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Archive for December, 2011

Newspapers used to have a section entitled “Births Deaths and Marriages”. My granny used to read it first. I don’t remember ever reading it. I’m not sure if any newspapers still have such a section. Yes, they have “Obituaries”, usually of famous, or “important” people, but that’s not the same. What about the people we know? The people whose lives are close to ours?  

When I had a holiday in Antigua a few years ago I stumbled upon a local  radio station which every morning had a section where the presenter shared who, in the community, had died, and who was experiencing bereavement. These were astonishingly moving short stories. Little obituaries of individual lives which then spilled outwards into a naming of the relatives who might be listening, or might be known by the listeners. More than a listing of names, there were small, interlaced stories of significance related about the place of the deceased in the lives of the bereaved. I’d never heard anything like this before, and haven’t since. It was rich, multifaceted and multilayered. It was deeply human.
Maybe the births and marriages were similarly announced at other times of the day. I’d like to think so.
But where do we share the births, deaths and marriages now?
Why am I thinking of this, on this last day of 2011?
Well, I found myself reflecting on the year, and reflecting from a perspective of gratitude (December is the month of gratitude in my “months of meaning”). 
My first thought was the birth of my grandson, Charlie. He’s one of those happy babies who smiles widely, chuckles loudly and seems to spend much of his life so far in quiet contentment. How wonderful! What a gift! And what a lesson. He reminds me to smile, to laugh and to relish quiet contentment.
Then I thought of deaths I’ve encountered this year. Not just the deaths of friends and colleagues, but the deaths of friends and loved ones of my own friends and loved ones, the ripples and effects of which have deeply touched me too. These losses, these new, intense absences, make me more aware of the gratitude I have for their having been in  my life, and I reflect on what unique gifts each and every one of them brought. These deaths, and reports of deaths remind me how much we enrich each other.
So that led me on to marriages. Well, rather than marriages, I’d like to expand this section to a consideration of relationships – relatives, friends and colleagues. There have been challenges, trials, opportunities, illnesses and changes for many people I know this year, and I find, that in all of these circumstances these difficulties and changes heighten the importance of the individuals to me. I am touched ever more deeply by the lives of others it seems, and this, in turn, intensifies, broadens and deepens the love I experience in my life.
So, how about your own section on “Births, Deaths and Relationships”? 
Which would you like to record? Which would you like to reflect on? And what have they brought into your life, viewed from the perspective of gratitude?

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2011…..ebbing away

2011.....almost gone

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It’s been a very full and frequently challenging 2011. So I’m taking a break…..sometimes it’s good just to sit for a bit.

just sitting

That’s not me in the photo by the way, but I am in the same place as this guy – Capetown

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Have you come across the slow movement yet? It started with “slow food”. Slow food, of course, is the opposite of fast food. It’s pretty easy to figure out what a “slow food” movement would be about. Fresh, locally sourced ingredients, individually prepared, and savoured as its eaten. Taking the time to really appreciate each and every mouthful. A bit like “mindful eating” really. 

Next came the “slow city”. The mayor of San Miniato in Italy, with local support declared his town a “slow city”, banning the opening of fast food restaurants and chain stores, encouraging walking, cycling and the nurturing of green public spaces. Several other towns have signed up to these principles creating the “slow city movement”.
There’s a lovely blog named “slow love life“. Read this phrase from its front page….SLOW LOVE means engaging with the world in a considered, compassionate way, appreciating the miraculous beauty of everyday moments, and celebrating the interconnected nature of life”
Then, recently some scientists have called for the formation of a “slow science” movement, posting this manifesto online  and asking for scientists to freed from the perpetual pressures to produce publishable results, to be less outcomes driven, and more exploration driven.
So, how about a “slow medicine” movement? Where doctors, nurses and other health carers take the time to fully understand a person’s illness, and are able to establish therapeutic, compassionate relationships. Where there isn’t a reflex to jump into a “quick fix” by prescribing a drug which will only mask the disease or temporarily modify it. Where it’s a fundamental value to discover what is unique about every individual and to help to stimulate and support every patient’s ability to self heal and self repair. In other words where the focus shifts from short term, outcomes driven goals, to improving quality of life and enabling people to actually develop and grow through the process of being ill.

Acute, fast Medicine
Acute, fast medicine has its place, and that place is at the edge of life. When your illness is sudden and severe I think the advances made in medical technology make a HUGE difference. Quick decisions, and rapid, precise actions bring the ultimate results – the difference between living and dying today.
Acute, fast medicine involves a sharp focus on only what is important to achieve a well defined outcome (not dying for example) in a short period of time (minutes or hours usually).
This model is just not appropriate either for trying to help someone to have a healthy life, or to live a good life in the presence of a chronic disease.
If someone has a condition like diabetes, multiple sclerosis, asthma etc, then using the fast, acute methods to rapidly change a very small part of the whole person is not enough. The timescale of a chronic complaint is weeks, months or even a lifetime. The outcomes which make a difference over that timescale can’t be so easily defined and measured. They are about qualitative rather than quantitative change.
The crucial shift from acute problems to chronic ones involves a broadening of the focus, a deepening of understanding to encompass the whole person inextricably embedded in the multiple contexts of their life.
This takes time, and it takes the establishment and maintenance of a relationship.



Manifesto for Slow Medicine

  • Every person is unique. It takes time to get to know a person. Appointment times should be long enough to discover a person’s uniqueness.
  • Good health care is developed from an understanding of the person who is ill or who wants to stay healthy. Understanding should take place before acting.
  • More than a knowledge of disease is required to deliver good health care. There also needs to be a knowledge of the person. Diagnosis should not be limited to knowledge of disease. It should encompass a knowledge of the person.
  • Doctors, nurses and other healthcare professionals  are people too. Every health care worker is unique. Recognising and nurturing this uniqueness is as important as defining knowledge, skills and attitudes required to carry out tasks.
  • Delivering good health care requires self awareness and understanding on the part of the person who is caring. Reflective practice should include working on personal growth.
  • The core of health care is the relationship between individual people – patients and carers. Priority should be given to the relationship.
  • Good health care is relationship based, not event based.
  • Continuity of care should therefore be given priority in order to support and develop healing relationships.
  • Health care is for life. Defined, time-limited outcomes are arbitrary and are not a substitute for life long care.
  • Health carers should work in supportive, understanding environments which enhance the delivery of healing relationships. These environments are co-created by the leaders, managers and health care professionals working in accord with compassionate, person centred values.

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Last year I studies Interpersonal Neurobiology with Dan Siegel, whose book, Mindsight, I highly recommend. He teaches around the essential triad of brain, mind and relationships and understanding the links between these three turns out to be tremendously illuminating. On the relationship front, Dan draws on his training in attachment theory and demonstrates the links between early nurturing and personality later in life – particularly in connection with how we form relationships.

Sir Harry Burns, the Chief Medical Officer of Scotland, highlighted in a brilliant presentation earlier this year the key importance of early years in determining future health and health behaviours.

On top of this comes this research from the University of Minnesota demonstrating –

“Your interpersonal experiences with your mother during the first 12 to 18 months of life predict your behavior in romantic relationships 20 years later,” says psychologist Jeffry A. Simpson, the author, with University of Minnesota colleagues W. Andrew Collins and Jessica E. Salvatore. “Before you can remember, before you have language to describe it, and in ways you aren’t aware of, implicit attitudes get encoded into the mind,” about how you’ll be treated or how worthy you are of love and affection.

Wow! during the first 12 to 18 months! How important is love? You can’t over emphasise it.

You might be thinking yikes, if it’s set in the first 18 months, what hope is there? Well, it turns out we can have lots –

The good news: “If you can figure out what those old models are and verbalize them,” and if you get involved with a committed, trustworthy partner, says Simpson, “you may be able to revise your models and calibrate your behavior differently.” Old patterns can be overcome. A betrayed baby can become loyal. An unloved infant can learn to love.

 

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1Q84

1Q84, the latest novel from the Japanese author, Murakami. In fact, it’s three novels, with the whole trilogy published at the same time, parts one and two in one volume, and the third part in a separate volume. I’d say this is my choice for fiction book of the year. It’s the first novel I’ve read as an ebook and the fact the entire trilogy was on my iPhone and my iPad meant I didn’t need to carry around three large books. I’ll return to that point later.

I loved reading this novel. It has pretty much everything I look for in fiction. Good writing, great storytelling and a book which either makes me think, or somehow changes how I experience the world.

1Q84 is set in Tokyo in 1984 and tells the story of two young people, one of whom is a hired assassin who murders men who abuse women, and the other who is a maths teacher by day, and a writer in his own time. The writer ghost writes a poorly written but fascinating story told by a strange, reclusive 16 year old girl. It becomes a best seller and brings unwelcome attention to highly secretive cult.

Both characters become aware that something isn’t right about the world, the most marked feature being the presence of two moons in the sky. To mark the difference between this world and the world of 1984, they refer to it as 1Q84. It’s this kind of plot turn which is typical of Murakami and which takes you into a border zone between reality and the world of imagination.

The fact that the unusual features of 1Q84 are described in the “novel” written by the 16 year old makes you wonder whether or not all the characters are now living in this novel within the novel you are reading.

This latter theme is probably the key of the whole novel. As well as being a page-turning great read, and a magical love story, 1Q84 really stimulates your thinking about the relationship between imagination and reality, the place of fiction in our lives, and the central importance of story in the creation of the lives we experience. Take a look at this extract –

1Q84

Isn’t that such a great point about stories? They reflect the messiness, the complexity and the uncertainty of reality, and they change us. In so doing, reading fiction does literally change the reality of the worlds we co-create.

I downloaded this trilogy as a Kindle book and fired it up on both my iPad and my iPhone. I don’t know if you’ve used this technology for reading but it’s great. Both of these devices have lovely, bright, clear screens which make text very readable, and as you progress through the book the different devices keep up with you – so when I would open the book on my iPad, it would automatically offer to jump forwards to the place I’d reached when I last read it on my iPhone, and vice versa. That might sound a little clumsy but it’s a seamless and brilliant experience. It meant I could have a quick read in any few spare moments using my phone, and settle down with the iPad to enjoy the larger screen when I had some more significant reading time. I think this was partly responsible for making this such an immersive experience. I could feel I was living in Tokyo at the same time as living in Scotland.

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sea path

There’s change underway. Don’t you feel it? The old certainties are crumbling. The global systems are stumbling from crisis to crisis. From “Arab Spring” to “Occupy” there’s spreading unrest. From country to country austerity measures are being imposed by governments without popular democratic support.

Underlying these economic and political stories there are bigger changes flowing. Ian McGilchrist’s excellent “The Master and His Emissary” describes a struggle between two world views – one emerging from a left brain approach to the world, and one from the right. He makes the case that the left brain approach has dominated for the last four hundred years or so creating our industrialised, command and control based societies.

Seth Godin’s superb “We are all Weird” shows how mass consumption, mass production and mass control, the dominant ways of 20th century world, are being replaced by an emphasis on difference, diversity and uniqueness.

Next year is 2012. There are many predictions that this will be a crucial year for humanity.

Let’s embrace it. Let’s embrace change by shifting our focus and our energy on bringing about the changes we want.

Let’s embrace the following “C change” –

  • Consumption to Creativity
  • Credit to Cash
  • Control to Coherence
  • Competition to Co-operation
  • Coldness to Compassion

Consumption to Creativity
When politicians and economists talk about growth, which they claim is an essential characteristic of a healthy society, they mean consumption (or production of goods and services to be consumed). Their emphasis is on figures like GDP, or Gross Domestic Product, the turnover and profit of large companies, which is how much they’ve sold, and how much money they’ve had to spend to produce those sales. But is this growth? Production for consumption? What’s the point of that? Ever greater consumption, at best, is not a sustainable path. At worst, a tipping point will be reached (has been reached?) where the pursuit of greater consumption becomes harmful, divisive and destructive. So, consumption is not a a good target, nor is it an adequate surrogate for growth.
In human beings, greater consumption tends to produce bigger, fatter people. There’s a limit to the amount a person can consume. As the limits are reached waste (and waist size) increases.
Consuming for the sake of consuming doesn’t happen in Nature. Animals consume what they need to be fit and healthy. In the wild, they never become obese. Plants consume in order to grow and develop. Here’s the lesson to be learned from Nature.
If growth is about healthy development, then greater growth should constitute a genuine improvement in life. If it is just about consumption, it becomes a source of degeneration and decline.
So what if we could learn the lessons of the plant world, for example? What if we rated development more highly than consumption? Development, in human terms, is about improving physical fitness, mental resilience, wellbeing, skills, talents and capacities.
There is a common theme underlying these qualities, and that theme is creativity. Creativity produces growth and development. It expands both our abilities and our expressivity – our talents and our self-expression.
What if we prioritised development, improvements in skills, knowledge, performance, as well as expressivity?

This would require a shift away from consumption to creativity.

Credit to Cash.
This current crisis of the global economy, is a crisis of a system based on ever increasing consumption and credit. Once lending slows up, the financial system grinds to a halt. What was the key characteristic of the 2008 crisis? The drying up of credit, or lending, as trust and security fell amongst the banks and financial institutions. Yet, increasingly, finance is based on illusion. Banknotes bear words promising to pay the bearer were originally backed up by gold reserves. If you wanted you could turn these pieces of paper into real gold. But now with derivatives, and computerised, digitised money, the amounts of “money” in the world are no longer related to reality. Country after country is reported as being in debt. Debt they can’t pay off if asked to do so. Who is everyone in debt to? Who is asking to be paid off? And with what? Imaginary money is used to buy ever greater amounts of imaginary money, spiralling up into ever more unstable, unsustainable levels of debt and credit. The total amount of national and personal debt in the world is higher now than ever before in history.
One way to gain greater financial health at a personal or family level, is to move away from imaginary money to real money. In other words, to reduce the amount of credit needed in daily life by moving towards a cash, or bartered economy.
If I do this for you, then you’ll do that for me. Real goods, real materials, real cash. If countries did that too, then the need for credit would diminish.
The less the need for credit the less power and privilege will be held by those who gain from imaginary financial instruments. Those who hold power over whole countries through lending would be disempowered.
What if all the countries which have debt, agreed one day to declare they had no debt? What if they set the counter back to zero? Recalibration Day. Where power shifted back to people and away from the rich minority who hold all the “credit”.

Control to coherence

Industrialisation comes with an emphasis on control. The scientific method of the industrial age has become a way of predicting future states and developing technologies to achieve those states. The wave of industrial development known as Fordism, has produced a whole management ethic around command and control structures. The development of mass production, mass marketing and mass consumption, reduces individuals to units to be controlled and life to outcomes determined and managed by those who hold the power.
Yet, the universe is a vast, complex, unpredictable and uncontrollable place. An individual life is unpredictable and uncontrollable. The crises in the global financial systems, the revolutions and power struggles of the political systems and the ecological stresses manifested in both climate change and the constant appearance of apparently random catastrophic events, from tsunamis to earthquakes, to hurricanes and volcanic eruptions, surely make it crystal clear to us that control is, ultimately, impossible.
What to do? Nobody feels comfortable out of control. Nobody feels safe and secure in rapidly changing, completely unpredictable situations.
We can’t achieve control. But we can achieve coherence. We can actively seek to be more in harmony….with each other, and with the Earth. The greater our actions produce coherence in our interconnected domains of Life, the more we will experience a sustainable, nourishing way of living.

Competition to Co-operation
One aspect of Darwin’s work has been picked up and overblown to an enormous degree – competition. It’s highlighted as the key characteristic for success and survival. Nature is presented as “red in tooth and claw”, one endless struggle pitching every individual organism not only against other species but against all the other members of the same species. Only the best, the fastest, the “fittest” survive.
Of course, there’s something in that view, but that is not all Darwin said, and it’s certainly not all there is to evolution. The other important characteristic is in fact co-operation. It can be argued that it is actually the ability of human beings to interact socially which gives them their dominant place in the evolution of Life on planet Earth. Our social skills include our development of language, and our faculty of imagination which underpins empathy and compassion. It may be that these are the most important human features.
All creatures engage in competition and co-operation but human beings really excel at forming bonds, creating networks, sharing information and resources.
The creation of a economic and financial system based on competition has led us down the path to war and totalitarianism throughout history. Maybe it’s time to up the emphasis on our co-operative powers instead and see what systems we could create from that perspective.
Some may argue that there’s a link between male dominance/competition and female nurturing/co-operation. Could it be that a healthier future lies in shifting the centuries old gender bias of cultures, religions and economic-political systems? Increase the influence of women in all aspects of society.

Coldness to Compassion
One of the greatest problems with reductionism is that if you reduce a human, you no longer have a human. The reduction of human beings to units within a mass dehumanises.
In health care it should be impossible to discover stories of neglect or cruelty. Sadly, that’s far from the case. How can a patient be left unattended, treated as a “case of…..”, uncared for within a health service? Why is poverty tolerated? Why is there famine, rape, torture, human trafficking, terrorism?
A lack of compassion.
With sufficient compassion none of these horrors would be possible.
So there’s my final “C” change – from Coldness to Compassion. A shift of emphasis towards the heart.

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