So I know I said I might not show you the rest of Chapter 3 but I thought I might share what I have so far so you can read it all together if you have not yet managed to read any of it. Once I have finished it all I will then go back and fill out the chapters with more detail. It is going to be a while before it is all finished though.
Since becoming an adult I have struggled with my mental health and well-being. Over the years this has manifested itself in a number of ways, ranging from general anxiety, self-hatred and physical symptoms. I was going to say I manage to avoid a dependency on this journey, but that would not be strictly correct. From the age of 16 until I was 44 I had an addiction to nicotine and I definitely used that as a crutch. Throughout my adult life my depression manifested itself as a physical ailment, generally I would present with joint and back pain. The pain I was experiencing was very real, however maybe not as severe as I felt it was. All the diagnostics came back negative each time. Eventually I was referred to the community pain team. This team was made up of a nurse, a physio a doctor and a psychologist. Each member of the team would take it in turns to triage new referrals. I was triaged (luckily for me) by the psychologist, who ended up continuing to see me. He started me on my journey of recovery from my back and joint pain and on my journey for managing my mental health and well-being. I recognised that my back pain was a useful framework for my poor mental health to take hold of my life, it also provided a shield for hiding my shame.
I had 4 sessions with the psychologists where we talked about how it all started and eventually how I found the pain useful, actively seeking it out to give me something to hide behind. When the negative thoughts were too much I would concentrate on pain in my back, telling myself and all those around me that is was the pain that was too much to cope with, allowing me to withdraw from the world. In my eyes it gave me a legitimate excuse not to be at work, to be grumpy and sit in front of the TV. Being away from the world does not help your depression however, the pain is still the same, the only relief is that you don’t have to interact with people.
As I said though these sessions changed my relationship with my back pain. For the first time I had permission to talk about the real reasons for my pain. It was just like shining a light on those childhood nighttime demons that lurk in the corner of your bedroom. When you shine that light you realise it is just a dressing gown. I started talking about the triggers for my pain, that made them somehow smaller. This was not an overnight sensation, however it showed me what was triggering my feelings of anxiety and how that manifested itself in me becoming tense and therefore creating that pain. Some of the anxieties were connected to unhelpful habits, others were reactions to what Professor Steve Peters would call my Gremlins. Gremlins are unhelpful negative memories associated with certain situations, places, sounds and smells. These gremlins would trigger those anxious feelings. By recognising these triggers I could start rewriting those memories with benign memories. Most of these gremlins were not based in fact but came from assumptions I was making about my relationship with the place I worked and the people I was working with. This was a long slow process but I did start to rewrite those memories. I now do not experience anxiety when I approach my work place. I still experienced pain for a good 3 months after being discharged from the pain team, but my relationship with the pain had changed and I no longer used it as a shield, I was beginning to manage my feelings by facing them. I stopped catastrophising the pain and accepted that my back was hurting because of the tension I was creating and once I relaxed, the pain would subside. I was then able to carry on with whatever I was doing and eventually the pain would diminish.
With regards to my anxiety I still have episodes of anxiety and low mood, sometimes on a weekly or even daily basis. The difference now is I do not deny these feelings, I am now willing to accept that this pain is psychological. It is still pain and I feel it as I would any other physical pain. Painkillers are not going to work, I once tried antidepressants when I first acknowledged that my mental health required attention. I am no longer on antidepressants, I came off them under the supervision of my GP. So far in this chapter I have been reluctant to call what I was suffering from depression. Now in my blogs I have called it depression, but then when I here about what people who suffer from depression go through I am more inclined to think I have low mood and anxiety as a result of not paying attention to my mental health, which is very different from having a diagnosed condition. My GP called it mild depression, and prescribed antidepressants for a few months in the first instance with regular check ups . In the end I was on them for a year. In hindsight I was grateful for them, they gave me the time and space to get use to paying attention to my mental health. Once I had come off them I felt able to be open about my feelings, and start looking for ways to look after my well-being. As I said I do not believe I was depressed or mentally ill, I believe I was mentally unhealthy, just as I was physically unhealthy. Essentially I had been neglecting myself and was paying the price for that.
This chapter is not about mental health or ill-health it is essentially to help you pay attention to your well-being. If you believe that you may be depressed or suffering from anxiety, then speak to a health professional. If you think you are suffering from any illness that is having a debilitating effect on your life then you need to be assessed and diagnosed by a Doctor, whether that is appendicitis or depression they are both potentially life threatening illnesses that require assessment and treatment immediately, take it seriously and get yourself checked out.
If you are feeling essentially well or just a bit clunky and under the weather then this chapter may well help you stay mentally healthy and even make you feel significantly better.
When I was looking around for ways to help me,someone suggested I have a look at the work of Martin Seligman. He is one of the founders of positive psychology. Positive psychology looks at the psychology of a healthy mind and the behaviours and conditions that encourage that state. I discovered his book Flourish in which he describes what extensive research in the US suggests are the conditioned required to mentally healthy. The research suggests if you have an abundance of the following then you will flourish and be less likely to access mental health services;
Relationships (that are positive)
Meaning (in your life)
I remember looking at this measure and thinking that is easy, I have always had an abundance of positive emotion. I love a good laugh, I am always cracking jokes. That was true but when I looked deeper I asked myself how often I smiled, I mean really smiled. How often did I look at the world and see more than just my surroundings, how often did I see my beautiful surroundings. I remembered being on holiday in Thailand and having my breath taken away by the beauty of the country. I asked myself since then, how many times had I felt that. I struggled to be honest. I can tell you now every time I take my dog for a walk, go for a run, or just look up at the sky I feel joyful and grateful for living in a beautiful country. I listen to music and smile, I laugh out loud daily. I feel joy when I see family and friends. I smile when I see or hear that a friend is doing well.
Ask yourself do you smile, feel joy and laugh on a daily basis?
Do you find yourself during your day taking part in an activity that requires no effort or thought? An activity that you enjoy for the sake of it, for the pure joy of it. Whilst writing this I was wondering, what I do that is engaging. I suppose once I get out there, running is engaging, but I have to get out there and I have to get into the rhythm of the running before it becomes mentally effortless. Reading a good book I suppose creates the most engagement for me, and most of all researching for this book, reading about how the mind works, how we behave and what makes us successful and effective. I love reading about this, I love talking about it as well, I love giving masterclasses and lectures on this subject. That creates the most engagement for me. I can spend hours prattling on about how to empty your bucket, understand your stressors and connect with each other. I love it, it energises me and the better the response from my audience the more engaged I become. So there we are that is my engagement. This stuff, my passion provides me with engagement.
Do you look up and realise hours have gone? One common activity that creates engagement is catching up with a best friend over a coffee that leads to several coffees and then a race across town to pick the kids from school, because you completely lost track of time, catching up on old times. Some of you might get engrossed in a good book, sometimes that might be a new book or an old favourite. Whenever there is a new Jack Reacher story I will pre-order it and devour it as quickly as possible, I will binge read it in about 2 sittings. Other people love to curl up with a favourite book, something they have read over and over again, it gives them comfort and transports them to another time, without any effort or too much thought.
Music is another way to create that engagement, either playing or listening. Music like many engaging activities also creates a positive emotion. It is obvious really that for you to be engaged in an activity that you enjoy it.
So do you take part in engaging activities regularly?
Loneliness is a real problem in modern society. In 2018 The Office for National Statistics released a report on the characteristics and circumstances that are associated with loneliness. The findings are not unsurprising but stark all the same. 1 in 20 adults reported feelings of loneliness between 2016 and 2017.
You are more likely to experience loneliness if you, are single or bereaved. People with long-term illnesses are also more likely to experience loneliness. If you live in rented accommodation, and feel disconnected with your community you are more likely to be lonely. What was quite striking for me was that people aged between 16 to 24 are more likely to be lonely than any other group.
Being single or bereaved, having a long-term condition and even disconnection with the community are unsurprising causes of loneliness. At first glance though the fact that young people are more likely to be lonely than older age groups is surprising. I don’t know about you, but when I imagine lonely people I think of a little old lady or man sat in a flat, not a young adult. In fact over 75s are 63% less likely to report loneliness. That really surprised me. The ONS provides a couple of explanations; a) older people have developed a resilience to loneliness, as a result of adverse life events; or (and this will make you sit up and notice) b) most of the lonely people are already dead before they get to 75%! According to the ONS loneliness increases mortality by 25%, so being lonely reduces your life expectancy. It is vital not only to your state of mind, but to your life that you seek out positive relationships. You won’t only be having an impact on your life, but the life of the person you are connecting with.
If you see the same person everyday, on the train or the bus, or in the lift, start with a smile, then progress to a hello. Now not everyone will respond, but there will be people willing to connect that will say hello.I can think of a number of people who I have connected with, and have a positive, friendly relationship with, that started with a smile and a nod of the head. If you think about it all our relationships start with at least 2 people who have never met before (even your mum and dad). Be bold give them a smile, let them know that you believe there is more that connects you with them, than disconnects you.
Does you life have meaning? Is there a purpose to what you do everyday? Putting it another way, what gets you out of bed in the morning? What gives my life meaning in the first instance, is being Dad to my boys. Being a father is an integral part of my being. Next is caring for people. For most of my adult life nursing has provided me meaning. Nowadays I do very little hands on nursing and spend my days as a nurse educator and internal coach.
Essentially all of these roles (Parent, Nurse, Educator and Coach) all provide the same meaning for me. That is caring for and supporting my fellow human beings. I hope I have a positive impact on the people I meet. Being an active positive member of the human race is my meaning. It is as simple as that.
When I had poor mental health and spent time away from work, I was disconnected from my meaning. I didn’t feel I made a positive contribution to the people around me. At the time I was a Ward Manager and was deeply unhappy with what I perceived my role to be and started to disengage with the job. There was a clear gap in my view between my values and what was expected of me. My job no longer had meaning as far as I could see. When I was a Staff Nurse I was caring for my patients, using empathy and compassion, something I felt comfortable doing. I assumed that being a Charge Nurse meant that I would extend this care to my staff as well as my patients. However at the time these attributes were not valued for managers. Coming to work and not being valued had a terrible effect on me and I could not see any meaning to what I was doing and who I was. My mental health suffered and eventually I became so unwell I went off sick. I was not ready to be open about my mental health at the time. My poor mental health manifested itself as back pain. Nurses notoriously have bad backs, so the normal aches and pains became unbearable pain. I would find myself in unguarded moments holding myself with so much tension to create more pain in my back. I couldn’t stop it, I needed the pain so I did not have to engage with the world. Being of sick removed nearly all meaning to my life. I only had being a parent to hang on to, but I didn’t always recognise it. It was a vicious circle the more time I spent off work the less meaning my life had. The less meaning my life had the worse my mental health became. At the time I was not aware that any of this was going on in my head, I had convinced myself that my back was the problem.
As you know there was a happy ending for me. The psychologist who saw me and helped me realise that my poor mental health was driving my back pain, gave me a way back into the world and reconnecting with my meaning. This didn’t happen overnight as you know the struggles with my poor mental health continued for a while longer. My journey to good mental health is relatively recent. Since combining both my nurse educator role and coaching role, I have developed a clear sense of meaning in my life. Becoming an internal coach has given me the confidence to start a blog and do some life coaching, which have all added to this sense that my life has meaning because I contribute positively to the human race.
What have you achieved? It doesn’t have to be a dramatic achievement, like a first class honours degree or running the London Marathon (although there are plenty people I know who have done this). Accomplishment means you have achieved what you set out to do. It does need to have been challenging though. It needs to have required effort on your part. We have all achieved something in our lifetime. Can you remember that feeling you got from that sense of accomplishment, being able to complete something you have never done before?
On many occasions this accomplishment comes along side the other PERMA components. For instance learning to play a musical instrument or singing in a choir creates positive emotion, engagement, possible positive relationships if you are in a choir or a band, even meaning as music entertains others. Then when you can either play a piece of music that is recognisable or you sing with your choir at a concert, you have accomplished something.
The question is do you challenge yourself to accomplish something most days? It does not have to be really hard, but should challenge you. I go for a run at least once a week I don’t run far or very fast but I do it, and every week I accomplish running at least 1 or 2 miles and even 3 miles. I always aim to exercise for 30 minutes and push myself each time to be out for a little longer. Every week I write at least one blog, to me I have accomplished getting my message across, hopefully bringing some light to someone’s darkness. When it is published on my website I look at it and think, I made that. What have you made this week?
Often all we need to do is take stock of PERMA to realise what a full, and rich life we lead when we actually break it down. As Brene Brown says in her book Daring Greatly, we often live in a world of scarcity, where we never have enough of anything, we could all do with more of something. If you do a quick inventory of your life using PERMA it can often be evident that you have enough and you are enough.
Another little checklist I like to use comes from Brene Brown, and that is her BRAVING checklist. Often when our well-being is low it is because our self-worth and self-esteem has taken a battering. It is however nearly always ourselves that is the main assailant. It is then worth considering how much trust we have in ourselves. This BRAVING checklist helps you address any trust issues you may have with yourself.
Boundaries: Do I respect my own boundaries? I am clear about what is okay, and what is not okay?
Reliability: Am I reliable? Do I do what I say I am going to do?
Accountability: Do I hold myself to account?
Vault: Do I respect the vault and share appropriately? I am sharing too much? Am I sharing something that is not mine to share?
Integrity: Do I act from integrity? Do i do what is right over what is expedient?
Non-Judgement: Do I ask for what I need? Am I non-judgemental about needing help?
Generosity: Am I generous towards myself?
Before we can even think about connecting successfully with others, we must pay attention to our well-being. When we strive for success it can be very easy not to pay attention to ourselves. If we do this we will pay the price. Paying attention to your well-being is not just vital to success, it can be the difference between a long and happy life or an early death.
Our well-being is heavily dependant on our relationship with shame and vulnerability.
What drives your shame?
Our shame diminishes us, it stops us being vulnerable and therefore connected with those around us. Shame can quickly turn into blame, and jealousy, it encourages us to search for what disconnects us rather than what connects us.
When i think about what I am ashamed of, I realise that I have heard a lot of the descriptions I use from other people. We share a lot of our shame with the people around us. How ridiculous is that? So we all share common themes in the very thing that causes us not share and drives disconnection!
Now not all of our shame is shared by everyone, however the broad themes of our shame are. To illustrate this I will list a few things that create feelings of shame in me;
- Not being handy, I am completely inept at all things DIY, everytime a craftsman, my brother in law, or my brother does some work around my house I feel that I am somehow less of a man. (I know it makes no sense and what I can and cannot do does not define me, but that is my initial feeling).
- Having poor mental health, when my mental health is poor and my mood is low, I instantly go to a place of shame. I want to hide it away, I am afraid that I appear weak and flawed. Now this is an initial response, and I am able to overcome this shame, however every time I feel low I go straight to feeling ashamed and wanting to hide away.
- Being overweight, I am not comfortable with how I look, it makes me feel like I am somehow a failure. I can hear you all shouting “go on a diet then!” You are right, I could do something about it. I have made attempts in the past with varying degrees of success. This then drives that shame of being weak willed and a complete failure. Oh god I can feel my jaw getting tight with shame just writing about it.
Some of you will recognise those feelings of shame that I have described. There are a lot more where they came from, but lets not over share.
You will notice that our society and culture drive the three triggers of shame I have described. If you are going to be a successful man in our society you have to be able to build and maintain your home, keep your shit together and be pleasant on the eye, amongst many other things, which I probably do not possess.
Our shame and vulnerability is shaped by our map of the world (our paradigm). It is probably best to describe paradigms before we start to talk about how to tackle our shame and lean into our vulnerability.
Stephen Covey describes paradigms as our maps of the world. What is important to remember though is that a map is an interpretation of the territory before us and not the actual territory. It is important to make this distinction, as we will all have different interpretations of our territory even though we may share that territory with others. Our experiences and how we interact with our territory will determine how we draw/paint our map. The stories we are told will all add to the detail of our maps. The stories we hear come from a variety of sources, not just our families, but from our local community, news media, social media, and fictional media. This therefore creates a rich and detailed map that does share some similarities with those people we share a culture with. Below is a picture that is used frequently to describe paradigms and perception. Some of you will recognise it, and be able to see both the old lady and the young lady. Some of you will only be able to see one or the other.
Once you see either the old lady or the young lady for the first time, your paradigm has shifted and more detail is added to the map of your world. You will forever be able to see both. As we interact more with our surroundings the more detail we add to our map. These interactions, create more data, which is then incorporated into our ever expanding map, however how we view this data is dependant on our previous experience with similar data. The problem is those previous experiences may not be our own, and may come from stories, many of which might not be completely factual. Can you see why parts of our map of the world might not be completely useful to us, and in fact can be destructive. It is important to challenge ours and others paradigms if we want to start to step out of this shame that our paradigms can generate.
So how do our paradigms shape our shame? It is probably best if we dissect some of the shame I experience and discover where it comes from. Let’s look at the shame driven by my body image. This is based on a few different paradigms. Firstly I see that our culture values men that are slim, muscular and athletic, and I am none of them, however if I ate correctly and exercised regularly I would have a body like this. Our society values people that eat healthily and exercise well, therefore I see people that live up to this ideal as successful. I do not live up to this ideal therefore I am not successful. Occasionally I will make half hearted attempts to live up to this ideal and then give up, therefore I am a failure and therefore I am less valuable as a person, and that is where my shame comes from. If we don’t live up to our paradigms we can feel less valuable as a member of our community and this makes us feel ashamed. There is no reason why I don’t live a healthy lifestyle other than I choose not to, and if I don’t challenge my paradigm I feel really ashamed of this.
Up until a few years ago I was a smoker, this was a source of great shame. Everyone knows smoking is unacceptable (another paradigm), therefore every time I lit up a cigarette I would feel ashamed, every time I tried and failed to give up I would feel more ashamed. To all of you out there that smoke, you know it is bad for you, you know all of the reasons why you should give up, however the reasons you continue to smoke are just as valid. By all means feel guilty for smelling like an ashtray, and making others cough. But you smoking does not diminish you as a person, I would still like you if you are funny and caring, you being a smoker does not change that, so don’t be ashamed, feel guilty but not ashamed. Guilt does not diminish you as a person, it accepts that you are as complex and flawed as the next person, and that we make mistakes and make poor decisions.
So how do we keep our shame in check? I don’t believe we can ever defeat our shame but we can keep it in check. The first thing to do, is to think more critically about why we feel ashamed. What is our view of the world based on? Is it based on fact, or from stories we have been told. If it is based on stories, how accurate are those stories? Our paradigms come from our memory banks, and the problem with our memory banks are that they are generally a mix of fact and fiction. Therefore how reliable are our paradigms. If our paradigms struggle to stand up to critical review, why do we put so much store in them, and why should they drive so much shame? Just asking yourself why you think that way, can start to diminish your shame.
Let’s put this to the test with my body image shame. My shame is partly driven by my inability to stick to a diet and healthy lifestyle. When I think about it, the paradigm I am stuck in, is that I should find living a healthy lifestyle easy and therefore my inability to do this means I am somehow less of a person.
Now how does this stand up to scrutiny?
What evidence do I have that supports this paradigm?
Pictures of smiling toned healthy people on social media telling me how much they enjoy drinking kale and beetroot smoothies, and doing the plank.
How reliable is this source? Have I ever seen someone drinking drinking a kale and beetroot smoothie or doing the plank in the flesh?
No I haven’t.
Have I ever drunk a kale and beetroot smoothie, if so what did it taste like?
Yes I have and it was the most disgusting thing ever.
Have you ever done the plank, and if so did you feel like smiling when you were doing it?
Yes I have, and no, I tried not to be sick if I am honest.
Just writing this has reduced my shame.
When you start picking apart your shame and what drives it, you start to treat yourself with empathy, you start to understand your own emotional response to your shame, this allows you to show yourself some compassion. Brene Brown in her books Daring Greatly, and Dare to Lead suggests that empathy is the antidote to shame. Empathy and compassion shine a light on that shame.
We are more accustomed to hearing about empathy and compassion in the context of showing them to others. This comes next as being empathic with others really does put that shame in a box. Brene also points out that, to truly be able to show empathy to others you have to be comfortable showing yourself empathy.Once you have started to diminish your shame you are able to successfully articulate your emotions when feeling that shame. When a friend is experiencing shame you are then able to draw on your own experience of shame, and can share those emotions with them. When we start sharing what shames us we start to recognise that many of the paradigms that drive our shame are shared by the people around us. When we notice that we share those emotions, and that diminishes the shame further.
By being present and responding to what is really happening, rather than anticipating what might happen based on what we believe has happened in the past, or what we believe people will think of us, and sharing those feelings, we can keep our shame in check. I don’t think it is possible to banish our shame completely but we can prevent it from ruling our lives.
We can often confuse guilt with shame. Now guilt is an emotion we feel after we have behaved badly or done something wrong. Guilt is nothing like shame. When you behave badly and subsequently feel guilty you are acknowledging that you have behaved in a way that you do not find acceptable, and that you are sorry that you behaved that way. Guilt provides the opportunity to make amends, to show accountability. By expressing guilt you are saying that you are not less of a person because of your behaviour, and you want to make it better. Shame says that as a result of your behaviour you see yourself as a bad person. For example if I feel guilty that I have not been able to stick to a diet, I am saying that I am not happy that I have not been able to stick to it, but I am not a failure, I do however need to find a diet and adjust my attitude to having a healthy lifestyle. My shame however says that I am a failure and I deserve to be fat and unhealthy, and I will always be fat and unhealthy, because I am useless. I much prefer to feel guilt. Guilt demonstrate dissatisfaction with the current status quo without diminishes my sense of self worth.
If we want to tackle our shame, and start making meaningful changes to our lives we have to challenge our paradigms, start practicing empathy and sharing what drives our shame with the people we care about. It is possible to manage our shame, we just have to start being kinder to ourselves and each other.
Do you embrace your vulnerability?
The other day I was facilitating a team building session, and I had asked the participants to pick out at least 5 values that they felt were important to them. Not what they thought they should value but what they really valued. This is more challenging than you think it might be. As it is difficult to find the words that describe your values I provided them with 3 pages of words that describe thier values. I then invited them to use the lists of values to start them off, but reminded them that they were not wedded to that list. Nobody used any values that were not on the list. Now this could have been that they were happy with the wide selection, or that they did not feel comfortable enough to tap into their individuality for fear of getting it wrong. This fear is driven by our shame. We all know how shame attempts to diminish us to make us less of a person. We all know now how to combat this shame. We do that by confronting it and talking about it with our fellow ashamed friends and colleagues. The problem is, that you have only just read the chapter on how to combat that shame. Fair enough you may have read Brene Browns work on shame and vulnerability, but shifting your shameful paradigm takes a lot of practice flexing your empathy muscle. So what else is there to do but avoid shame at all costs by not putting yourself at risk of mucking things up. “Probably best if you play it safe….remember the last time you tried to express your opinion at a meeting….you made yourself look a right tit”. I have said that to myself so many times. It has always led to me keeping my mouth shut in a meeting instead of letting people know, what I have observed or experienced as I was fearful that I would not be taken seriously and be dismissed, therefore diminishing my self-worth. The probem is with this approach is that it can end up having the same effect as the one you were trying to avoid. People could start to think that Matthew never contributes to meetings, he somehow appears disinterested, and is not engaged. Don’t get me wrong embracing your vulnerability is not about running off at the mouth at every opportunity. But perhaps I could have just been vulnerable and spoken up, and trusted my judgement that what I had to say had value. If it didn’t then the conversation would move on, I may feel a little silly, but I it has not harmed me.
The difficulty with avoiding vulnerability is that it is driven by our limbic system, as is shame. It is evolutionary neccessary for us to live in groups (something we will look at in depth later in this book). So it is important to us not to look foolish, as foolish means weak and less useful to the goup, which may lead to us being cast out and left to starve to death lonely and unloved. Yeah I know a little extreme. The thing is the limbic system is primitive and it’s primary function is to keep us and our species alive. It does not care which century we are in or how dangerous our outside world is. If it is left unchecked it will assume any threat is a threat to life unless advised otherwise. Therefore when you notice that another member of your team is ridiculed behind their back for making a suggestion at a meeting, your limbic system makes a note to put in your memory bank, so the next time you are in a meeting and consider making a suggestion your limbic system, goes and gets that note and waves it in your face, saying don’t do it, you then get that funny feeling in your stomach and your mouth goes dry and you say nothing. The urge to say nothing is as strong as it would be if you were alive a thousand years ago about to question the leadership qualities of your village chieftan. Only you are not likely to be cast out or get your head chopped off. The limbic system has know time uderstanding the current political climate it is just interested in you staying alive, it leaves all that stuff up to your frontal lobe.
So there you are embracing your vulnerability and confronting your shame is not going to be easy. Your limbic system is always going to scupper things and avoid vulnerability at all costs. Don’t worry though there is a way to manage how your limbic system responds.
Before we explore how to create the right conditions for you to be able to vulnerable it is important to explain why avoiding vulnerability and being a slave to your shame is not just toxic, it can be down right dangerous. Vulnerability avoidance can stop us from speaking up or acting when we see things are going wrong, things have been missed or when someone is acting with malicous intent. History is littered with testimony from bystanders that either did not think it was there place to say anything, they didn’t like to say anything or they were too afraid to say or do anything. I am not saying that to be able to embrace vulnerability you should put yourself in harms way. There have been occassions in history and to this day where people may be in mortal danger if they spoke up or acted on what they saw. Some of those people put themselves at risk and others didn’t, now that is a whole other debate that I have no wish to get into. If your life is in danger you are going to make decisions based on your values and what you are faced with. I am more concerned with situations much more common place, situations that happen on a daily basis.
As part of my role as a Clinical Nurse Educator I teach Human Factors (risk management) to Health Professionals. The basic premise of this is that we are all at risk of making errors or contributing to errors as part of the error chain. One of those human factors that creates an environment for error is a steep authority gradient, where someone is clearly in charge. This leader however is not interested in discussion, and likes to let everyone know that they are in charge. Everyone is expected to do as they are told and there are consequences for disobedience. No doubt you can all think of examples of leaders like this either first hand or through stories. So imagine you are working in an environment like this, say for instance that you are a junior nurse on your first ward and you are involved in the resuscitation of a patient. The resuscitation is being performed by a domineering Consultant who is barking orders at everybody. All involved a clearly nervous, no one is acting until they are told to do so by the Consultant. You notice that the green oxygen tubing that is attached to the bag and mask that the consultant is using to provide respirations to the patient is not attached to anything. It is you first ward but you are pretty sure that your tutor told you that the oxygen should be attached when using the bag and mask, but the Consultant is really shouting at everyone and you are too afraid to speak up just in case you have got it wrong. That patient subsequently dies, now how would you feel? Like you I would like to think that I would have spoken up, and faced the wrath of the consultant, and some of you would, there are some of you who wouldn’t. Now imagine you are 18 and that Consultant is in his 50s with 30 years experience as a Doctor, how easy do you think it would be.This is not a real example, however I have witnessed situations where an authority gradient has put patients at risk, and I have read incident reports from all over the world describing this behaviour. There lies another problem, we have all heard examples of this behaviour and have a perception of the type of people and the situaitons where this authority gradient might be present. When you hear these stories your limbic system becomes very interested and lays down memories in your memory bank, just in case you encounter such people or those situations. So when you come across something that remotely looks familiar your limbic system leaps into action to ensure your safety. So regardless of whether or not this person and the culture they work within operates a steep authority gradient, you will behave as if there is one. So you start to percieve that if you speak up or act on your initiative that you will face sanctions regardless of the lack of concrete evidence. This perception of a steep authority gradient is just as dangerous as a real authority gradient. Our limbic system is on the whole very useful but it can be a right pain in the arse if you don’t manage it.
How do we embrace our vulnerability. What makes us do the things that make us vulnerable, like telling someone we love them, or walking in to that interview for a job. Well in those two circumstances it is the limbic system that can drive you taking the risk. After all the limbic system is interested in keeping you alive and keeping the species going. So it stands to reason that your chimp brain would not have too much trouble doing either. There is clearly nerovousness as the chimp does not want to lose face, as surviving in the pack is important, but having a partner and a good job that provides economic security, definetly satisfy the chimps needs. However speaking out when you think something is wrong can be very different, as I discussed earlier. So how can some people stand and say something when they notice someone senior doing something wrong and how can I get up and speak to large groups of people when it makes me so nervous.
The stories we tell ourselves have a big influence on whether or not we are willing to embrace our vulnerability. The stories we tell ourselves are influenced by the stories we hear from our friends and family, and then the myths and folklore we hear, as we grow up and what we hear at work. All of this fact and fiction from a such a wide variety of sources is all jumbled up filed in our memory bank, to be used at a later date either by our human brain or our chimp brain. In his book The Chimp Paradox Professor Steve Peters describes these memories as either autopilots (positive) or gremlins (negative). So when the chimp brain goes running off to the memory bank to look for precedent to justify it’s continued involvement in the situation and it’s subsequent actions to keep you safe, it comes across either gremilins that justify it’s involvement or autopilots where it can handover control of the situation to the human brain. The trick is then to create autopilots or positive/benign memories for certain situations that we have come across where our chimp brain has stepped in and prevented us from embracing our vulnerability. The thing is our memory bank is not that great at distinguishing between fact and fiction. When we start talking about and sharing our memories, especially those that drive our shame, then we can run them past our human brain and the human brains of our companions. With everyone in the room using their human brains we can fact check the information we hold about certain people, places and situations. It is then possible to rearrange previously held inaccurate memories that were gremlins, so they become auto-pilots. As mentioned in previous chapters talking and sharing shines a light on shame and changes it from a monster to in the corner of the room to your dressing gown hanging on the door. When collecting new information be sure to check the facts. Practice thinking critically, don’t just take things at face value, check what assumptions you are making about the information you are being presented with, how much of it is true and how much is just made up, and how can you check how accurate it is. Most things are never as bad as they seem. Notice I wrote the word practice, thinking critically is not an easy thing for most of us to do. So if you really are serious about embracing your vulnerability you really will have to practice examing some of the stories we hear that become part of our memory bank. Now the questions you ask yourself are very similar to those you ask when examining your shame. Afterall this stories and memories form the basis of that shame that stops you from being vulnerable. Below is a quick checklist to use when confronted with new stories or when you are examining old memories.
- Did I witness it first hand?
- If not
- How reliable is the source of information?
- What assumptions am I making about this information?
- How can I check it’s validity?
- Do I believe it?
- If I do believe it what are the implications?
I know it can be a little bit labourious to start with, ut once you start practicing it does get easier and easier.
I mentioned it earlier that I get nervous everytime I teach or speak publicly as most people do. When I was younger it did it so much so that I just would not do it. Even up to 6 years ago when I became a clinical nurse educator I really struggled to stand up in front of people. The story I told myself was that I was boring, I had nothing important to say and more importantly the audience thought I was stupid and useless. When I examined this story critically I established that yes I could be a little boring at times and there was sometimes gaps in my knowledge. I could however change those things by listening to what people needed, knowing the subject and adding a bit of myself to the teaching. When it came to the audience having a poor opinion of me as a person I exposed very quickly that this had no basis on fact and existed in my mind and nowhere else. Now no doubt there will be people who do not like me, but I can not do anything about that. So I adjusted what I needed to do and regularly enter the arena of the class room or lecture theatre. I am still scared and nervous but I am able embrace my vulnerability as my chimp mind only now sees autopilots in my memory bank instead of gremlins.