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Archive for the ‘psychology’ Category

I came across a Royal College of General Practitioners document recently – “Fit for the Future” – It is a vision of General Practice in the UK for 2030. There is a lot in it that I’d support but one of the statements is this –

An overhaul of the GP-patient record into a personalised ‘data dashboard’, accessible by healthcare professionals across the NHS, and that will draw on data from the patient’s genomic profile and wearable monitoring devices.
Now, maybe you read this and it excites you, but it made me stop and think “Hang on a minute! A ‘data dashboard’?”
I remember a line from the English philosopher, Mary Midgely, in her book, ‘Wisdom, Information and Wonder’.
One cannot claim to know somebody merely because one has collected a pile of printed information about them.
She wrote that back in 1989, and it’s clear that, since then, we have, to some extent, replaced the piles of printed information with hard drives full of data. But the point remains the same – you won’t know somebody just by looking at data.
One of my roles when I worked at the ‘NHS Centre for Integrative Care’ in Glasgow was to train young doctors in holistic practice. They’d be allowed to spend as long a consultation as they wanted with a patient then they would come to “present the case” to me. In other words, they’d consult their notes (often several A4 pages of notes) and tell me what they’d learned about the patient. At times what they actually communicated to me were detailed descriptions of the patient’s symptoms. Sometimes so many symptoms in such detail that the amount of information was quite overwhelming. By the time they’d finished I would find myself saying “Well, you’ve told me a lot but I don’t know who this person is'” I had no picture of the patient, their life, how illness came into it, how they’d coped, or the effects the illness had had on them, their family and their friends. A holistic case history is not a “pile of printed information”.
Data, or information, as Midgley pointed out, makes “much better sense when [it has] a context”. The context is revealed by the story. I don’t see how you fully understand a person without hearing their story.
Yet, one junior doctor told me she was being taught elsewhere “Never believe patients. They lie all the time. You can only believe the data” (meaning the results of investigations). That appalled me. What kind of Medicine can we practise if we think “patients lie all the time”? What kind of Medicine can we practise if we distrust their personal, unique stories, but trust only in “data”?
Now, I’m not saying that data isn’t useful. It can be. It would be daft to ignore that. But putting data up front and centre to the point where it replaces the relationship and the story? That’s my fear. That someone will think, “all we need is good algorithms and they will deliver all the right answers once we feed the data in.”
I’m sceptical. It doesn’t seem rational to me. It doesn’t seem realistic to me. And it risks shoving aside human values and the crucial importance of relationships.
Then, just yesterday the UK Health Secretary, Matt Hancock, put forward an aspiration for every newborn child in the UK to have their genome sequenced.  Interestingly, a poll of doctors revealed – “>2000 responses. Only around 10% of doctors would find genetic data more useful than postcode in planning the care for a newborn baby.”
I think we have to claim the ground for the importance of the unique human story. If, as doctors, we fail to consider the environments and circumstances of an individual life, we will fail our patients.
Data without contexts has some use, but it is not a full understanding of, or even a “knowledge of”, a patient.

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I get the chance to see a lot of lovely sunsets in this part of the world. I find them compelling. Every time. I just catch a glimpse of pink in the sky and I’m up looking out the window for a better look, then, as often as not, picking up my camera and heading out to the bottom of the garden.

Well, the other evening there, I just framed the shot, but as I pressed the camera shutter release I slipped a bit. When I checked the LCD screen at the back of the camera I could see the picture was very, very blurred, but decided to keep it and look more closely once I’d uploaded it onto my computer.

Look what I saw…..!

Well, I know, you could argue this is a mistake. You could argue that I failed to capture the sunset as it “really” was. But I absolutely love it.

See how the red colour pours over the vineyards as if it is a pink fog (there wasn’t any fog there.)!

It’s like a painting….a watercolour with the water seeping over the canvas.

It seems transcendent to me – transcendent in the sense that the boundaries are dissolving. There are no hard edges. No barriers. No limitations. It looks fluid, flowing, dynamic, evolving before my eyes.

I started by thinking I’d made a mistake.

But it turns out I’d made something unique. Something I’d never made before. Something very, very pleasing.

What does that say about “perfection”?

What does that say about “creativity”?

What does that say about “serendipity”?

When I saved the image to my hard drive I started to name it, and, without really stopping to think or consider, I named it “Red shift”.

PS that title takes me right back to 1974 and album by Peter Hammill….The Silent Corner and the Empty Stage

Funny the way the mind works…….

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See this large rock just above the harbour in Biarritz? How does the sea make it to the shore when this rock is in the way?

The most obvious way is to go around it.

And that’s what most of the water does. It makes it way towards the shore, and back out to sea again by breaking against the rock and flowing around each side of it.

That’s one way to deal with an obstacle, with something standing in your way…..find a way around it.

But, wait, look at this…..

…the water has found another way as well.

It goes THROUGH the rock!

I suspect this has taken a very, very long time for wave after wave to make its way through a small crack in the rock, widening the gap slightly every time it passes through. But look at it now. Sometimes when a more substantial wave hits the far side of the rock it flows directly through the gap. Doesn’t happen every time. Just when the waves are big enough.

So, there’s the other solution. Keep going. Keep pushing up against the obstacle, looking for a gap, an opportunity, a way through, and once you find it, come back again and again. Each time, it’ll get easier. Each time the gap will get wider, the way will become broader.

Something else…..this is just beautiful to watch. Mesmerising even. Over the course of a few minutes you can see how the rock and the sea sculpt each other. It’s a delightful relationship.

Oh, and something else……Michel Serres, a French philosopher who died recently, used to describe human beings as “anticipation creatures”. I recently listened to an episode of one of my favourite podcasts, Onbeing, where the science journalist, Erik Vance, talked about “the drugs inside our head”. He was discussing the poorly understood but fundamentally important phenomenon known as the “placebo effect”, and one thing he said was that our brains are “prediction machines” (well, I hate the metaphor of “machine” applied to living organisms, but you get the point…).

Both Serres and Vance are talking about our incredible ability to spot patterns, so that we can predict the future. OK, not too far into the future, and not with 100% accuracy, but we don’t just notice the world, we anticipate it.

As I stood watching this phenomenon of the white surf gushing out of the mouth in the rock, I was quickly captured by the experience of anticipation, watching the swells on the surface of sea further out, trying to predict which would turn into waves big enough to pour through the rock.

It was hard to stop.

It was delightful.

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We humans are pretty good at making maps. We do it all the time. Dr Dan Siegel, a psychiatrist and neuroscientist, describes the three commonest maps we make in the frontal cortex of the brain – a “me” map, a “you” map, and a “we” map. You might wonder about the use of the term “map” there, arguing that we create “images” rather than maps, but let’s not get bogged down on that one. I like both terms (one of my favourite principles in life is “and not or” – 🙂 )

The thing about a map is that it shows contexts and connections. It shows us where we are, where we might want to go, and helps us to imagine how to get there.

I was in Tordesillas, in Northern Spain, recently and visited the “Treaty House” which displays a number of ancient maps. Here’s one set which particularly grabbed my attention.

It’s a set of panels describing the known world at the time – the world of the “Occident” followed by a set describing the unknown world – the world of the “Orient”. Take a look –

In this first section you can clearly make out Britain (although Scotland hasn’t really become known yet!) and you can see the areas we now call Portugal, Spain, France, Scandinavia and so on.

The next one extends the first one to show Italy, Greece, Turkey, “The Middle East” and also more of the North African coastal countries.

For a medieval map it’s surprisingly accurate. It might even have helped people to find their way from one place to another.

But then check out these two panels of the “unknown”, “Orient” –

At first there are elements we recognise – The Nile, The Caspian Sea, but the further East we go, the more the map becomes an expression of a creative imagination.

Isn’t that fascinating?

I’ve never thought of mapping out what I don’t know before. After all, where would I stop? The older I get, the more I realise how much I don’t know – how much WE (we humans) don’t know. But it might be a fun idea, don’t you think? To sketch out some maps of the unknown…..

The personal maps of “me”, “you” and “we” are constantly being updated, constantly evolving, and we create them from both what we know, and what we don’t know…..from our memories, our present day experiences, and our imaginations.

Map making turns out to be a dynamic and fundamental ability. I wonder how aware we are, on a day to day basis, of the maps we have made, the maps we are making, and the influence they have on our lives.

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Here’s a common experience I have.

I’ll be sitting in my garden reading and I hear a very high pitched, very distant bird call. I recognise it immediately now, even though I’d never heard it before moving here five years ago. It’s a buzzard. Although the call is quite faint, it catches my attention every time. I’m sure that’s helped by how often it’s silent here surrounded by the vineyards. (Although on other days the machines of viniculture create quite a racket, and a nearby airbase sends up training flights some days more than others)

When I hear the call of the buzzard I look up and peer into the sky to try and locate the bird. It’s not always easy because very frequently they fly so high they appear as just small black dots.

I saw this particular one and whilst often the buzzards circle and swoop on invisible highways in the air, this one appeared to be completely still. It was just hanging there, the way I often see the kestrels do, although they do that much closer to the Earth than the buzzards do.

So I took a photo with my phone.

Can you spot the buzzard?

Hey, it’s a bit like a competition I used to do with my dad. One of the newspapers would print a photo from a recent football match but with the ball removed from the image. You had to place a cross right on the dead centre of where you thought the ball was. The person who got closest won the money. It was called “Spot the Ball”. Well, this is “spot the buzzard”.

Answer at the end of the post ………..

Once I found the buzzard I started to wonder how it could just hang like that in the air. I started to wonder how it could fly with such apparent little effort. I started to wonder why it cried that particular call. I started to wonder what the world looks like from up there. How much detail can the buzzard see? Why does it fly SO high in the sky?

Wonder.

Everyday wonder.

I’ve referred a number of times to the French phrase “émerveillement du quotidien” which I love so much. It pretty much means “the wonder of the every day”. I find that when I get one of those moments, those moments of wonder, that my day feels a better day.

I find that the wondering connects me to awe.

I feel awe….astonishment, delight in, admiration for, whatever it is I’m wondering about. Not least because the wondering doesn’t have any immediate answers for me. Well, obviously, sometimes, the wonder drives curiosity and I later go searching online or in books for more information about whatever it is I’ve been wondering about. But that’s something different, isn’t it? Curiosity and knowledge-seeking. There’s just something delightful, uplifting even, about the process of wondering which doesn’t immediately drive knowledge-seeking, but, instead, creates a feeling of awe.

And here’s what happens next. When the wonder blends with awe I feel myself “taken out of myself”. I have an experience of transcendence…..what Arthur Koestler described as an “oceanic” feeling. I feel an increased, and deepened, connection with whatever is “outside” me, whatever I’m paying attention to. I feel an expansion and a loosening of boundaries. I feel a diminishment of separateness and an enhancement of oneness.

So, I wasn’t surprised when I read yesterday about “spiritual emotions”, especially as they were listed as follows –

  • Wonder
  • Awe
  • Transcendence

What sets off the spiritual emotions for you?

 

Oh, and, yes, as promised, here’s how to find the buzzard………

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Sometimes when I look out over the vineyards I can see the rain coming. Like a swathe of grey chiffon dropping down from clouds in the sky to soak the green vines below, or like the wet fingers of the rain gods lightly stroking the face of the Earth.

It’s quite beautiful.

It’s like change manifesting itself, the future showing its hand.

Of course it means it’s time to take the washing in from the line, or to head indoors until it passes, but sometimes, it just appears, then disappears again. I can see it just there on the other side of the vines, then within a few minutes it’s gone, never having come this way at all.

It’s a daily reminder that the future is not predictable.

The French philosopher, Michel Serres, wrote that human beings are creatures which anticipate. He said we are always looking ahead, imagining what might be there, what might be coming our way. I think there’s a lot of truth in that. I know that if I stop to watch my thoughts for a while, some of them are memories, some are old patterns of thought passing through again. But often they are anticipations, thinking ahead to later today, to tomorrow, to next week, month or even the years ahead. None of which exists yet. None of which I can be sure of.

In fact, I’d say that even when I am practising a focus on the present I discover that much of the here and now content of my mind is anticipation – planning, expecting, wondering what if this, and what if that, anxieties or fears, hopes, desires or longings.

Isn’t it strange that we give such attention to the unknown, and unknowable, future?

Yet, isn’t that perhaps one of our greatest strengths? The one which gives us not only the ability to plan, but the power of creativity? The one which enables us to imagine another world? Isn’t that where we get our ability to be prepared, as well as our ability to be active agents of the future?

Wondering what’s coming next isn’t necessarily all about worry and fear. It can enable us to cope, to adapt. And it can allow us to manifest our own creations.

 

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See this little bird? She’s a redstart. There are a pair of them who spend a lot of time in my garden in the summer months. I first spotted a male a few years back and was struck by his distinctive call. I even got to imitating it and “having some conversations with him” – well, I know, that’s pushing it a bit far. I’ve no idea what he was telling me and I suspect he had no idea what I was telling him. After all, I’m not even sure, myself, what I was telling him! He disappeared over the winter and then reappeared the falling Spring. I heard him before I saw him, and I had a hunch he recognised me.

Can wild birds recognise individual human beings? I read a report of a study recently which suggests that they can. I can’t say that surprised me. I have a strong feeling that we have become familiar to each other.

Since then he’s come back every summer and this summer, in particular, his partner has been about a lot too. I find that pretty much any time I go out into the garden to sit and read, that within a few minutes one of the pair, or occasionally, both of them, turn up nearby, watch me for a bit, then hop down onto the grass, getting ever closer, before nabbing a fallen mulberry or something and flying off.

This photo here is a rare success. As I sat with my book I noticed her on the fence post and slid my phone from my pocket to grab a quick shot. Then she flew off.

Now, I have no idea how much of this is my imagination but I do get a good feeling when one of these little birds comes to join me for a few minutes. And that got me thinking about the importance of relationships in life. How important it is for us to form and experience bonds, not just with other people, but with other living creatures, whether they be birds, trees or flowers!

I think these bonds we form have a special quality. They enhance life, they add flavour to the ordinary day, they “enchant” us. Literally. So how do they come about? Well, I’ve got a theory.

They come about through a particular kind of attention – “Positive Intention Attention” (PIA) – I think when we pay attention with positive intent that we create bonds, bonds of mutual benefit, “integrated bonds”, healthy, life-sustaining, life-enhancing bonds. That’s what I mean by “positive intent” – an intention to create bonds of mutual benefit.

So, I’ve decided that’s what I want to do more of, every day – pay Positive Intention Attention to the experiences, events and phenomena of the every day – and, by doing that, I have a hunch, the every day will become just that bit more extra-ordinary…..

 

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