Sunday, December 20, 2009

Some Thoughts About Conflict Resolution

Conflict exists in all relationships and organizations, so the purpose of conflict resolution training or programs isn’t to eliminate conflict, but to provide more thoughtful and positive ways of addressing it than might otherwise be available. At best, conflict resolution can improve a relationship or an organization; at least, it can avoid increased antagonism.

Conflict resolution training or programs don’t replace the responsibility for people in relationships to work things out, and they don’t replace authority in organizations. People remain in charge. In relationships, they are responsible for themselves and their decisions. In organizations, people are responsible for the duties of their positions. Conflict resolution training or programs may help people to understand themselves and others better, and therefore to communicate more effectively and make better decisions.

Mediation can be an important function in conflict resolution, by supporting communication and negotiation among the parties. The people involved in the conflict need to express their points of view meaningfully and listen to one another; that’s the communication part. Once that’s done, the solution to the conflict may present itself, so to speak. If it doesn’t, there may be a need for negotiation. The mediator may have to teach communication and listening skills before the parties will be able to use them. While people vary in their communication and listening skills; few people without training and practice are able to think or speak clearly in conflict situations.

As a conflict resolution consultant, I’ve found that it’s often useful to speak with people separately before meeting together to try to resolve the conflict. People often haven’t thought through what the conflict is about, even from their own point of view, much less that of the other party. It can require one or even several 1:1 conversations before people can articulate what matters about this situation, from their own point of view, and then to begin to look at it from the other person’s.

Some conflict resolution consultants think that finding the truth of situations is not necessary to conflict resolution. They think that everyone has their own story, and people agree to whatever they can agree to if they're speaking clearly and listening to each another, and that's that. Other conflict resolution consultants think that the truth must be discovered in a way that everyone can agree to in order for the way forward to become apparent. My experience indicates that situations are different from one another, but in each one there’s a sort of minimum necessary truth that has to be acknowledged by everyone in order for resolution to happen.

Monday, November 23, 2009

Attorneys and Experts

Attorneys and experts tend to approach the role of the expert from quite different perspectives. Attorneys tend to be intent on building a case, and to see the expert's testimony as slotting into the narrative which they are constructing. They are also interested in containing costs, and thus minimizing the amount of time the expert provides; except in really big cases where there's enough at stake, and enough opportunity to win, that the attorney wants the expert to do whatever is necessary to contribute to the most credible case. Experts, on the other hand--assuming they are working as experts and not as "hired guns" to produce whatever testimony the attorney is paying for--are approaching the case from the perspective that they have to find out whatever they might need to know to actually function as experts. The end results may or may not slot neatly into the narratives the attorneys are trying to construct, and arriving at them will take as long as it needs to take for the experts to find out what they need to find out.

Now, if the expert is just asked to testify to a point in his or her field--for example, whether vocational rehabilitation programs have a responsibility to supervise their clients in order to protect them from abuse by other clients, or whether children have been known to produce false claims of sexual abuse as a result of suggestive or otherwise defective interview technique, or whether blows to the head in a fight can cause brain damage--that's a pretty cut-and-dried project. An expert could reasonably give a pretty good estimate of how much time such a project would take, and wouldn't need a lot of time to complete it. However, if the expert is asked to testify about whether a particular vocational rehabilitation program was negligent in a particular case in which one client was allegedly abused by another, or whether a particular interviewer interviewing a particular child used defective technique that could reasonably be expected to have produced a false report of molestation, or whether a particular client has brain damage, which may or may not have resulted from an alleged altercation, that involves the kind of investigation about which the expert, at the start, knows neither what the end result will be nor how much time it will take to get there. The best one could do would be to give pretty wide parameters of estimate.

Saturday, November 14, 2009

Perception and Reality

I was out walking my dog the other night, crossing a well-lit neighborhood street at a stop sign, when a car approached the intersection, slowed down but didn't stop, and then began to turn and came straight at us as we were crossing. I shouted at the driver, who stopped, lowered her window, and shouted back at me that I should have been wearing a light.

Well, I was flabbergasted. The intersection was well lit, there was a stop sign, I was crossing at the corner, and it was still my fault that she didn't stop, didn't see us, and almost hit us. There are at least a couple of things to be learned from this about how the mind works, and what the relationship is between what we perceive and what is real.

First, the job of the mind is to make sense of what happens going forward. She didn't see us in the intersection, therefore it was my fault for not wearing a light. Second, she had no capacity to retrospectively self-evaluate and self-correct.

So here we have an example of how we can misperceive reality without realizing it at the time, and how we can still not realize it even after it has been pointed out to us in a situation in which a potential disaster, which would have been entirely our fault, has just been narrowly averted.

Saturday, October 17, 2009

Medill News Service Article w. Interview

Study says they're happy, but young people say they're stressed
Oct 15, 2009
Past pimples and prom, a recent study says adults 18 - 25 have the highest happiness rating.
The survey by Gallup based on more than 600,000 interviews revealed that happiness is highest among younger Americans and lowest for those in their 50s and late 80s.

Young adults may be happier because of the obligation-free days of youth, said Kathryn C. Keller, a licensed clinical social worker.

"They have a future ahead of them and nothing bad has happened," she said.

Upbringing can also play a role in the happiness, said Dr. Lisa Razzano, a professor of psychiatry at the University of Illinois at Chicago.

"They've [parents] become more engaged," Razzano, said. "This creates positive affect, which we associate with happiness."

Even with a recession, young Americans in college can stay on the bright side, said Dr. Michael Bricker, clinical psychologist.

"Those individuals are experiencing the downturn in a different way than those who must work and provide," he said. "There's a little more freedom in youth."

Those assessments are in contrast to how some young adults feel.
"There's a lot of pressure on us," said Gevorg Azizi, 20, a DePaul junior. "Yeah we're happy and we go out, but there's also a lot of pressure, and that can lead to unhappiness and depression."

Paul Evangellu, 20, explained the pressure.

"We're in college right now during some of the worst times right now during this recession," the DePaul sophomore said. "Hopefully by the time we graduate it will be over, but right now, we can't really tell."

One psychologist expressed doubts about the study, which asked people if they had smiled, laughed or had positive feelings the previous day.

"There are two different kinds of smiles," Dr. Jay Einhorn, a clinical psychologist, said. "One that's genuine with involuntary movements, then a conscious smile that means, 'I'm not hostile and I want you to like me.'"

Nonetheless, Einhorn emphasized the importance of mental self-care with regular exercise, deep relaxation and self-observation.

"If we're more aware of ourselves, we have more psychological freedom, which allows for more behavioral choices," he said.

Related Links
Gallup polls

©2001 - 2009 Medill Reports - Chicago, Northwestern University. A publication of the Medill School.

Sunday, August 16, 2009

My 2¢ on Healthcare Reform

My 2 ¢ about health care reform reflects my experience as a healthcare consumer, a healthcare provider, a former administrator of a healthcare facility that both operated on healthcare payments and purchased healthcare for its employees, and as a parent of young adults trying to make their way in the world.

First, there are obvious and glaring problems with the current system. The worst of those is that too many people are uninsured and unable to purchase even a basic package of insurance coverage. Our current system of employer-provided insurance evolved in a time when people worked for one or two employers for their entire careers. It is badly out of adjustment at a time when people change jobs often, have periods of unemployment between jobs, and are often working as independent contractors rather than full-benefit employees. The business model has changed dramatically, but the insurance model hasn't caught up with it.

Next are a set of problems inherent in an industry that is set up entirely as a market: loss of coverage for high-expense illness and treatment, loss of coverage when changing jobs for "pre-existing conditions," refusal to pay because of narrow interpretations of policies, and, often, erroneous nonpayment because of sheer incompetence resulting from poor training and supervision of insurance company employees--which, of course, benefits the companies which don't pay benefits that customers are entitled to. This requires the customers to engage in lengthy and frustrating campaigns to receive benefits which they have paid for and are entitled to; often they just give up.

On the provider side, doctors and other healthcare providers have had to deal with increasing costs for repetitious claims submissions and wasteful, often idiotic, and sometimes downright unethical hoops that they had to jump through in order to receive insurance reimbursement for services they've provided to patients. (This got so bad in my clinical psychology practice that I withdrew from all third party payment several years ago.) With the exception of very brief treatment, the entire inpatient mental health system has been scrapped, except for the very wealthy. Coverage for extended intensive outpatient treatment, while less expensive than inpatient treatment and often preferable, is very rare.

Healthcare is trending toward unsustainable costs at the individual, family, and national levels. For children covered under their parents' insurance, finding an affordable policy that provides adequate coverage is impossible when they become adults, and can't find, or don't want to take, jobs that provide insurance. Meanwhile, healthcare gets more and more expensive, critically cutting into business competitiveness and government solvency at the state and national levels. All these problems are very serious and that is what drives the urgent need to reform the healthcare system

On the other hand, there are genuine reasons to be concerned about reform. The first reason is that whatever form it takes, reform is going to have to vastly expand coverage while managing costs, and that means that there will inevitably be some sort of a two-tier system, consisting of a first tier of basic care that everyone receives, and a second tier for those who can buy supplemental private insurance or pay out of pocket. Many people react to this situation with dismay, insisting that health care should be a completely equal right for all, and that everyone should receive the same level of care. The problem with that wish is that it's an economic non-starter, an example of "the 'perfect' being the enemy of the good." In fact, we already have a multi-tier system, except that the lowest tier is composed of some 50 million people with no coverage at all. Everyone will be better off if everyone is covered with a basic package, and costs for that package are going to have to be carefully managed if the system is to remain solvent.

It would be better if leaders of the national push for healthcare reform could say this forthrightly. Unfortunately, they can't. It would be politically very unpopular, unacceptable to many people, to acknowledge the need for a two-tier system, even if it addresses the worst problems in our current one. The result of reform leaders not being able to acknowledge the necessity for a two-tier system is that the reform leaders become hypocritical in asserting that all these uncovered people can be covered without the system becoming unaffordable if we just apply best practices and eliminate waste. That is bullshit, pure and simple, and anybody with common sense knows it. The reform leaders who know better are dissimulating, the ones who don't are deluding themselves.

How people react to it will depend on whether they are inclined to trust the government or not. Those who are inclined to trust the government will interpret the reform leaders' posturing as politically necessary to get the job of health care reform done. Those who are inclined to distrust the government will interpret it as a snow job in order to extend the power of government at the cost of the freedom of the people. That's a lot of what is happening now in the opposition to healthcare reform. It would be better if the reform leaders could acknowledge the issues. Of course, the genuine concerns of people who don't trust the government are being fanned by the usual parties for the usual reasons.

My own attitude, having been in all these roles with regard to the healthcare system, is that reform is urgent and necessary. And it seems to me that we finally have a climate in which most legislators are willing to say that publicly. However, a serious obstacle to reform is the feeling on the part of many legislators that we really have to take our time and get this right the first time. Simply put, I don't think we can. The systems are too big, the issues are too many and too intertwined, to get it right the first time. So my perspective is that we are just going to have to go ahead and fix what's most broken, understanding that we won't get it all right and we're going to have to keep correcting and adjusting and fine-tuning as we go along. I frankly doubt that the take-it-slow legislators have adult children who are, or will soon be, without health insurance, or family members whose care has exceeded the benefits in their policies, or who have been prevented from receiving necessary mental health or other services because they are excluded from coverage, or who haven't been able to change jobs for fear of being ineligible for insurance because of an illness they needed care for while working on their current job, or who perhaps even were not hired because they or a family member have an illness which would threaten to raise the company's insurance premium.

The bottom line is that the problems in healthcare are too urgent not to go after, even with the understanding that we'll have to adjust as we go. Reform will result in a two-tier system in which everyone has a basic care package and those who can afford to supplement can do so through the insurance marketplace. A marketing consultant might call it "basic care plus," meaning that everyone gets basic care and those who can afford supplemental policies can add a "plus." No, it's not perfect. But in healthcare reform, the way things are right now, the perfect is the enemy of the good.

Sunday, July 12, 2009

Two Deaths: Robert McNamara and Michael Jackson

Robert McNamara died on July 6, and Michael Jackson died on June 25. News of the death of Jackson, the megastar entertainer, has driven news of the death of McNarama, architect of the Vietnam war, to the margin of the news cycle. On George Stephanopoulos’ program this morning, Michael Jackson was discussed at the Round Table (will a group of commentators, on the air), while Robert McNamara got a few pictures, without comment, on the In Memoriam section.

I suppose that the Vietnam war is old news. It may reside in the political and military DNA of the U.S.A., but it’s not a hot item; and not very important to the fans of Jackson, most of whom were too young to have been around during the war. Besides, Vietnam is a war that many in the U.S.A. would rather not remember.

McNamara and Jackson are worthy subjects for reflection: each outstandingly talented and achieving the pinnacle of success in his field--managerial leadership for McNamara, popular entertainment for Jackson--and each the tragic victim of his success.

It seems to me that neither the public effusion of emotion following Jackson’s death, nor the relative silence following McNamara’s, feels right. Both men were brilliant in some ways and tragically flawed in others. McNamara’s life has been looked at in detail, while Jackson’s has yet to be, notwithstanding all the publicity he received. But neither man’s life, to borrow a phrase from a Jackson song, can be understood entirely in “black or white.”

McNamara, the man with the quieter obituary, seems to me to have lived the much more consequential life, and in fact did a lot more damage. He goes to his reward, such as it may be, with the deaths of 58,000 Americans and between 1 and 3 million Vietnamese on his hands; as well as the pain of the physically and psychologically wounded, and their children and theirs, and generations poisoned by the toxic residues of the defoliant Agent Orange, millions of gallons of which were dumped on Vietnam. He spent the rest of his life trying to do good, trying to balance the books. Of course, he felt that he was trying to do good as Secretary of Defense, managing the Vietnam war. His life is a case study in good intentions.

It is certainly a special contribution that he came forward, in a memoir, "In Retrospect: The Tragedy and Lessons of Vietnam," and a documentary film by Errol Morris, “The Fog of War,” to try to present what he had learned from his mistakes in Vietnam. While I agree with those critics of McNamara who feel that he didn’t go deep enough in his public self-reflections, didn’t get down to the core of what he believed about himself that allowed him to do what he did, it’s also true that he didn’t have to come out with a public examination of his decisions at all, especially when he admitted making mistakes of such dreadful consequence. I think everyone should see “The Fog of War.”

There is still not much reliable information about Jackson’s life, notwithstanding all the publicity that he benefited and suffered from. It will emerge over time, I expect, as reporters do the research, talk to people, get the facts, and publish them. The haste with which so many public mourners seem to be trying to build a Jackson legend makes it seem like they are trying to erect a monument over his life which will keep the facts buried beneath it. To the extent that there’s any validity in that impression, I don’t think it will work over the long run. There’s too much curiosity about this King of Pop, and too much market value in his biography, so I expect that the facts will come out.

I asked a client, a middle aged woman who is often wise notwithstanding a bunch of learning disabilities, what she thought about Jackson. “I really liked him when he was a kid and young man,” she said, “but then he got really weird.”

Unlike McNamara, Jackson never did any public self-examination. Perhaps he might have if he’d lived. There’s no evidence of real self-reflection in his referrals to suffering the intrusions of his life; that of abuse by his father, of prying from media, and of repeated legal accusations. While the cause of his death remains to be announced--it was not included on his death certificate--speculation is that some lethal cocktail of drugs, prescription and perhaps illegal, was involved.

Jackson’s tragic personal decline after achieving the pinnacle of pop fame recalls that of the earlier King of Pop, Elvis Presley; also dead in middle age, reportedly of a lethal cocktail of prescription drugs, after his personal life had spun out of control following his unprecedented success as an entertainer. Jackson had reportedly set himself to become the King of Pop. His marriage to Presley’s daughter may have been more about merging with the legend of the King than love; although they might have found union in their experiences of the spectral ups and downs of the limelight.

Jackson seems to have lived his way into the roles that he aspired to, even changing himself physically with plastic surgery. There can be a particular genius in that--Bob Dylan’s career shows a similar pattern of the artist vanishing into different roles. Perhaps it was a combination of this type of genius and a tragic lack of self-reflection or sense of boundaries that made Jackson merge with others through his physical appearance, rather than just through his personality and his art.

I wonder what kind of personal integrity, what kind of anchoring of the self, is necessary for performers like Presley and Jackson to be able to manage so much fame and wealth without being damaged by it. The Beatles famously decided to stop touring because they couldn't hear themselves play over their screaming fans, and however much their heads may have been turned by their fame and wealth, the impression is that at some point, after all the hard work and insane success, each one got his feet more or less on the ground and put his life ahead of the pursuit of more and more success. But they were a group, not an individual.

I wonder whether an individual performer who did have sufficient personal integrity and self-anchoring would even go after so much fame in the first place; although, if that's where your whole life had been pointing you, how could you not? I wonder if Jackson, so talented and driven by his father’s ambition before his own took over, ever had a chance to go through any other door than that of pop fame. I wonder if there was ever a time when his self had a chance to develop for its own sake. For McNamara, it seems to have been power, not fame, that drew him; power and a desire to serve that was warped by a self in need of serious work before he could manage the power he was reaching for.

There’s a certain bleak amusement in imagining the souls of Michael Jackson and Robert McNamara, having died within a couple of weeks of each other, and so different from each other, together in a waiting room in the afterlife (heaven or hell, you choose), awaiting their judgment, having a conversation about the successes and failures, as they would like to see them, of their lives. Perhaps, as they listen and respond to each other, the super-dynamic performer who touched so many people with his art and hurt some with his life, and the super-analytical director whose power hurt so many people and who then tried to help on a commensurate scale, might begin to find some of the the perspective that was so lacking in their lives. But someone else would still have to teach them about self-reflection, about insight, for neither could teach the other about that.

Sunday, June 7, 2009

A Caveat on Tests and Scores

For many years I've included a Caveat on Tests and Scores in my psychological evaluation reports, before I report the test results. Here's the current version, taken from a report in process.

Before the Test Results: A Caveat About Tests and Scores

Psychological tests are useful tools as long as we remember their limitations. They are sampling procedures whose goal is to elicit examples of behavior which represent how the person being tested functions on those abilities which the tests seek to measure. The people who make the tests try to select items which are representative of those abilities, and to name those abilities accurately. Tests are interpreted by comparing individual results to how a broad sample of comparable people have responded to the same sets of items. There are thus several steps in the process at which test results can be misleading: test items might not be representative of the abilities being assessed, the abilities being assessed might not be accurately named, and the normative group on which the test was statistically standardized might not be representative of the population to which the individual’s results are being compared. In simple language, tests might be more or less well constructed, accurately named and meaningfully interpreted. All tests are approximate and all are works in progress. Each has its own history of evolution through theory and practice, and will continue to be modified and superseded.

“Intelligence tests,” for example, would be more realistically named, “Samples of Some Aspects of Intelligence.” Measuring human ability is not like measuring a plank of wood, even though we call them both “measurement” and express both as numbers. No one has ever seen “intelligence,” or the difference between one point and another on an I.Q. scale; intelligence is always inferred from samples of observed behavior.

Unlike the measurement of a plank of wood, the scores of psychological and psychoeducational tests nearly always show some variability. The scores of a person who takes the same test at different times, or equivalent forms of the same test, will probably not be quite the same. Similarly, a person who takes two different tests which are supposed to measure the same thing will nearly always receive somewhat different scores.

Test results that are presented as approximate grade or age levels can be affected by many factors, such as the availability of the child to instruction at the time the subject or skill being measured was learned, and the person’s functional abilities, then and now, in attention, receptive language, and working memory. Test results also may not reflect the potential benefit of repetition, study, or remediation, so they may not reflect overall ability. Considerable controversy exists about whether it’s even possible to have nationally accepted age and grade equivalent standards. In addition, a nationally balanced normative group, if such could ever be constituted, may not be representative of the level of academic achievement expected in, or typical of, a particular locality, so students might score higher or lower depending on the particular education they’d received.

Thus, it is usually the overall pattern of scores which are important, how they relate to one another and what they mean about how the person’s performance relates to that of his or her peers, and not individual scores.

It is also important to remember that scores might not always mean what we assume they do. Careful attention has to be given to the reasons why a child makes errors on some items. For example, a child may make an error on an item involving phonological processing because of a true phonemic processing deficit, because of a syntactic mistake rather than a phonemic mistake per se, because of lack of comprehension of what the item was asking of him or her, because of a lapse of attention, or because of some combination of factors.

Furthermore, the nature of intelligence and personality are still being researched, reconstrued, and debated, and the tests which we use to assess them are, of necessity, imperfect. Abilities such as practical intelligence, social intelligence, problem solving, creativity, and what might be called “self intelligence,” meaning ability to manage one’s emotions and behavior and improve through reflection on one’s experiences, are largely ignored by existing tests, but are vitally important for success in life. Wisdom, a vitally important characteristic, is virtually unmeasurable by any extant test.

In summary, psychological tests are useful to help develop an impression of how a particular person is functioning in some ways at a particular time in his or her life, as long as we keep their limitations firmly in mind.

Sunday, May 3, 2009

My Friend Talks of Suicide

“Laura” writes:

Dear Dr. Einhorn:

I am a 13 year old girl with a friend that talks of suicide. She
refuses to tell her parents, and I live too far away from her to talk
to them. I know she needs help, but she will not talk to her parents.
Will you please see if there is anything you can do?
I realize you are very busy, but if there's anything at all, please
respond to this email.
Thank you so very much,
Laura D.

Dr. Einhorn replied:

Well, you could call her parents, Laura. Or you could talk to your parents and ask one of them to call her parents.

Laura replied:

Yes, however they don’t believe she is serious, and my parents have never met her before, as I met her at summer camp.

Dr. Einhorn discusses:

Laura’s concern for her friend and feeling of helplessness come through clearly in her question, and this is often the position that friends, family, and even professionals are in when caring for adolescents, or adults, who are, to any degree, suicidal. There is lots of help that can be brought to the suicidal person--including therapy, medication, outpatient and inpatient programs, and support from friends and family--but often the person herself, or, as Laura indicates is the case here, her family, don’t take the risk seriously enough. And it is a serious risk: suicide is rated as the third largest cause of death for adolescents.

Of course, we can only talk in generalities here, because we have no information about the people involved. We don’t know, for example, whether Laura’s friend is talking about suicide as a way of expressing her emotional overload, maybe blowing off steam, without really intending to do anything (in which case she still seems to be in need of help), or whether she is seriously at risk for self-harm. So, the question becomes, not what Laura can do for her specific friend, but what someone in Laura’s position might consider doing to follow through on her concern.

Laura feels like there’s nothing that she can do and she’d like me to step in and do something here. But this is a situation in which I have no “standing,” to borrow a legal term; I don’t know any of the people involved, and they don’t know me. Laura is the person who knows the girl who talks of suicide, so, like it or not, she is the person faced with the choice about what to do. She’s reached out to me, hoping to pass this “ball” to someone who can carry it better than she can, but the truth is that no one can carry it better than she can at the moment. That’s one of the problems and challenges of knowing someone who is suicidal. If you do something to try to help them, your attempt to help might be rejected as inappropriate, interfering, or silly. If you don’t, and the person does make a suicidal attempt, or, actually commits suicide, you might regret not at least having spoken up in some way to try to help. There is no easy way to deal with a situation like this.

I can think of a couple of options that Laura might consider, and readers might think of others. She could advise her friend to talk to a school counselor, who would then be in a position to evaluate the seriousness of her talk and call her parents to advise them to get treatment for their daughter. This might be the easiest path for all concerned if the girl would talk to the counselor. If she won’t, and Laura is still concerned, she can still talk to her parents and ask them to call the girl’s parents, even though they don’t know each other, to express parent-to-parent concern. That might help the friend's parents take a second look at their daughter's state of mind and risk for self-harm. Sometimes students will anonymously advise counselors in schools that a fellow student is making suicidal statements, but I don’t know that Laura would even know what school to send an anonymous letter to. And of course that could always boomerang on her, if it prompts intervention that the girl or her parents resent.

One issue that this raises is what the responsibilities and limits of friendship are. That’s a question that each one of us has to answer for ourselves, in different relationships, sometimes over and over again. It’s a real challenge, and no fun at all, to have to deal with this question in this relationship at this time, but that is the place where Laura’s life has taken her, even at her young age.

It’s a shame that adolescent suicide is such a problem in our society, and it’s worth our time to ask why that should be; what pressures are adolescents responding to? Answering that is beyond the scope of this Q and A, but I’ll appreciate any thoughts that readers care to contribute.

As for you, Laura, you are to be commended for your caring in raising this issue about your friend and reaching out for help, and supported as you seek within yourself for the wisdom to find, and the courage to do, the right thing; whatever, in this situation, that may be.

Sunday, April 19, 2009

I've just read "The Writing On My Forehead," a novel by Nafisa Haji, and recommend it.  Written from the point of view of a feisty and questioning first generation American daughter of Indian-Pakistani Muslim parents, it covers a lot of ground about culture, family, morals, choices, and  traditions, within the context of a very readable story.  I was interested in the characters and, at one or two points, it bought a tear to my eyes.  

Saturday, March 7, 2009

When a Privacy Guarantee Means You Give Yours Up

A colleague, on a professional listserve, reports that she was contacted by a hospital's development department after her daughter had been treated there.  "Hello Barbara," said the development caller (not real names).  This is Jonathan calling from ____ Hospital.  How are you tonight?  I'm calling because your 12 year old daughter, Laurie, was a patient here.  Is that correct?"  Jonathan went on to ask Barbara for a donation to the hospital.  

Barbara was appalled, and asked her colleagues whether this wasn't a violation of privacy laws.  Another colleague did some research and found this on the hospital's website:  "In the continuing effort to enhance _____ Hospital's mission of service, periodic communications and invitations to consider philanthropic support may be sent to patient families..."  This language must have been included in fine print on one of the required documents, probably the one that guarantees patient privacy.  

So a guarantee of patient privacy is actually a violation of it.  You think you're signing a privacy guarantee when you are actually giving up your privacy.

The linguist Geoff Nunberg, commenting on Terri Gross' "Fresh Air" program on NPR, highlighted a similar deceptive use of language when he said that most "guarantees" were actually "limitations of liability."  

This kind of misuse of language is actually a violation of trust.  And right now I am seeing violations of trust as being at the heart of many psychological problems in human relationships in our society.

Although the legal structure, pace of life, social decentralization, constant persuasion pressure from multiple sources, and technological sophistication of our culture bring it to a whole new level, the basic problem of violation of privacy is a very old one.  Idries Shah, in his "Caravan of Dreams," quotes a tradition of the Prophet Mohammed about this:  "Whoever invades people's privacy corrupts them."  

There's probably no more important psychological issue today than the reestablishment of public trust in institutions, and for that, institutions are going to have to become more trustworthy.  One of the chief changes that will require is the recognition of the importance of institutional honor in the relationships that institutions have with people at all levels; consumers, investors, workers, regulators.  

We have no trust in our institutions because they have no honor.  The hospital's treatment of Barbara is, in a word, dishonorable; not in that it asks patients for donations, but in that it slips the permission to do so into a document that purports to be a guarantee of their privacy rights.      

Saturday, February 14, 2009

Clean Slate

We never start with a clean slate, because we always have a history that is embedded in the neurons of our brains and bodies.  We always start with a clean slate, because awareness is always now.  


Hanging my bathrobe in the closet, I felt a tug as the belt came out of the loops and fell onto the floor.  Looking to see what the belt had gotten snagged on, I discovered that I was, in fact, standing on one end of it.  And I wondered how many times we try to accomplish something that doesn't work out--in this case, hanging up my robe--and think that something in the environment is obstructing our success--whatever the belt had become snagged upon--when in fact the obstruction comes from ourselves.  We are, so to speak, "standing on one end of the belt while trying to hang up the robe."  Of course, it's because we haven't noticed in the first place that one end is longer than the other, and dragging on the ground...

Self-Respect and Self-Esteem

Some people equate self-respect with self-esteem, which is usually understood as having a good opinion of oneself.  But I would say that self-respect is saying what needs to be said and doing what needs to be done.