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Inequality

November 15, 2013 by bobleckridge

inequality

What’s wrong with this picture?

Is this degree of inequality a problem? Is it sustainable? Should we try to address it?

Posted in from the living room, from the reading room, life | 1 Comment »

What is it to be a man?

November 14, 2013 by bobleckridge

Blind Light1

Fritjof Capra, in his “the hidden connections” refers to anthropologist, David Gilmore, who studied images of men, or male “ideologies” in many cultures around the world. He found interesting, consistent themes.

Gilmore found that in culture after culture, ‘real’ men have traditionally been those who produce more than they consume. The author emphasises the ancient association of manhood with material production meant production on behalf of the community. ‘Again and again we find that “real” men are those who give more than they take; they serve others. Real men are generous, even to a fault.

I think that is striking – producing more than you consume for the benefit of the community sounds an excellent ‘manhood’ quality to aspire to. He goes on to say that over time this image has changed, so that now it is common to see the ‘big man’ as the one with the greatest personal wealth and most power over others. Sadly, I guess that’s the image we are more familiar with these days.

So here’s what I’m wondering…….how did that change? And why? How did the image of manhood change from one who serves and provides to one who hogs the most for himself and exerts power over others?

Those questions, naturally, lead me to wonder what we can do (if anything) to reclaim the ancient images of ‘real’ men, and to encourage boys to become such ‘real’ men…….

Posted in books, from the living room, from the reading room, life | 1 Comment »

Mindbody

November 13, 2013 by bobleckridge

twostone1

twostone2

I was gifted this stone recently.
I love it’s yin yang quality of inextricably bound black and white. You can’t have one side without the other. You can’t separate one side from the other.
This is what the “mind body” idea is to me. I don’t tend to use the term “mind body” because I don’t accept it’s duality. I don’t accept the implication that mind and body are separate/separable entities.
We live with our whole being. We become ill in our whole being.
Health involves the coherence of the whole organism, not just a part of it. Aren’t mind and body just two different perspectives on a person? Each with its own qualities, but each inseparable from the other.

Posted in from the consulting room, from the dark room, health, life, photography | Leave a Comment »

Patient centred-ness in Integrative Care

November 12, 2013 by bobleckridge

Facing the Med

There’s a lot of talk around just now about “patient centred care”. It’s one of those concepts that nobody argues against. In fact, pretty much everyone claims to be doing it. If that’s true, then it must mean different things to different people. Or it must have so many aspects, that different people resonate with the concept because they understand and value one of those aspects.

There’s a vast and growing literature on “patient centred care” but I’d like to make a contribution to the debate. I’m writing here from the perspective of a generalist, holistic, integrative doctor. I work at the “NHS Centre for Integrative Care” which, we claim, is a patient centred service within the NHS.

Some health care services are disease centred. There are Diabetic Clinics, Asthma Clinics, Hypertension Clinics and so on. These are specialist services where only people with particular diseases are seen, and where progress is measured primarily by measuring changes in the disease activity.

Some services are therapy centred. When you attend one of those services, only particular therapies will be used, no matter what your diagnosis, or who you are. The two biggies are surgery and drugs. Most services are designed to support the delivery of one of those two therapies. “CAM” (“complementary and alternative medicine”) clinics are often therapy centred too. Acupuncture Clinics, Osteopathic Clinics, Homeopathic Clinics etc. When you go to one of those you will see someone who has specialised in that particular therapy, and they will try to help you using that therapy.

Integrative Care is a patient centred therapy. It delivers individualised, multidisciplinary care using a range of different therapies, based on a holistic, personalised understanding of the individual patient. It is generalist, in that it is not limited to patients with specific diseases, and it is integrated in that it is not limited to the use of one particular therapy.

Now, I’m sure, there are many who will explain why their disease-centred, or therapy-centred service is also patient-centred, but I hope it’s helpful to clarify why an “integrative care” service cannot be defined by either the therapies used, or the disease diagnoses of the patients attending.

Posted in art, creativity, from the consulting room, from the dark room, from the living room, health, life, photography, Uncategorized | 3 Comments »

Patterns of the planets

November 11, 2013 by bobleckridge

The other day I came across, in David Wade’s beautiful “Crystal and Dragon” book, a little drawing of the paths each planet takes (relative to Earth) and, apart from making me want to dig out an old “spirograph”, I thought it was simple but wonderful.

planets

 

There are patterns everywhere, and we human beings seem to be particularly good at spotting them.

There is diversity and uniqueness everywhere. In the cosmos, in the solar system, on our planet, Earth, in every living organism.

Posted in books, from the reading room, life, science, Uncategorized | 3 Comments »

A luminous pause

November 10, 2013 by bobleckridge

clouds

Jung said

life is a luminous pause between two great mysteries

James Hollis, in “The Middle Passage” ends that book with

A great mysterious energy is embodied at conception, bides a while and finally goes away. Let us be gracious hosts, let us consciously assent to the luminous pause

Isn’t that wonderful?

Posted in from the dark room, from the living room, life, photography, psychology | Leave a Comment »

Direction

November 9, 2013 by bobleckridge

floating petals

I came across this statement the other day

You can’t direct a living organism, you can only disturb it.

I think this is such an important truth, yet we lose sight of it all the time in health care.

Our current reductionist, mechanistic model of living organisms has resulted in our unsustainable version of health care, based on the premise that diseases are entities which can be defined, isolated, attacked and removed, using “evidence based” interventions which are certain to produce the outcomes demonstrated in clinical trials.

Life, of course, isn’t like that. The intended “outcomes” are difficult to achieve, impossible to predict in individuals, and turn out not to be the end of the story when life carries on.

Why is that?

One reason, it strikes me, is because you can’t “direct a living organism”. You can’t control a living organism. People aren’t like cars. Living beings contain many, many parts (cells which work together to create tissues, organs and networks), but those parts relate to each other in non-linear ways.

Simply, that means that doing X to Y will not predictably produce Z.

The failure to remember that leads to polypharmacy where each “evidence based” drug is prescribed to direct a part of the living organism – the heart, the brain, the lungs, the stomach etc – but when that part changes under the influence of the drug, it’s relationship to the other parts changes – unpredictably (and the drug, which is not specific to the part it is trying to direct, produces changes in many other parts at the same time)

If we remember that we can only “disturb” a living organism, not “direct” it, then we are called to be more humble, less certain (and so more aware, more reflective at every stage), and more holistic.  We are called to constantly return to the focus on the person, on this unique individual we are caring for, and to assess, with them, how life is changing as a result of this “disturbance”.

We can’t control individuals. But we can disturb them, and then ask with them, how is life now? What direction is life taking?

Posted in from the dark room, from the living room, life, photography, Uncategorized | Leave a Comment »

Hope

November 8, 2013 by bobleckridge

the colour of light

Václav Havel said

[Hope] is not the conviction that something will turn out well, but the certainty that something makes sense, regardless of how it turns out.

One of the commonest things patients tell me is that our work together has given them hope. That’s always very heart-warming feedback, because without hope, it is difficult to live.

But reading Havel’s statement about hope not being “the conviction that something will turn out well” got me thinking. I suppose because I completely agree. I don’t think hope is about giving people the conviction that all will be well. How could anyone give that guarantee after all? The future remains unknowable….whether we are well, or whether we are sick.

But if hope is not about believing a disease will go away, what is it? Havel says it is the “certainty that something makes sense” and I think that is right. One of the values of integrative practice is that it is sense making. Taking a holistic, individualised approach to a person, listening empathically and non-judgementally, with full attention and acceptance, sets up the potential for understanding – for the practitioner to understand the patient, and, for the patient to understand themselves, their illness and its place in their life. Understanding is sense making.

I think hope is something else too, though. A lot of people who consult me feel stuck, trapped, suffering, or in despair…..they are scared that this is now how life is going to be. Hope emerges when it becomes clear that change is not just possible but probable. Havel uses the word “certainty” and as the future is unknowable in detail we can’t offer certainty about specific outcomes.

But change is one of life’s certainties. As every individual is actively involved in creating their own experience, hope emerges when we realise life can be different, and that our choices can influence how different it can be.

Posted in from the consulting room, from the dark room, from the living room, health, life, personal growth | 1 Comment »

the direction of your dreams

November 7, 2013 by bobleckridge

sunset

 

Thoreau writes, in Walden –

I learned this at least, by my experiment; that if one advances confidently in the direction of his dreams, and endeavors to live the life which he has imagined, he will meet with a success unimagined in common hours.

There’s a lot in that sentence. Does it inspire you? If it does, what does it inspire you to do?

It inspires me to become more aware of my dreams (and to try to distinguish my dreams from the dreams I’ve acquired). It inspires me to experiment, to see whether or not I’m surprised by how well those dreams can be realised if I take action – if I choose to “advance” in the direction of my dreams.

Posted in from the dark room, from the living room, personal growth, photography | Leave a Comment »

The dynamic, flowing, rippling story of YOU

November 6, 2013 by bobleckridge

water green from reflected leaves

I love stories. I love the stories I hear every day in my consulting room. New stories. Amazing stories. Unique stories.
Years ago, when I started this blog, I called it “Heroes not zombies“. My hope is that what people read here will inspire them or stimulate them to wake up, reflect, and create a brand new story. In the story of YOU, you are the hero.

James Hollis in his “Creating a Life” says this about stories –

Each of us lives out a story, a dynamic narrative whose only consistency is that we somehow show up in each of the scenes…….The gods set things in motion, but the choices are ours. The sum of those choices, and their consequences which may ripple through generations to come, is the story of our life.

What story are you living? And what story will you choose?

Posted in Uncategorized | 1 Comment »

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