On doctors and other divas

It came up in the comments that doctors might have an implied dispensation from communicating with empathy to their patients. I think many people, not least many doctors, would hold this view.

It’s based on a number of unexamined assumptions.

1. Skill or service or efficiency is not concerned with empathy or relating.

2. Not only is skill or service or efficiency not concerned with empathy or relating, they are in contradistinction; more of one guarantees less of the other.

3. Empathy or relating is a “nice-to-have”; it’s the icing on top but makes no appreciable (read, measurable) difference in the execution of a skill or service, nor in the world generally.

There’s also a fourth underlying assumption which Seth Godin notes (how great is this guy? Posts seven days a week, produces potent little gems most):

4. Trapped in the “scarcity model” of thinking, we assume if someone is truly gifted they don’t have the “time or focus to also be kind or reasonable or good at understanding our needs”. In short, a “diva” is great because she is a jerk.

All these types of assumptions are markers of the “scarcity model” of thinking, the conception of the world in which everything is finite. They are also markers of a conception of the world in which a fatuously mechanistic cause-and-effect operates.

It’s all nonsense, all a fundamental delusion about the world and the way it works, and people like Professor Jody Hoffer Gittell are illustrating it.

***

Professor Gittell is Professor of Management at Brandeis University in the US, and on a recent trip to Australia she shared her findings about the determinants of performance in the airline industry and hospital sector.

Professor Gittell looked at the organisations in each sector that performed well and those that performed less well, and distinguished three parameters as being vital to the performance differential:

  • shared goals
  • shared knowledge
  • mutual respect among workers.

So what? we might ask. We could all intuitively predict the presence of these factors, or factors like these, may lead to increased performance in an organisation.

Her findings are startling in showing the degree to which these factors make a difference. In fact, in the hospital setting, she finds these factors – factors which pertain to what’s happening outside the operating theatre – to be the greatest determinant of the effectiveness of the hospital, the satisfaction of staff and the patient outcome.

She has now shared her model of organisational performance which she calls “Relational Coordination” with many hospital systems around the world. And all over she meets with the same startlement, the same evidence of our delusion about the way the world works. As one UK surgeon, a little less invested in his amour propre, said to her:

It’s really hard to get it’s not what we’re doing in the operating theatre that determines the outcomes.

***

For more information about Professor Gittell, go to her website or to the Relational Coordination site.

Conversational polka

He was funny and theatrical and I was having a good time talking to him. Then I started to notice that every so often he would make a bid to lead the conversation into the “downward spiral“* and that his poison of choice was politics. What else?

When I noticed it, I decided I was not joining him. I felt too full of happiness that day to be taking no low road.

The first time it happened I mildly acknowledged one of his points, and he was satisfied. At least for a bit. Second time it happened, I offered nothing. Third time it happened I decided I had to enter the dance in earnest. I started a conversation for possibility instead and invited him into it.

At some level he registered the deviation, and was big-hearted enough to choose to follow my lead. He tried the old gambit once or twice more, but his heart wasn’t in it now, and each time I just invited him back into the conversation for possibility. We talked and laughed for hours, and both of us felt exhilarated when we said goodbye. As Homer S would say, we were “embiggened”.

***

In the past, I was a downward-spiral-talking addict. I would do whatever it took to get people to talk doom and gloom with me. I still remember the kind of voluptuous hunger I felt to participate in yet one more session, and the twinge of triumph I’d feel when the old familiar strains would start up.

Nowadays, it’s different. My default position is that I’m not engaging in such conversations. Some days, I forget and get caught up in it again, but most days I’m not going there.

The impact of the downward spiral conversation is vicious. It disempowers the direct participants, and through them, proliferates in the conversations of all the people they come in contact with. It kills the possibility of anything new. It makes us immensely boring to ourselves.

If someone starts a downward spiral conversation in your vicinity:

  • disengage by saying something like, “this topic makes me feel disempowered [or unhappy or demoralised, etc]; I’d like to talk about another topic”, or
  • start a conversation for possibility.

***

* Rosamund Stone Zander and Benjamin Zander, The Art of Possibility

Image: Conversation by Piet Noest

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Resurrections

“It’s a life of crucifixions and resurrections,” said the priest. “Of course,” I thought, “that’s what Easter means.”

***

Last weekend, my mother’s quilting club put on their bi-annual quilt show. It was held in a white art gallery overlooking a bay. The sun was out, the gardens just starting to turn gold.

They’d set up a table selling raffle tickets at the local shopping centre in the preceding weeks, and on the morning of the opening one of the club members talked about the show on a major Sydney radio station.They were overwhelmed with visitors, some who’d driven for hours. The gallery staff were caught off guard. Having advised the club they could not provide their own tea and cakes, the cafe was now overrun with quilters desperate for a cup. The queues persisted for hours.

My mother had several of her quilts on display, as well as three quilts for sale. So many were the quilts, they had room to hang only one of the quilts she had for sale; the others were merely draped over the nearest spare object.

She could have sold the quilt on display at least 10 times. She had people fighting over it, and scores of people asking her about the colour palette and technique. Afterwards, she had a phone conversation with the woman who bought it and the woman told her she had come to the quilt show with an academic in textiles who had described the quilt palette as outstanding.

It was the same story with the quilts that weren’t even hung. She had numerous offers for each. One woman, on learning someone else had just bought the quilt she wanted, asked my mother if she would take a commission to make another. In fact, my mother not only sold all the quilts many times over, she got several requests for commissions and offers for the quilts which weren’t for sale.

My mother and her quilts were the talk of the show.

***

My mother will turn 80 this year. For most of her life, she has considered herself shy, and she frequently suffered in social settings. She was often unhappy and frustrated. Then about 12 years ago she discovered quilting and her life has been transformed. She found something that satisfied her need for creative expression, for passion, for friendship and sociability, and since then everything’s been different.

My father died in July 2010 after being married to my mother for 51 years. The first nine months were awful, and I feared for her life too. Now I see she’s turned a corner. Another resurrection has occurred.

***

Image: The classic Roebuck quilt (not my mother’s version)

Choose your reason for being sacked

Curious story in The Age yesterday* about a case before the Fair Work Ombudsman involving a young woman who was sacked from her job as a personal assistant for a real estate agent because she was “too short” and “looked too young”.

She had been in the job two weeks when she was dismissed. She had recently assisted at an auction by recording bids, and in a phone conversation one of the directors of the company told her her height:

could be a disadvantage at an auction where there was one or more interested parties and she would not have the presence to effectively negotiate.

Another director emailed her to say:

Some of the directors at the auction on Saturday were worried by your overall young look. This will be an ongoing concern.

The Ombudsman fined the company for breaching the Fair Work Act under which it is “unlawful to discriminate against employees on the grounds of, among other things, age.” The company was also ordered to make clear to all their staff that federal workplace laws had been contravened.

What’s so curious, you ask?

What’s curious is that it came out in questioning that the reason given to the employee for her dismissal was not the real reason. The real reason, a director of the company admitted, was that the director who fired her

felt a little awkward admitting that he had very little on to justify an assistant and incorrectly used [her] age.

What’s curious is that neither the journalist writing the story, nor the Ombudsman, made any comment about the lie and the fact an employee was made to feel physically inadequate rather than have a director of the company feel awkward. Instead, the journalist and the Ombudsman concerned themselves only with the ostensible reason for the sacking. Why?

Well, for starters there are no fines for lying or being a jerk. Pity.

***

* Clay Lucas, “Sacked worker too short and too young”, The Age, April 2, 2012

The feared communication

So, I haven’t exhausted the topic of truth-telling yet. I’ve got something more to say.

A few years ago I took the series of courses known as the Curriculum for Living offered by Landmark Education. The first course in the series of three is the Landmark Forum; the second is a course known as the Advanced Course; the third is a course that stretches over 3-4 months which is called the Self-Expression and Leadership Program.

I’ve been a participant and a coach in the latter program, and there’s an exercise in the program that never fails to stun people. The exercise requires each participant, over the course of the program, to interview at least five people who are close to them. They can interview as many people as they like, but five is the suggested minimum.

The interview structure and set-up

The interview consists of five questions:

  1. What are my strengths?
  2. What are my weaknesses?
  3. What can you count on me for?
  4. What can’t you count on me for?
  5. If you were speaking on behalf of the people who know me, how would you describe me?

Participants are carefully coached on preparing for the interviews. They are told when inviting someone for an interview, they are to make it absolutely clear that:

  • the interviewee is free to say whatever he or she wants to say
  • the interviewer is eager to have an absolutely truthful conversation
  • regardless of what the interviewee says, the interviewer will not react to, nor in any way, dispute their answer.

Participants are encouraged to invite their nearest and dearest, as well as their nearest and not-so-dearest, into an interview. People generally interview their husband or their wife, their siblings, their parents, their bosses, their friends, their work colleagues and so on.

Interviews can be conducted by phone, or face-to-face.

The outcome

As you’d expect, many people are terrified at the prospect of this exercise. Some put it off until the very end of the program, some don’t do it.

Most people, however, do take it on, and listening to them talk about it is an extraordinary experience. People who might not have said a word for the entire 3-4 months, stand up and talk about what their boss said to them, or what their wife or their brother said to them, and they are exhilarated. “I was expecting something really negative and it wasn’t at all! What a surprise!”, they usually say, their faces lit up, their whole body moving freely.

What’s happening here?

The relief is huge. But why relief? Because we spend our lives fearing a certain communication is about to come our way. You know the one I mean. That certain communication you think is designed just for you that you feel might very well kill you if you heard someone saying it to you.

So potent is the fear of receiving this communication, we design our lives to make sure no-one ever says it. For example, we enrol in endless courses and proudly insist on our teachability to ensure we never hear someone telling us we’re dogmatic or closed-minded, say.

When participants do the interview exercise, they discover without fail that the feared communication is not there. Interviewees inevitably say something quite different.

Multiple effects

The exercise generates multiple effects, not merely the relief of not hearing the feared communication.

It also uncovers any unfinished business between two people. Because participants quickly realise it’s impossible to invite a person for an interview, or in some cases, to complete the interview, unless the unfinished business is addressed. Suddenly, it’s there staring you in the face and you have a unique opportunity to resolve it.

By far the biggest impact of the exercise lies in experiencing oneself as someone who is not afraid of the truth, someone who can handle truth-telling. For this reason alone, the exercise is priceless.

***

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Too little said, too much communicated

I’ve been thinking about this matter of lying that came up in the last post, and it occurred to me we operate under three assumptions when we’re considering whether to be truthful with others:

  1. Only what’s said counts
  2. The person to whom I’m talking is small and fragile and couldn’t possibly handle the truth
  3. No-one will know I haven’t been truthful if I just say nothing.

1. Only what’s said counts

We have it that we’re not communicating if we’re not speaking. Wrong. The unsaid is communicated, and the unsaid shouts louder than the said. Not only does the content of the unsaid shout, the fact of it does too. All of us are geniuses of the first order when it comes to knowing something is there, something is off. As the great US novelist, Anne Tyler, has one of her characters say of his family situation:

Too little said, too much communicated.

And saying something rather than nothing doesn’t change the equation one jot if the something is not the truth. Withholding the truth and giving a “white lie” instead is still a case of the unsaid. The fact of the lie, the fact of the withholding, registers. It registers in the speaker and in the other person and in the world.

The world is not merely the said; it is also the unsaid. The world is not merely the things; it is also the non-things. The world is not merely being; it is also not-being.

2. “They are small and fragile and couldn’t possibly handle the truth”

Only one thing to say here, and I’d suggest a mirror would come in handy. Who is small and fragile and not able to handle the truth?

All of us are large and able. Unexpected wonders occur when we give up our listening of others as small.

3. No-one will know if I haven’t been truthful

Wrong again. You’ll know.

***

Image: Photograph by George Roder

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Good-looking

There’s a passage by the best-selling author and philosopher, Alain de Botton, that makes me laugh like … well, “like a parent on the opening night of a school play.”

… my priority was to be liked, rather than speak the truth. A desire to please led me to laugh at modest jokes like a parent on the opening night of a school play. With strangers, I adopted the servile manner of a concierge greeting wealthy clients in a hotel … I sought the approval of figures of authority and after encounters with them, worried at length whether they had thought me acceptable. When passing through customs or driving alongside police cars, I harboured a confused wish for the uniformed officials to think well of me.*

Priceless. I see myself as an seven-year-old walking down the street in a new dress with my mother and sister, holding my sister’s hand for once, preening and thinking to myself  “Everyone will think we’re so good.” Or my father, driving the five of us, telling us to “sit up straight” as we passed a police car.

Wanting people to think well of us, wanting to look good, is universal, fundamental and the root of much anxiety and difficulty. It was running the show in a story I heard yesterday.

***

A writer was invited to speak at a conference about happiness and its “causes”. For some time leading up to the event he was worried because he did not feel happy. How was he going to speak on happiness to 1,000 people when he was feeling unhappy?

The event went ahead and he spoke on this and that, and did not come clean that he was struggling. A little while later he did come clean, though not with the original audience. He confessed to his blog audience instead, and his unhappiness over the lie was still palpable.

His story has a number of interesting angles. You can look at it from the angle of integrity. From everything this man has written in the past, the absence of integrity will be eating him alive. It also vividly demonstrates our desire to look good. It was so strong in him, as it is in all of us, that it overrode his desire to be honest, even though honesty is what he regards as the “calling card” of all his writing. Do you get that? His desire to look good at the conference – his desire to be seen as a happy person – trumped what most mattered to him, the very essence of his identity.  Small wonder he’s feeling miserable.

There are a number of things he can do to restore his sense of self, but that’s a post for another day.

Consider that true freedom, true peace of mind, happiness even, lies in giving up our desire to look good.

***

* Alain de Botton, The Consolations of Philosophy

More 360-degree foolishness

Susan Scott, author of Fierce Leadership, describes 360-degree reviews as one of the worst “best practices” used by organisations.

Feedback, she says, is invaluable. It’s just “the anonymous part that gets us in trouble”.

We’re like Woody Allen saying, ‘I’m not afraid of death. I just don’t want to be there when it happens.’

Similarly, we’re not afraid of feedback. “We just don’t want to be in the room when it’s delivered.”

Here are some of her issues with anonymous feedback:

  1. Anonymous feedback doesn’t tell us what we need to know because it is anonymous;  ie, “most people don’t provide specific examples to support their evaluations because more specifics might help the recipient guess who wrote it.”
  2. When the feedback is given, usually once or twice a year, it “rarely immediately follows the behaviour that generated the evaluations, so exactly what we did right or wrong [...] remains a mystery.”
  3. Mostly, such feedback “merely affirms what we already know about who we have been since the day we were born.”
  4. Anonymity is “addictive and contagious”; we “grow accustomed to withholding our real thoughts and feelings. We become anaesthetised, barely registering the consistent message our gut has been sending us for years: Tell the truth. And we infect others.”

Why can’t we be straight with our work colleagues? It’s very simple, though we cook up a storm of reasons and justifications to pretend otherwise. “No, no, they’d be too upset”, “He couldn’t handle it”, “She’s going through a divorce”, “He’d get uncomfortable if I praised him”.

Ah. There’s the clue, the “tell”, as Scott calls it.

Who’d get uncomfortable?

The simple reason for our reticence is that we’re addicted to safety, addicted to being comfortable. Even if it’s momentary, we avoid discomfort at all costs.

She asks,

What is it we fear?

And answers thus:

The consequences of authenticity – intimacy and vulnerability. We fear being real, being ourselves, disclosing our real thoughts and feelings, being seen, being known.

She concludes,

It’s time to change all that.

To read her manifesto about changing it, read the book or go to the Fierce website.

***

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360-degree cruelty

Earlier this year, when chatting with a client, I happened to mention I was writing a book about leaders. Instantly, the atmosphere changed, and the idle chit-chat became a real conversation. She told me a tale to make any employee’s hair stand on end.

In the previous year, she had had difficulties in the working relationship with her boss who had since left the company. She didn’t elaborate about the difficulties. Somewhere in the midst of the strife she had been asked to complete a 360-degree review.

A 360-degree review is an online survey which rates different aspects of an employee’s performance. It is sent to a certain number of people who are peers, “subordinates” and managers of the employee, the idea being it will provide various viewpoints – a 360-degree panorama – of an employee. The employee chooses the people to whom the survey will be sent, but does not know which person has given which response because the responses are anonymous.

The client did as requested and got a big shock. On the parameters purporting to measure emotional intelligence she scored close to the negative end of the spectrum. This was directly counter to her expectations. She said,

I was totally devastated.

She mentioned two other points:

  • as a result of the review a coach had been hired to help her raise her performance in specific areas
  • over a year later, she still puzzles about who said what, and why they might have said it.

I’ve thought about her story several times since I heard it. Here are some observations.

Institutionalised cruelty

360-degree reviews represent institutionalised cruelty. Franz Kafka wrote about modern man’s worst nightmare: the unspecified crime alleged by the unspecified accuser. And here we are, practicising the nightmare every day.

Institutionalised cowardice

360-degree reviews represent institutionalised cowardice. Such is the terror at the prospect of speaking to another human being in a way that’s straight and frank, a whole industry of cowardice has been concocted to avoid it.

The impact

A person treated in this way may be seriously impacted for months, even years, into the future if he or she doesn’t have the opportunity to get complete on the experience. In this person’s case, the coach may be able to assist her; however, at the time we spoke the emotional charge was still palpable.

How’s she left?

This person was big enough, courageous enough, to continue in her job, and since that time things have improved dramatically. The problematic manager has resigned and she admires her new boss. On the other hand, she is left unsure of where she stands with her colleagues and what they really think of her. That’s potentially crippling.

What about you? Do you have any horror stories of 360-degree reviews and other organisational instruments of torture? Add a comment or write me an email. I’m going to start keeping a file of them.

****

Image: From the movie, The Trial by Orson Welles, 1962, based on Kafka’s book

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Five kick-arse questions

A couple of years ago on this blog I discussed a woman who was going round asking people a question and turning their answers into a book (hey, books are created on a lot less). Now, I didn’t mind the idea; it was just the question that sucked:

Have you had a happy life?

I ask you. Is that not a dumb question? Not least because you gotta catch people on their deathbed it seems to me before you’d get a response. Who else would be strong enough to give an answer to that question, except the dying?

And if the past tense thing is not enough to make you squint, there’s still the whole beside-the-point thing. Really, there’s only one correct answer to this question and that’s “who cares?”

No, no, no, questions are precious jewels and have to be handled accordingly. Here are some not-so-dumb questions for your delectation over the weekend.

1. What does it mean to be?

Martin Heidegger was a philosopher with a very big insight, in fact, the biggest since about 500BC.

Consider that every time we say something like “I am confident”, “I am no good at numbers”, “They are stingy”, “John is always on time”, “My wife doesn’t understand”, “My son will never get a job”, “Muslims are x” or “Christians are y”, we are communicating our understanding of what it means to be.

Heidegger realised all these instances of the verb “to be”, all these is’s and are’s, indicated that we think of Being as something fixed and immutable in time and space. Not only that, he said, we’d been thinking of Being as something fixed and immutable since the time of Socrates over 2,000 years ago.

Before Socrates, Heidegger realised, it had been a whole other picture. The pre-Socratic Greeks did not think of Being as something fixed and immutable, but as an arising into presence, an arising and an abiding. The ancient Greek term is poïesis, from whence the word poetry, and it translates as something like coming forth, emerging.

What would life be like if we thought of people and situations as instances of poïesis, as instances of being which arise or emerge according to context, as mutable, malleable, contingent, something that can be called forth? Every time on this blog I seem to be saying something weird, or something you may not get, consider that this is where I’m coming from, or intending to come from.

2. What is Nature asking for?

When I read this question by Rosamund Stone Zander in The Art of Possibility I was stopped in my tracks. What is Nature asking for? Man, I love this question.

It occurred to her when she was out in a canoe “on a dazzling summer day off New England’s coast” and she found herself “not knowing how to cope with so much beauty.” What is Nature asking for?, she thought. The answer, when it came to her, “springing from a naive part of me”, was that it’s asking us to participate.

Her question, and answer she found, reminds me of a favourite, half-remembered quotation of a fisherman, from a Daphne du Maurier book:

his dull eye surfeited with undigested beauty.

3. How to live?

All the great writers are asking this question. The greatest of the great, such as Leo Tolstoy and Virginia Woolf, are asking it explicitly. Like all questions, only more so, it demands its asking, over and over again.

4. Who am I being?

This one’s the natural corollary of question 1. If what it means to be is not what we think it is, who might we be, now and in every moment? If being is not fixed in time and space, but is called forth, who or what might we call forth?

If I’m facing a difficulty — if I’ve lost my job, if my marriage is breaking up, if one of my children is in danger, if I’m facing illness, if I’m uncertain or I’ve lost my bearings — who am I being in the face of it? Am I being righteous, indignant, resentful, bitter, timid, passive, resigned, a victim? Or am I being trusting, powerful, resourceful, in action, courageous, mighty, loving, inventive, accepting, forgiving?

Who are we, who we be, is in our hands, not in our circumstances.

5. How do you stop the wind from coming through the other end of your telephone line?

The inimitable Totsymae asked this question this week, and had me and thousands of others pondering the mysteries of ending telephone calls. Tots, you are a gem.

***

Image: Piazza d’Italia, by Giorgio de Chirico, 1913