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Archive for the ‘from the reading room’ Category

The importance of story

Posted in books, creativity, from the reading room, life, narrative, philosophy on January 30, 2008| 39 Comments »

The people who come to see us bring us their stories. They hope they tell them well enough so that we understand the truth of their lives. They hope we know how to interpret their stories correctly. We have to remember that what we hear is their story.

Robert Coles in “The Call of Stories”.

Stories have always fascinated me. I love them. Every day when I sit in my consulting room patients tell me the most amazing, fascinating and unique stories. As a medical student I was taught how to “take a history” – I hate that phrase actually – who’s doing the “taking” and what exactly are they “taking” and from whom? Doesn’t seem right to me at all. Instead I prefer teaching medical students how to listen to patients’ stories. However, the point is that this is the beginning of all diagnosis. To a certain extent listening to the patient’s story is a diminished art. There’s an over-reliance on technology and a lot of doctors just don’t seem to be able to make a diagnosis without a test these days. Diagnosis is a form of understanding. It’s a process of trying to make sense of somebody’s experience.

If stories are so important in clinical practice, then how can I learn to handle them better I wondered? There is a developing area of medicine known as “narrative-based practice”, with associated “narrative-based research” methodologies, but materially-orientated, reductionist scientists look down on narrative. They prefer data. So, when I started to study narrative (which, technically is the story AND the way that story is told), I couldn’t find much work from a scientific perspective. I had to turn to the humanities.

One of the books which I really love in this area of study is “On Stories” by Richard Kearney (ISBN 9-780415-247986). Not only is it a fabulous exploration of the place of story in human life, but it’s written completely beautifully. Richard Kearney is a philosopher but he’s also a magnificent writer. This one book taught me more about the importance of story than any other.

Telling stories is as basic to human beings as eating. More so, in fact, for while food makes us live, stories are what make our lives worth living.

This sets stories at the heart of human existence – not optional, but essential.

Aristotle says in “Poetics” that storytelling is what gives us a shareable world.

The key word there is “shareable”. It’s through the use of story that we communicate our subjective experience and its through the sharing of subjective experience that we connect, and identify with others.

Without this transition from nature to narrative, from time suffered to time enacted and enunciated, it is debatable whether a merely biological life could ever be considered a truly human one.

Beautifully expressed. Sets narrative at the heart of what it means to be human and stands it against those who would take a materialistic view of life which they claim can be reduced to data sets and DNA.

Every life is in search of a narrative. We all seek, willy-nilly, to introduce some kind of concord into the everyday discord.

This is one of my favourite lines in the whole book. This is exactly the power of story – it enables us to “get a handle on” life, to bring some kind of order out of chaos.

What does Richard Kearney mean by story then? Well, I’ll finish this post with two more quotes from his book which make it very clear and very simple.

When someone asks you who you are, you tell your story. That is, you recount your present condition in the light of past memories and future anticipations.

This shows that story collapses time, bringing the past and the future into the present. Story telling requires memory, imagination and expression.

Every story requires –

a teller, a tale, something told about, and a recipient of the tale.

Nice and simple, but what profundity lies in there. For every story, there is a unique human being doing the telling, there is the story itself and its subject matter, and, very importantly there’s the recipient – the listener or the reader. Story is, as Aristotle said, a way of creating a shareable world. That’s the greatest potential of blogs, I reckon. By sharing our stories we create a shared world. Yes, sure, stories can divide as well as connect, but without stories, there is no potential for connection, no potential for compassion and no potential for the creation of a meaning-full, and better world.

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Happiness the Confucian way

Posted in from the consulting room, from the reading room, health, life, psychology on January 28, 2008| 5 Comments »

Psyblog has a good post about happiness from the perspective of Confucian teaching in the light of modern discoveries. I was particularly attracted to the quote by Confucius at the start of the post –

“The one who would be in constant happiness must frequently change.”

I’ve often said that one guaranteed “fact of life” is that everything constantly changes. Nothing stays the same. There’s an old story told of a ruler asking for a speech which he could use in ALL situations, and several of his philosophers and teachers taking on the task and failing, until finally, one man gives him the speech which works in all situations (another version of this story involves King Solomon looking for a ring which will relieve his suffering which he fears will go on forever, and he is given a ring with a few words carved into it) What was the speech? Same as the words in King Solomon’s ring –

THIS TOO SHALL PASS

That’s a recognition of the reality of constant change. Japanese culture holds transience in much greater esteem than many other cultures. That’s partly why they greet the blossoming of the cherry trees every Spring with such enthusiasm. (if you’re ever in Japan in the Spring you’ll see thousands of people out photographing the cherry blossom and photos of the earliest blossom will appear on the front pages of the national newspapers). To be in touch with the cycles of the seasons and to celebrate the changes between them can bring great pleasure.

A fundamental characteristic of a complex adaptive system (CAS) is that it constantly changes, constantly adapts.

The first two lessons in the Psyblog post are “Invest in intimate ties” and “Embrace society”. Both of these emphasise the importance of engagement – along with adaptation, one of the key characteristics of a healthy CAS.

The other lessons are interesting too, including “have fun” and “educate yourself” – both of which are about creativity and growth – the third of the characteristics of a healthy CAS.

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Think before we act? Turns out we don’t……and that’s the truthiness

Posted in from the reading room, psychology on January 26, 2008| 5 Comments »

How do you think the brain and body work together? A lot of people reckon we figure out what we want to do first, then our brain moves into a kind of second phase and make the body do what we’ve decided we want to do. Seems logical, huh?

Well, it turns out it’s not like that. Here’s an interesting study which shows that the brain and the body work at the same time, not brain first, body later! A group of psychology researchers asked people (yes, college students again….you have to watch out for those psychology studies, they mostly use college students as their guinea pigs, and do you think college students are typical?), sorry, lost the thread a bit there, they asked people questions and observed what movements their arms made on the way to either the “no” or the “yes” buttons on the computer. They found that in response to the more ambiguous questions the students’ arms moved more between the buttons, than they did on straight forward questions. What that means is that they could be seen to dither a bit before answering the ambiguous questions. Their arms and brains were working together – simultaneously. It gets more interesting……..they dithered more towards “yes” when answering a “no” question than towards “no” when answering a “yes” question, suggesting that people have a general bias towards assuming a statement being true.

These dynamic data showed that participant arm movements had lower velocity and curved more toward the alternative response box during ‘no’ responses than during ‘yes’ responses—suggesting that we experience a general bias toward assuming statements are true,” the authors explained.

The authors conclude that this shows we lean towards “truthiness”.

You know, I’d never seen that word before, but when you go searching on the net about it you can find LOADS. Start here at wikipedia. The word seems to have been made up by, or at least given a specific, new definition by comedian Stephen Colbert. Here’s his explanation –

Truthiness is tearing apart our country, and I don’t mean the argument over who came up with the word…It used to be, everyone was entitled to their own opinion, but not their own facts. But that’s not the case anymore. Facts matter not at all. Perception is everything. It’s certainty. People love the President because he’s certain of his choices as a leader, even if the facts that back him up don’t seem to exist. It’s the fact that he’s certain that is very appealing to a certain section of the country. I really feel a dichotomy in the American populace. What is important? What you want to be true, or what is true?…

Truthiness is ‘What I say is right, and [nothing] anyone else says could possibly be true.’ It’s not only that I feel it to be true, but that I feel it to be true. There’s not only an emotional quality, but there’s a selfish quality.

What lies behind this, as he highlights, is that old need for certainty. Human beings don’t handle doubt very well. There’s a strong tendency to seek certainty and when that is applied to beliefs (whether religious or scientific) it leads to that statement in the above quote – ‘What I say is right, and [nothing] anyone else says could possibly be true.’Don’t know about you, but I prefer to find a way to deal with doubt. It’s more real. Truthiness doesn’t leave much room for dialogue.

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The Prosperous Peasant

Posted in books, from the reading room, personal growth on January 15, 2008| 10 Comments »

I read the Prosperous Peasant, written by Tim Clark and Mark Cunningham, recently. It’s one of those books which teaches (in this case five) principles (or ‘secrets’) which you should learn if you want to have a better life. The writing is better than many other books of this genre, partly, I suspect, because both of the authors are already established writers, one of them a novelist. Their writing skills show. The message of the book is very simple – here are the five principles –

  1. Gratitude attracts luck
  2. Know your gift
  3. Conceivable means achievable
  4. Effort determines results
  5. Collaboration breeds success

I’m not going to elaborate any of these here. There’s nothing ground-breaking in here. However, my favourite one is the third one. A long of goal-setting and visualisation teaching is ridiculous and sets people up for disappointment. This particular principle emphasises that you have to be able to “conceive” how you’re going to achieve what you want to do, and that’s what makes it possible. It’s the conceiving that sets it apart from fanciful daydreaming. The principles are all ones you’ll have read about elsewhere but I like two things – the first is the way the principles are taught using the classic storytelling method. This time the stories are set in Japan, during the time of the samurai, and each story is well told and memorable. The second is that, unlike The Secret, the principles are practical, reasonable and useful. There’s nothing quasi-religious or mystical about it. It’s got charm. You can read the book for yourself, or have a look at the website.

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Blogging consciously?

Posted in from the living room, from the reading room, writing on January 11, 2008| 2 Comments »

Skellie asks if you are blogging consciously. She’s been thinking about it since reading the zen habits’ post “Wake up: A guide to living your life consciously.”

As she says

Living consciously is about analyzing and evaluating your actions, habits and behaviors, rather than simply doing. In other words, asking why rather than doing without really thinking.

And as both her post and the zen habits one points out, we can apply that principle to anything we do in life. In fact, it’s a key, distinguishing feature of living a hero life instead of a zombie one. The more we pay attention to what we are experiencing right now, the more chance we have of making conscious choices and becoming the authors of our own lives, the heroes of our own stories.

I particularly like Skellie’s last point where she asks if blogging is enjoyable for you or just a chore and says if it is a chore you should be thinking of re-focusing. I completely agree.

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Michael J Fox and illness

Posted in from the reading room, health on January 10, 2008| 4 Comments »

Michael J Fox has an illness known as Parkinson’s Disease. It’s a disease of the nervous system which causes both tremor and decreased mobility. Diseases of the nervous system really hit a person’s sense of being in control of their own body. We tend to take it for granted that our bodies will just do what we tell them and when that doesn’t happen it’s a really central challenge to our need for control. Here’s what he says –

I can’t always control my body the way I want to, and I can’t control when I feel good or when I don’t. I can control how clear my mind is. And I can control how willing I am to step up if somebody needs me.

That’s one of the things the illness has given me: It’s a degree of death. There’s a certain amount of loss, and whenever you have a loss, it’s a step toward death. So if you can accept loss, you can accept the fact that there’s gonna be the big loss. Once you can accept that, you can accept anything. So then I think, Well, given that that’s the case, let’s tip myself a break. Let’s tip everybody a break.

My happiness grows in direct proportion to my acceptance, and in inverse proportion to my expectations.

Acceptance is the key to everything.

Which isn’t to say that I’m resigned to it, or that I’ve given up on it, or that I don’t think I have any effect on the outcome of it. It’s just that, as a reality, I get it.

There really is a lot in those little answers! Look at how he deals with the issue of loss of control. What helps him to deal with his illness is knowing what he can still control – clarity of mind and motivation to help others – and those things are more important than controlling limbs.

He speaks of how coming to terms with the sense of loss which his illness brings has better prepared him for death, and in doing so, better prepared him for life.

I also like what he says about acceptance, and how he distinguishes that from resignation. It’s about being real. Isn’t that true? How much unhappiness and suffering do we experience because of our refusal to accept reality, focusing instead on how we’d prefer things to be?

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If it’s not fun, it’s hard to learn

Posted in education, from the reading room on January 9, 2008| 7 Comments »

Mihaly Csikszentmihalyi is an intersting author. He’s promoted the concept of ‘flow’ experiences from his research into happiness. This article by him is about education.

It has turned out that mass education is more difficult to achieve than we had anticipated. To close the gap between the rather dismal reality and earlier expectations, researchers and practitioners have placed their faith in teaching methods modeled on computers and other rational means for conveying information – which in turn were modeled on industrial production techniques and on military human systems design. The implicit hope has been that if we discover more and more rational ways of selecting, organizing, and distributing knowledge, children will learn more effectively.

Yet it seems increasingly clear that the chief impediments to learning are not cognitive in nature. It is not that students cannot learn, it is that they do not wish to. Computers do not suffer from motivational problems, whereas human beings do.

This strikes me as very true and it reminds me of Dickens’ character, the school-teacher Gradgrind, whose educational theory was that children were empty buckets waiting to be filled with facts!

if educators invested a fraction of the energy on stimulating the students’ enjoyment of learning that they now spend in trying to transmit information we could achieve much better results.

How many of your learning experiences have been fun ones? I’ll bet that the fun ones stuck and the boring ones disappeared.

He concludes –

There are two main ways that children’s motivation to learn can be enhanced. The first is by a realistic reassessment of the extrinsic rewards attendant to education. This would involve a much clearer communication of the advantages and disadvantages one might expect as a result of being able to read, write, and do sums. Of course, these consequences must be real, and not just a matter of educational propaganda. Hypocrisy is easy to detect, and nothing turns motivation off more effectively than the realization that one has been had.

The second way to enhance motivation is to make children aware of how much fun learning can be. This strategy is preferable on many counts. In the first place, it is something teachers can do something about. Second, it should be easier to implement-it does not require expensive technology, although it does require sensitivity and intelligence, which might be harder to come by than the fruits of technology. Third, it is a more efficient and permanent way to empower children with the tools of knowledge. And finally, this strategy is preferable because it adds immensely to the enjoyment learners will take in the use of their abilities, and hence it improves the quality of their lives.

I’m sure he’s right. Check out the full article. It’s short but worth reading and although his focus on helping children to learn, the exact same principles apply to grown ups!

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Doing it now so you don’t have regrets

Posted in from the living room, from the reading room, life on January 6, 2008| 2 Comments »

Did you read about an Englishman called Eric King-Turner? He’s 102 and has just set off to emigrate to New Zealand with his wife (who is a native of NZ). He said it wasn’t important to him that he’d be the eldest Briton to emigrate. What was important was –

“What’s important is that when I’m 105 I don’t want to be thinking ‘I wish I had moved to the other side of the world when I was 102.’ “

There’s the message. Do it NOW!

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Growth as in better not bigger

Posted in from the reading room, life, personal growth on January 6, 2008| Leave a Comment »

In Charles Handy’s Empty Raincoat he tells a story of speaking to a successful winemaker in California. He asked this man what he hoped for in the future and he said he wanted to grow his business. Handy could see that the valley was already full of vines and couldn’t see how the business (a vineyard) could grow bigger there, so he asked the man, sharing that thought. Oh no, said the winemaker, growth is not making it bigger, it’s making it better.

I like that story.

Growth is an essential principle of life. If we stop growing, we stop living. And I don’t mean just waist size! Growing for a human being should be about growing better – increasing your knowledge, your skills, your wisdom, your pleasure, and your sense of purpose.

Here’s my wish for you in 2008 (I’m writing this on January 1st) –

May you grow this year. May your life grow better in the ways that matter to you.

May you know that you are a hero, not a zombie!

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Charles Handy’s Doughnut

Posted in from the reading room, health, life, personal growth on January 4, 2008| 1 Comment »

Another of Charles Handy’s useful concepts from his Empty Raincoat is the ‘doughnut principle’. He says to imagine an American donut (see how I changed the spelling to the American one?) but to invert it so that instead of a hole in the middle, you have a core, and outside of the core you have an area bounded by the donut’s edge.

He says the core is what’s essential. It’s the agreed given of a job, or a project, or a person. And the outside of the core is the potential. The potential is variable and you can develop as much or as little of it as you want. But it does have a boundary, or a limit.

Without a boundary it is easy to be oppressed by guilt, for enough is never enough.

This is a good model in health care. The core might be the essential health outcomes you’d hope to achieve eg a normal blood pressure reading, but the outer ring of the doughnut represents the potential which might be achieved – how might this person’s health be improved, not just their blood pressure?

Societies which overemphasise the core can be too regulated.

This is his warning and it’s so true. It’s the danger inherent in a system of targets in health care. The ‘Quality Outcomes Framework’ at the heart of UK General Practice is the core, but if it consumes all of the doctors’ attention and energies, we’re going to lose an awful lot of good medical practice that sits out there in the potential.

There’s also something in this idea of a core which reminds me of the concept of virtues, where the focus is on developing character rather than on tasks and duties.

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