to me was Maslow’s interest in self-actualization and its relationship to self-transcendence.  We can understand self-actualization as ‘achieving one’s full potential’ and self-transcendence as ‘decreased self-salience and increased feelings of connectedness,’ (again, not read the paper; it’s linked in Kaufman’s article) or basically subsuming and/or integrating oneself within a greater whole.  At first you may think that these are mutually exclusive states of mind and being.  The coolest thing is that it’s not actually an either/or proposition; it is absolutely both/and:

While self-actualization showed zero relationship to decreased self-salience, self-actualization did show a strong positive correlation with increased feelings of oneness with the world.

Self-actualized people don’t sacrifice their potentialities in the service of others; rather, they use their full powers in the service of others (important distinction). You don’t have to choose either self-actualization or self-transcendence– the combination of both is essential to living a full and meaningful existence.

It reminds me of another subsection of Chapter 3 in Leading Change in Healthcare, wherein Suchman et al discuss holding the tension and balance between self-differentiation (clear sense of individuality) and attunement (deep awareness and acceptance of how we are connected and resonant with those around us).  It also reminds me of Brené Brown’s work on trust; she describes eloquently in Rising Strong how we can neither trust others nor be trustworthy ourselves without clarity and boundaries around who we are and our core values, and living in that integrity all of the time.

Once again, I find encouraging and validating evidence for something I really feel I have known since an early age:  We are all our best selves and our best communities not in competition, but in collaboration.   Cohesion in diversity weaves a stronger social fabric of connections, more flexible and elastic.  But that means we need to know exactly what we as individuals each bring to contribute.  Personal, intrinsic meaning and purpose are foundational for substantive interactions with others and resilient communal relationships.

Our world can meet each and every one of our physiologic, psychologic, and self-fulfillment needs—we can provide this for one another.  We can each strive for our own goals, alongside our peers, and still help each other on the rocky, uphill parts.  We really need to stop with the scarcity thinking and get on with the business of working together, maximizing each of our strengths, and making society better for all of us.

Onward.

Humanity

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NaBloPoMo 2018: What I’m Learning

I have festered all day drafting this post in my head.  Procrastinating.  It’s still a jumble, so I’ll give it my best shot:

Donald Trump is a human being.  As much as I want to hurl epithets and lob rotten tomatoes at the television every time his face appears, or take a sledgehammer to whatever device I hear his voice on, I know these are unproductive responses to the emotions he triggers in me.  Breathe.  Must. Do. Better.

Ever since the 2016 campaign started in June of 2015, three and a half years ago already, I have felt an almost daily rage like nothing in my life yet.  I’m happy in some ways to report that it has not improved—I have not normalized this aberrancy of an administration.  But the constant animosity is not good for my health.  And the escalating divisions and vitriol between various groups of people, ever more visible on phone cameras and instant video, erodes our humanity every day.  I think I’m also increasingly sensitive to it all now.  On one hand I’m glad because awareness of humanity, and opposing those who diminish it, is good.  But again, it costs me.

Donald Trump is the personification of dehumanization (oh, the irony).  Some may feel this is an exaggeration, too strong a word to use.  It is not.  He is a hardened master of this insidious craft, and we are each capable of the same, whether we admit it or not.  It starts with making people abstractions—by seeing them, even very subtly, as less than whole people with feelings and needs equally important as our own.  Simon Sinek discusses it eloquently in his book Leaders Eat Last; you can read an iteration of his thoughts in this interview.  He describes CEOs like Jim Sinegal and Bob Chapman who, in hard times, gave employees raises and decreased workers’ hours, respectively, rather than laying anyone off.  I learned during a lecture, though I cannot find the citation (Boehm, 2015?) that only 17% of healthcare CEOs take the well-being of their employees into account when making decisions.  Sinegal and Chapman sacrificed some numbers to save people, Sinek says.  Too many leaders sacrifice people to save the numbers.  Turning people into abstractions is both akin to and a step toward dehumanizing them.

I have a friend who used to criticize people, ideas, or things by saying, “That’s (he’s) so gay.”  He would deny his negative attitude, deny that he was using ‘gay’ as a derogatory term.  He would also deny that he was biased against homosexuals.  I believe he would never treat anyone badly because they were gay, let alone commit any kind of hate crime.  But ‘being gay’ was a negative abstraction to him.  It was abnormal, something to be derided and shamed—to be scorned.  His objection to the idea of homosexuality made homosexuals, as a group in his mind, less than.  I think we all do this more often than we know.  I wrote about it last year, describing how doctors in different medical specialties talk about each other in pejorative stereotypes.  We dehumanize each other every damn day.

Brené Brown describes this clearly in her book Braving the Wildnerness:

Dehumanization has fueled innumerable acts of violence, human rights violations, war crimes, and genocides. It makes slavery, torture, and human trafficking possible. Dehumanizing others is the process by which we become accepting of violations against human nature, the human spirit, and, for many of us, violations against the central tenets of our faith.

How does this happen? Maiese explains that most of us believe that people’s basic human rights should not be violated—that crimes like murder, rape, and torture are wrong. Successful dehumanizing, however, creates moral exclusion. Groups targeted based on their identity—gender, ideology, skin color, ethnicity, religion, age—are depicted as “less than” or criminal or even evil. The targeted group eventually falls out of the scope of who is naturally protected by our moral code. This is moral exclusion, and dehumanization is at its core.

Dehumanizing always starts with language, often followed by images. We see this throughout history. During the Holocaust, Nazis described Jews as Untermenschen—subhuman. They called Jews rats and depicted them as disease-carrying rodents in everything from military pamphlets to children’s books. Hutus involved in the Rwanda genocide called Tutsis cockroaches. Indigenous people are often referred to as savages. Serbs called Bosnians aliens. Slave owners throughout history considered slaves subhuman animals.

Again, you may think that I over-exaggerate here.  What’s the big deal, you say, when surgeons say internists wear flea collars (stethoscopes)?  Or when Trump calls Mexicans criminals and rapists?  When he calls women dogs, Miss Piggy, and Horseface, you say, it has no real effect.  Sociology begs to differ.  It is a slippery slope from thoughts to words to action, and Donald Trump has poured oil on the Slip ‘n’ Slide by the bucketful.  Don’t believe me?  How else could we countenance forcibly separating toddlers from their parents when they arrive on our doorstep, fleeing violence and seeking asylum, sending the children across our country and deporting the parents, with no intention of ever reuniting them?  If that’s not dehumanization I don’t know what is.

Once again, Brené Brown says it much better than I:

Today we are edging closer and closer to a world where political and ideological discourse has become an exercise in dehumanization. And social media are the primary platforms for our dehumanizing behavior. On Twitter and Facebook we can rapidly push the people with whom we disagree into the dangerous territory of moral exclusion, with little to no accountability, and often in complete anonymity.

Here’s what I believe:

  1. When the president of the United States calls immigrants animals or talks about grabbing pussy, we should get chills down our spine and resistance flowing through our veins. When people call the president of the United States a pig, we should reject that language regardless of our politics and demand discourse that doesn’t make people subhuman.
  2. If you are offended or hurt when you hear Hillary Clinton or Maxine Waters called bitch, whore, or the c-word, you should be equally offended and hurt when you hear those same words used to describe Ivanka Trump, Kellyanne Conway, or Theresa May.
  3. If you’re offended by a meme of Trump Photoshopped to look like Hitler, then you shouldn’t have Obama Photoshopped to look like the Joker on your Facebook feed.
  4. When we hear people referred to as animals or aliens, we should immediately wonder, “Is this an attempt to reduce someone’s humanity so we can get away with hurting them or denying them basic human rights?”

When we engage in dehumanizing rhetoric or promote dehumanizing images, we diminish our own humanity in the process. When we reduce immigrants to animals… it says nothing at all about the people we’re attacking. It does, however, say volumes about who we are and our integrity.

Dehumanizing and holding people accountable are mutually exclusive. Humiliation and dehumanizing are not accountability or social justice tools, they’re emotional off-loading at best, emotional self-indulgence at worst. And if our faith asks us to find the face of God in everyone we meet, that should include the politicians, media, and strangers on Twitter with whom we most violently disagree. When we desecrate their divinity, we desecrate our own, and we betray our humanity.

So I resolve to stop participating in the erosion of humanity.  When I hear dehumanizing language from anywhere, especially among my own tribes, I must resist the urge to respond in kind.  I will look for opportunities to call it out.  It is so damn hard, I feel so often like a pressure cooker waiting for the valve to release.  So I must practice patience, kindness, mindfulness, deep breathing, and all of the habits I reviewed here yesterday.  I must find it in myself to always hold another’s humanity as sacred as my own, even (especially?) the people I despise the most.  It will be a lifelong exercise in discipline and agape love.  As the Obamas teach us, we must stay Fired Up, Go High, and Be the Change.  I can do this.  Donald Trump is a human being.