CHD’s Amazing Story of Teamwork

Posted on July 10, 2011 by Steve

The June issue of the Peer Spirit newsletter is out with the story of CHD’s building project.  It has now been a year and a half since we moved into the building and I am still filled with wonder and gratitude for that amazing project and the teamwork involved.

Thank you to Steve and  Rob, the contractors; to Stan , the architect; to the CHD Board of Directors for their patience and wisdom in maintaining the vision even when the prospects looked bleak; to Rico for finding ways to live with the financial impact; to the CHD staff and teams and especially to my co-facilitation partner, Roni, for her patience and ability to always find something to laugh about.  together we accomplished what none of us could have alone.

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Aikido Blend is an Evolutionary Move

Posted on July 5, 2011 by Steve

Here is an audio recording of Leadership: Mastery of the Three Domains,  a presentation by Richard Strozzi-Heckler to the Ultimate Men’s Summit.

In his talk, Strozzi-Heckler suggests that the blending move in aikido is an evolutionary adaptation that provides an alternative to the “factory loaded” responses of fight or flight or appeasement.  And he goes on to suggest that this blend is analogous to deep listening and seeing the world from the other person’s perspective.  Learning to blend as an alternative to the habitual patterns of opposing threats “shifts the cellular – maybe even the DNA – pattern of response.”

The notion of blending as being about seeing the world from another person’s perspective was not new to me and it resonates nicely with so much of what I am learning about how the brain works, mirror neurons, empathy, and so forth.  But the notion that blending is actually an evolutionary adaptation to our instinctual response patterns is an exciting new understanding for me.  It helps me to recognize that my persistent reactivity to incoming stimulus is more than just my old life-long instinctual pattern of taking care of myself.  And, there is an available alternative – the blend.

Virtually every aikido technique has two forms, amote and ura (also called irme and tenkan), triangle and circle.  The first is direct entry while the second is the blend.  The first is that instinctual fight response (I guess that aikido technique does not focus on the flight alternative – get the hell out of there) and the second is this evolutionary adaptation.

Last week in my aikido training, Sensei asked me which of the two forms was my preferred means of responding to a mixed two-handed attack.  Immediately, I was able to recognize my preference for amote (direct entry).  When asked why, I also immediately responded that it was more instinctual and gave me less time to think (and thereby mess myself up). This preference for direct entry reaction is typical of all of my aikido techniques.  And, as always, aikido seems to reflect life and I can see how much relearning I need to do in all areas of my life at the cellular (perhaps even DNA) level to be able to override the my instinctual impulse to fight with the more advance evolutionary adaptation of blending.

Ah, this is why I continue to practice and why I need to remind myself to be patient.  I am working to overcome patterns that run far deeper than my lifetime of experience.  And the potential consequences are significant – my little contribution to an important evolutionary change.  Seen from that perspective, feeling foolish and having my body thrown around seem like a small price to pay.

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The New Healthcare System

Posted on July 4, 2011 by Steve

The New Health Care System by David Nather is a good primer describing what is included in the 2010 healthcare reform legislation. It is clearly written and avoids the irrationality and rhetoric that has surrounded so much of the media coverage.  In fact, the book does a pretty good job of exposing many of the myths and outright lies (death panels and rationing for example) that have been circulated.

To be honest, I lost interest and hope during the long political battles and I had assumed that the bill which finally passed was pretty insignificant and disappointing.  Granted, it will not move us to a single payer system and it does rely heavily on the insurance industry, but overall, the results of this legislation are more significant and impressive than I expected.

Most significantly, the legislation will provide health insurance for 32 million people.  It also makes lots of small changes that will hopefully improve the efficiency (and maybe even the effectiveness) of medical care.  It really does seem like the intention of the changes were to align the financial incentives for health and for good, reasonable care while improving coverage.  If successful in eliminating the costs associated with uninsured and with inappropriate use of medical services (ie. emergency room care for non-emergencies), the new system will be much closer to cost neutral than what I would have expected.

Most of the changes do not take effect until 2014 and by then we will have endured another presidential election campaign and undoubtedly more hysteria from the R’s about repealing “Obama Care”.   One of the interesting subplots in this book were the explanations of how special interest groups attempted to preserve their benefits in the political process and, discouragingly, how much more savings and rational policies would be possible if there were political will and courage.

I was a little disappointed that the book did not go into more detail regarding “Medical Homes” and Accountable Care Organizations”.  But, I guess I will just have to do my own research into these.

“In October 2009, the Institute of Medicine estimated that a third of all health care spending in the United States – about $800 billion – goes to medical care that doesn’t make us better.”  So, 80% of the cost of the changes could be paid for by eliminating unnecessary and unproductive treatment and in return 32 million people can receive health insurance coverage.  “This won’t make us the first developed country that protects people from bankruptcy if they get sick.  We are just catching up with all the others.”

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My Travel Map

Posted on July 4, 2011 by Steve

It is interesting to see a visual of my travels. I feel a bit overwhelmed and discouraged by how much white space there is and so little green space. It could easily activate my competitiveness to want to try and see how many places I could visit. But I also know that I do not enjoy the experience of being a tourist; I need a sense of purpose in my traveling. I love to learn and experience new cultures but I also need to feel like I am contributing something of importance. I wonder where life will call me next and I sure hope that I am listening when the call comes.

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Adaptive Leadership in Healthcare

Posted on July 3, 2011 by Steve

I just listened to an interesting podcast from Plexus Institute in which Dr. Marcus Thygeson discusses the application of adaptive leadership to healthcare.

Several years ago, I discovered Ronald Heifetz in this article on leadership in Fast Company magazine.  I can remember sitting beside the trail above Bear Creek in the Wallowa Mountains reading this article and resonating so much with his concept of leadership that I went out and bought and read his book, Leadership Without Easy Answers.  In 1999, that was no small thing as I was only reading a couple of books per year (yes, I am grateful for so many changes over the past decade).

The theme in this book is that the goal of leadership is not to solve problems even though that is what managers are continually reinforced for doing; the goal is to provide the context within which adaptive change can occur.  Adaptive change is that deep, real work that changes behaviors and perspectives in fundamental ways.  I recall Heifetz’s description of civil rights legislation being an example.  Adaptation, of course, is that same process that is inherent in complex adaptive systems (CAS) which is just another word for living systems.  So, following the thread, adaptive change is the process by which life sustains itself and this is the process that any living system – whether a human body or an organization or a community – needs to be involved in.  No wonder, I was attracted to it – this resonates with all of my experience in working with systems and with all that I found unsatisfactory about traditional change management.

Adaptive change as contrasted with technical change requires the leader to create a safe holding container that will allow all of the competing voices to be heard.  The leader then asks the difficult questions which creates enough stress to fuel a conversation in which all of the perspectives are represented and in which real listening and understanding takes place.  From this process (as also described in Engaging Emergence and other studies of complexity) new solutions will emerge.  Such solutions come from a different level of order and consciousness and ultimately transcend the differences that created the conflict.  Since reading this, I have repeatedly returned to this understanding of leadership and when I discovered the Art of Hosting I found tools I needed for practicing adaptive leadership.

Heifetz has a more recent book, The Practice of Adaptive Leadership: Tools and Tactics for Changing Your Organization and the World in which he further develops the concept of adaptive leadership and provides supporting practices.  I’ve not yet read this book but from the podcast and this set of powerpoint slides from Dr. Thygeson, it is apparent that Heifetz has continued to develop his understanding of adaptive change and that they have a direct implications for healthcare at the individual and larger systems levels.

Recently in conversations about health, healthcare and wellness, I keep coming back to the idea of individuals taking responsibility for their own health and lifestyle choices. From my perspective, our current system of healthcare is unsustainable and unaffordable.  Our expectations are unrealistic.  These issues need to be part of any conversation about transforming our system from healthcare (aka illness care) to wellness.  That would be adaptive change!  I am grateful to Dr Thygeson for connecting these dots for me.  He describes much of modern medicine as attempts to apply technical solutions (medication, surgery, etc.) to adaptive problems (obesity, stress, relationships, etc.) and suggests that the role of a healthcare professional is to be an adaptive leader who creates the safe holding environment, asks the difficult questions and supports the patient in making adaptive changes in lifestyle.  Yes!  This is the connection that I have been sensing the need for.

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Why Stay?

Posted on July 1, 2011 by Steve

Today is the one year anniversary of my leaving CHD after 35 years of wresting with the question of “Why stay?”.   So, I love this reflection from Meg Wheatley.  What she says resonates with my experience for years of staying (in the job and in my marriage and even in raising llamas).  And yet there is also a time to move on, recognizing that one’s work is done in one context but that the bigger work continues even as  the focus or the context changes.  The work is still the work and for that I am grateful.

It’s normal to reach the point where we start questioning our motivation: “Why do I work so hard?”  “Why am I dedicating so much time to this?”  “Why do I stay in this work?”

And if we don’t ask these questions, our friends and loved ones surely will.  Usually if they’re confronting us with these, they already have the answers in mind: Stop working so hard; get a life; notice that other people aren’t nearly as dedicated as you.

Asking “Why stay?” can be an invitation to reassess not our work load, but our original commitment that brought us into this work.  Especially when we’re overloaded, burned-out and exhausted, it’s extremely helpful to pause occasionally and reflect on the sense of purpose and potential contribution that lured us into working for this cause.  Doing this with colleagues who also are working much too hard is a well tested means for deepening our relationships and strengthening our resolve to keep going.

Bt there is also a significant element of irrationality in why we keep going, even in the midst of defeat and exhaustion.  The question “why?” doesn’t lead us to any personal clarity or reassessment because there really isn’t an answer.

We’ve doing the work because we’ve doing the work.

If we try and develop an explanation beyond this simple statement of fact, we get into murky waters.  Yet even though it’s the truth, it’s a statement destined to promote either anger or confusion in our loved ones.

It’s an insufficient answer, and sometimes it’s the only one available.

Why Stay ~ from Perseverance by Margaret Wheatley, Asante Salaam and Barbara Bash


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What Fascia Actually Looks Like

Posted on June 29, 2011 by Steve

I just finished getting a treatment from my most amazing massage therapist, John Combe. I have learned so much about the holding patterns in my body and how they reflect (or perhaps even cause) the patterns of holding and resistance in my mental patterns. As a bonus today, John shared with me the following video that shows actual fascia, referred to as “fuzz’ in the video. Have been learning a lot experientially and conversationally with John about the role that fascia plays in my somatic inflexibility. Actually seeing what fascia looks like may help me visualize healthy functioning in my muscles.

This is one more reminder for me that “its all connected”.  In my Newfield training, we learned that our world view is maintained in three interconnected domains – language, moods and emotions, and the body.  Change any one of these and it will change the other two.  Any successful and lasting change will mean changing in all three of these domains.  We carry our lifetime of experiences in our body as much as in the stories we tell ourselves.  My inflexible body is tells the story of my pattern of resisting my struggles for control.  As much as I wish that my body was more supple and flexible, it is what it is for a reason and it tells the story of my life and expresses how I view the world.  And the hard-won changes in my body that have through aikido and yoga and lots of intense emotional work are something that I can be proud of.  I imagine that my muscles have less fuzz between them  and that they are able to move in ways they were unable to years ago.  I am so grateful for all of my experiences that have contributed to these changes.

Beware, this video has graphic pictures of muscle and tissue.

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Loss

Posted on June 28, 2011 by Steve

“If we are able to give ourselves to the loss, to move toward it – rather than recoil in an effort to escape, deny, distract or obscure – our wounded hearts become full, and out of that fullness we will do things differently, and we will do different things.  Our loss, our wound, is precious to us because it can wake us up to love, and to loving action.” Norman Fischer, Zen Teacher

When I read this quote this morning, it really resonated with me.  This week is the first anniversary of my leaving CHD and as I write this I realize that it is also the anniversary of some other very significant events in my life.  These include my moving out on my own after twenty five years of marriage and the ending of Spring Street House when we merged with Union County Mental Health in 1981.

A friend asked me what I meant when I told her that I was feeling the impact of this first anniversary from CHD.  The answer, I think, is contained in the quote.   I feel the loss and the accompanying sadness of each of these endings even as the intensity diminishes some over time.  But the sadness is not regret or a wishing to return or a questioning of my choices.

Is there such a thing as a happy sadness?  If so, that is at least part of my experience.  The sadness reminds me of what I value – relationships, the sense of belonging to something bigger than myself, the opportunity for creativity, learning and challenge.  It makes me grateful for the blessings that I have experienced and for the knowledge of having been awakened by love.

I feel grateful for having a heart that is capable of being broken open and for the experiences that have taught me that life does go on with a broken heart.  And I am grateful that by being broken open, a heart becomes bigger and capable of holding even more.  So, with the sense of loss and sadness that I feel in looking back during this season of anniversaries, I also feel a calling to move into the future with all of the gifts and capacities acquired thus far on this journey, prepared to live fully, to love and to let go of what I love.

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Leadership in Times of Complexity and Chaos

Posted on June 27, 2011 by Steve

The Leader’s Framework for Decision Making by David J. Snowden and Mary E. Boone
Harvard Business Review November 2007

This article provides a really nice connection between complexity theory and leadership, suggesting that different styles of leadership are needed for varying contexts:

  • Simple contexts (Domain of Best Practices) – the realm of the “known knowns” – calls for leaders to sense, categorize and respond.  Established answers exist and just need to be accessed.  A command and control style works best. (There are very few simple contexts within current business environments).
  • Complicated contexts (Domain of Experts) – the realm of the “known unknowns” – calls for leaders to sense, analyze and respond.  Like the simple context, things are ordered and there is a direct connection between causes and effects.  A leadership style of listening to experts and encouraging dissenting perspectives works best.
  • Complex contexts ( Domain of Emergence) – the realm of the “unknown unknowns” – calls for leaders to probe first, then sense and respond.  This is the realm in which answers are emergent and the whole is more than the sum of the parts.  A leadership style of experimentation, patience and openness to emergent answers works best.  This is the most common context in the contemporary environment.
  • Chaotic contexts (Domain of Rapid Response) – realm of the “unknowables” – calls for leaders to act first to establish order, then to sense and respond.   Chaotic environments are also the source of innovation if attention can be focused both on crisis management and creativity.

“Truly adaptive leaders know not only how to identify the context they’re working in but also how to change their behavior to match.”

“In the complex environment of the current business world, leaders often will be called upon to act against their instincts.  They will need to know when to share power and when to look to the wisdom of the group and when to take their own counsel.  A deep understanding of context, the ability to embrace complexity and paradox, and a willingness to flexibly change leadership style will be required for leaders who want to make  things happen in  a time of increasing uncertainty.”

These two quotes cause me to reflect upon our experiences at CHD.  We had a number of crises over the years, from staff unrest and public relations challenges to serious budget cuts.  At those times, we instinctively recognized the need to change our leadership style and to impose much more direction and “top-down” decision making than was our norm.  We also considered those times of crisis to be opportunities for change and we accomplished some amazing changes in quickly during these times of chaos.  Some of the operating principles during these critical times were:

  • Clarity of decision making.  Crises called for crisis management and in those times we declared that our normal decision parameters were being suspended or modified.  Key decisions were centralized with the CEO and later with the Admin Council.
  • Transparency and open communications.  We made an effort to share as much information as possible and to be clear when it was necessary to temporarily withhold information.  We had frequent meetings to share information and regularly shared written updates and background documents.
  • Request involvement.  We solicited ideas and asked for work groups to take on research and analysis tasks and to make recommendations to the decision makers.
  • Declare the end of a crisis.  Since our decision making processes changed and power became more centralized during crises, it was always important to remind everyone (leaders included) that this was a temporary situation and to explicitly declare the crisis over as soon as possible to return to more normal processes.
  • Acknowledge the situation.  Don’t minimize or avoid the pain and the challenges.  As much as possible, externalize the source of the problem and ask for patience, trust and understanding as we dealt with it.  This was important to minimize the internal finger pointing and defensiveness.  And it was always an test of how much trust and open communication we had developed.

 

 

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Celebrating the Beauty of Living Systems ~ Bryan Alvarez

Posted on June 26, 2011 by Steve

This is yet another amazing and beautiful TED talk. In it Bryan Alvarez describes the inticacy and beauty of living systems and shows the beginning of an atlas of the human body.

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