Let go of the fear factor in our healthcare system and face compassion – John Sturrock QC
One of the slogans in my report on the events in NHS Highland two years ago was: ‘Fear cannot be the engine’. It was prompted by the realization that many of the human difficulties that arise in the NHS and elsewhere are driven by an underlying fear. Fear of being caught out, of being discovered, of being humiliated or humiliated, blamed or criticized, of not achieving goals and being penalized, of not facing or appearing weak, or just plain failing to meet expectations, however unrealistic they may be.
Such fear can be insidious, demoralizing, tiring, demotivating, even frightening. This can certainly lead to suboptimal performance, especially if the anxiety becomes generalized. We know that fear can manifest as feelings of threat, of anticipated loss (whether it’s job, income, security or status) and that this can lead to outbursts of emotion, sadness and sometimes anger or other aggression towards others.
When a danger is felt, self-protection, a primitive resource essential for physical survival but much less useful in social situations, intervenes quickly. It can present symptomatically as anger. The angrier the mask, the more threatened we can feel. It can so easily spill over into what may be perceived by others as bullying or harassment.
And those who are seen as bullies often tragically feel intimidated themselves as fear bounces up and down and into and around the system. All of this can become institutionalized, especially if the behavior from above is unhealthy. The dysfunction can escalate and spread.
There are so many layers. Under the symptoms of anger and aggression, we recognize fear. Take that away, we are told, and there is a deeper need to be loved, appreciated, recognized, accepted for who we are and for what we are trying to do.
Yet we so often seek scapegoats as we seek solace in tribes and echo chambers and simply reinforce our assumptions and beliefs, ignoring the often obvious alternative viewpoints. Confirmation bias and willful blindness come into play. They say that we are not divided by our differences but by our judgments about each other. Them and us. Villains and victims.
The binary and contradictory world of good and evil, black and white, inside and outside, winner and loser, discipline and grievance. A transactional world in which we tend to be treated more like gadgets than very complex, multi-layered human beings. Where what separates us matters more than what we have in common, which is always far more important.
What to do? For me, that’s where the strand of love comes in. But we are so afraid, even ashamed, to use this word with its connotations of sweetness and delicate sensitivity. Maybe we should call it compassion… or kindness. Whatever word we use, it’s not at all sweet. Kindness and compassion is hard to do really well. To love is demanding.
Seeing others, including those who harm you, through the prism of compassion, seeking to understand them, takes a lot of courage and self-discipline. To understand that there are, almost invariably, two or more sides to every story: “they” can be just as “real” as you. Or, as it was once said, in retrospect, everyone is “wrong”. It all depends on your point of view, your point of view.
Being able to speak openly and frankly, without fear, in safety, about what matters to you is vital. To do this, you don’t need to be good friends with those you work with, but you need to respect them and feel respected by them. I would say that building relationships of respect and trust deserves the same resources and infrastructure that we put into, say, technological skills.
My experience from countless training courses suggests that building and maintaining relationships of respect and trust can be learned and practiced. It is fundamentally a question of skills, refined and refined over time, supported by continuous professional development. With that in mind, Core is hosting their last residential class at the end of August. More details: www.core-solutions.com.