Book Review-Dreamland: The True Tale of America’s Opiate Epidemic

I was in a darkened room listening to two presenters with their different vantage points on opiates in the workplace, and during the talk, they mentioned the book Dreamland: The True Tale of America’s Opiate Epidemic. I disagreed with what seemed to be the presenters’ fundamental premise that drugs are evil, and are to blame for the problems we face as a society, but that made me more interested in reading the book they seemed to be drawing from. Perhaps, in my desire to understand addiction, I had somehow ended up on a side street rather than a main thoroughfare of perspectives on addiction.

As I began to read, I realized that, much like my perspective in my review of The Fearless Organization, there’s a component of the problem related to the coverage in the book – but that there are many factors that have received insufficient coverage. In the case of Dreamland, it’s not just about the morphine molecule but also about people.

Oxycontin

The poppy plant, and the opiates it produces, have been with us since the start of civilization between the Tigress and Euphrates rivers. Morphine may have only been first distilled in 1804, but its history travels back much further than that. However, as recently as 1999, pain management became important to medicine through the work of the American Pain Society. Press Ganey surveys became powerful forces in medicine to assess patients’ satisfaction with their doctors. The lower the pain, the better the scores. Even today, patients are asked whether they feel as if their pain is well-managed.

Though the American Pain Society promoted pain to be the fifth vital sign, it is different than the other four, which can be measured by calibrated instruments. Pain is whatever the patient says it is – and that opens the door for problems.

About the same time, in 1996, in the search for the perfect, non-addicting version of the morphine molecule, Purdue Pharmaceuticals took oxycodone, a synthetic opioid, and packaged it in a time-release pill called OxyContin. The aggressive marketing of OxyContin along with other factors led to a massive increase in the use of opiates – in the form of OxyContin – to treat pain.

Pharmacological Theory of Addiction

At that time, it was believed that high and low feelings created addiction. It was further believed that OxyContin solved this problem by continuous dosing, and therefore it was non-addictive. However, the story has its problems. The first is what was purported as strong evidence that people who were prescribed opiates didn’t get addicted – as was previously believed. The “strong evidence” was a single paragraph written as an editorial about the results of the progression of abuse in inpatient settings – not the outpatient prescriptions OxyContin was being suggested for. The editorial was written based on a database query of those inpatients who developed addiction which as a result of controlled settings was relatively few. In short, OxyContin was sold as non-addictive. An army of drug representatives sold it to doctors this way, who, in turn, prescribed it for patients.

There was another problem, too. OxyContin contains a high dose of oxycodone. It was the time release formula that made this make sense. If you don’t crush the tablet, all is fine. However, like a child who is told not to do something, the cat slipped out of the bag. If you crush the tablets – which you learned not to do by a warning label – you can remove the time-delay of release, resulting in a dose of oxycodone all at once and creating a euphoria.

The understanding of morphine and related opioids is that they overwhelm a receptor in our brains – the mu receptor. In doing so, they are far more powerful than any high that people can get naturally. It’s also understood that, after the influence of opioids, these receptors take some time to recover. In effect, the belief is that no one stands a chance against a morphine-based drug.

Retraining the Brain

Support for the idea that opioids can reprogram a brain comes from Toxoplasma gondii. It’s a parasite that infects cats. It’s excreted in their feces and ingested by rats. T. gondii, Dreamland reports, “reprograms the infected rat to love cat urine, which, to healthy rats, is a predator warning.” There’s a problem with this. When I went to investigate this fascinating idea, it seemed more far-fetched than reality. When humans are infected with T. gondii, they are higher in extraversion and lower in conscientiousness (fear). This is the kind of behavior you might define in rats as loving cat urine: less fear and greater extraversion.

While it’s possible that opioids literally reprogram the addict’s brain (or even the first-time user), it seems like this is more like propaganda than reality. (See Chasing the Scream for more on how drug addiction has been propagandized.) It’s certainly possible that opioids change biases in the brain, and acclimatization happens, meaning higher amounts of natural endorphins are required to activate the same response as was previously possible. But, again, this is a far cry from reprogramming.

The secondary support for the reprogramming idea comes from the fact that addicts will do things that are harmful to them. The problem is that they’re only harmful in the long term. Humans use stress to get a performance boost and pay the long-term consequences. (See Why Zebras Don’t Get Ulcers.) It’s true that our ability to defer gratification and do long-term planning is a large part of our success. But it’s a far cry to say that anyone who eats an extra cookie at the picnic is an addict. (See The Marshmallow Test for more about the positive impacts of delayed gratification.)

Addictive Tendencies

If you rule out that drugs are inherently evil and can reprogram the brain, you’re left with the reality that people are getting addicted, and they’re getting addicted at a very high rate. There’s something going on. It seems to be that “something” is susceptibility to being addicted. Some would argue that we can be genetically predisposed to being addicted. The answer might be a bit more complicated than that.

The Globalization of Addiction shares Bruce Alexander and his colleagues’ work, including a very interesting experiment called “rat park.” The research indicated that rats will continue to drink morphine-laced water until they kill themselves, but Alexander and his colleagues found that’s only true when the rats are bored. If you give the rats a social interaction and playthings, they much prefer that to overusing morphine. In short, when you deprive rats of the kinds of stimulation and community they need, they turn to drugs.

If our addictive tendencies are anything like rats’ tendencies, it’s because of things that are missing in our lives. We see this trend happening today. Robert Putnam has written about how our communities and connections are unraveling in both Bowling Alone and Our Kids. (Each book approaches the problem from a different lens.) Sherry Turkle in Alone Together writes about how technology has changed the way we interact, making us simultaneously more connected and disconnected. In short, the breakdown in our communities is leading to more capacity for addiction.

Interestingly, it may be one of the reasons why successful programs involve communities, such as Delancey Street (see Change or Die and Change Anything for two places where this program is cited) and twelve-step programs (see Why and How 12-Step Groups Work). Even the growth of gangs seems deterred by improving communities, as they tend to be another way people escape their existence. (See Trust: Human Nature and the Reconstitution of Social Order for more.)

Drug Community

Communities may be a way of staying out of drugs – but once you’re in a community that centers around drugs, it becomes harder to get out. When all your friends are users or dealers, they’ll inevitably pull you back in. (There’s a story related in 12 Rules for Life about Satan touring Hell and showing off the cauldrons – including the one with no need for protection, as anytime a Russian starts to get out, the others pull them back in.) So, while community is necessary to avoid addiction, it can, at times, create a safe haven for drug addiction.

That’s what happened when OxyContin gained acceptance in the medical community and at large. It’s not that abuse didn’t happen before – it did. What changed was the constraints that limited addiction were removed, and, as a result, addiction soared. What started with honest primary care physicians prescribing a little more than they should because they’re weren’t well-trained in pain management degenerated in to pill mills.

Pill Mills

If you want to tell the difference between a regular doctor’s office and a pill mill, all you have to do is look at the parking lot. Dreamland recounts, “If you see lines of people standing around outside, smoking, people getting pizza delivered, fistfights, and traffic jams – if you see people in pajamas who don’t care what they look like in public – that’s a pill mill.” What’s a pill mill? It’s a cash-only business, where “patients” pay a fee to get a prescription for narcotics. The visits are notoriously short, and the doctors don’t suggest alternative treatments or understanding pain better. It’s a “just take this and it will get better” approach with no thought given to the root cause or how to stop the pain. All that’s hoped for is temporary relief.

These pill mills spawned their own systems. People would get put on disability not for the somewhat trivial monthly amount but because it also gave them Medicaid. And Medicaid would pay the sometimes $1,200 fee for their drugs. The street value of the drugs was often even higher than this. The result is a system where those with a little money would pay for the exam fee at a pill mill and split the pills they got after filling the prescription. The elderly would sell some of their drugs to make a little bit of money. It seemed like anyone addicted to pills would need to support their habit by selling some of them.

Another solution was to steal. Walmart grew in rural America and brought economies of scale and globalization. In turn, it shut down local retailers, who couldn’t compete. In many Walmart stores across rural America, theft is just a part of business. The Walmart greeters aren’t really there to greet people as much as they are there to deter theft. However, addicts weren’t deterred and instead found ways to work around the system.

Dial for Drugs

The socioeconomic system was primed. Many people were hooked on pills they couldn’t afford. They needed a cheaper solution, and it came in the form of a phone number. Mexicans from Xalisco began taking calls and delivering drugs to addicts. Farmers and their children barely subsisted on sugar cane they could grow. However, poppies and the black tar heroin harvested from it was very lucrative in the United States. They created a system of drivers, and selling small amounts made heroin more accessible and cheaper than it had ever been. Some reports are that a one-gram hit of heroin cost roughly the same as a pack of cigarettes.

The Xalisco boys would come into town through an addict who got them connected to the community – usually in exchange for supplying their addiction. They’d find methadone clinics – which were sometimes described as game preserves for addicts. Handing out a phone number and some free samples, they’d quickly develop a clientele. That would be the start of a new drug cell.

Police Presence

The system worked well. Drivers never had much heroin on them and what they did have were in balloons in their mouths. If they were about to be arrested, they’d swallow what they had. Even when that didn’t work, they never had enough to be perceived as a threat, so they either got small sentences or were simply deported. The drivers were mostly illegal immigrants, all from the area of Xalisco.

The Xalisco boys made a point of blending in. Simple cars and apartments were traded in frequently. Just enough for them to run their system. Even after the largest scale drug enforcement action ever executed, there was only a one-day blip in the supply of drugs to most cities. The structure was an organization of individual small business owners, each trying to bring heroin to a place that wanted it.

The Cost

The cost wasn’t measured in dollars. It was measured in lives. It’s tragic. Drug overdoses in some communities outpaced deaths due to automobile accidents. It killed indiscriminately. It was no longer limited to skid-row junkies that no one knew or cared about. It happened to children. It happened to businessmen, politicians, policemen, and the wealthy. Still, it was quiet for a long time. The shame and stigma wouldn’t let go. Slowly, the story changed. Slowly, people began to recognize the truth that had been forgotten and ignored – that treatment is more cost-effective than incarceration. Medical professionals started treating the addicted not as pariahs but instead as people who needed help.

People still die every day of drug addiction. They die directly through overdose and indirectly through the complications of drug use. We haven’t – and cannot – stop it, no more than we can stop the legions of drug dealers from trying to make a profit. However, the tide is slowly changing. We’re recognizing that we need to support and help rather than condemn and confine.

The Road Back

The road back from the path that liberalized the prescription of painkillers and the systems of drug dealers that our police were ill-equipped to fight is long. Those who succumb to addiction are prisoners who need to be set free. They need to understand that their lives can be filled with positive things. They need to understand that they can accomplish something – and that something can lead them to their own Dreamland.

Footnote

There’s so much more to Dreamland that I didn’t share. My point wasn’t to convey the entire length and breadth of the book. Instead, in this review, my hope was to share the core of the very real problem that gripped, then strangled, much of America. My hope has been and always is that anyone struggling with addiction can escape their prison and find their own personal Dreamland.

Book Review-The Burn Book: 8 Key Strategies to Recognize and Extinguish Teacher Burnout

I’m not a teacher in the traditional sense. Sure, I’m an educator. I stand in front of classes and teach, but not in the way that Colleen Schmit means “teacher” in The Burn Book: 8 Key Strategies to Recognize and Extinguish Teacher Burnout. As a former kindergarten teacher, she means teacher in the kindergarten-through-12th-grade sense. Still, I wanted to get a sense for how teachers experienced burnout, so I started reading.

Independent Book Publishing and Speaking

First, it’s important to note that several of the books I’ve published have been self-published. I even laid out the math of self-publishing in my post Self-Publishing with Lulu.com. It talks about the finances to get a book done and what you get back from it once it’s published. I also explained that self-publishing wasn’t for the publishing revenue.

There’s a well-known reality in speaking circles that a book makes you more credible and more valuable. There are numerous services that exist to help speakers publish books to create more credibility. From extensive editing services and flat-out ghost writing to services like Lulu.com, they are designed to get someone listed easily.

This is important, because The Burn Book feels very much like a book that was designed to increase Schmit’s credibility as a speaker. She speaks once in the book about needing to teach occasionally to maintain “street cred.” She also discusses her work doing professional development workshops for teachers. While I don’t fault the desire to get credibility, I’m sometimes frustrated when I’m looking for a well-researched and well-thought-out book on a topic. The Amazon listing for the paperback version of the book says 120 pages – but the Kindle version reports 59. In any case, the book is short.

Work Wife

Schmit recommends that teachers get a work wife (her preferred term) or a work husband. The intent isn’t something adulterous. Rather, she advocates a close relationship with a peer and mentor who can help you become a better teacher. My problem with this is that a friend of mine was deeply – and appropriately – offended when her former boss called her a “work wife” in front of the team.

Certainly, having others who can help you up when you’re feeling down and provide a path forward when your waypower is lacking can be helpful. However, I’m not sure everyone’s spouse would appreciate the recommendation. (See The Psychology of Hope for willpower and waypower.)

Blame, Shame, Guilt, and Sarcasm

Schmit appropriately recommends that teachers avoid blame, shame, guilt, and sarcasm in their classes. I’ve written several times about shame and guilt. Having said that, shame is bad, and guilt can be, but isn’t necessarily, good. (See I Thought It Was Just Me (But It Isn’t) for more on shame and guilt.) I think the key here is to respect your students and try to help, not harm, them.

What About Burnout?

Honestly, I missed the connection to burnout. There was the occasional reference thrown in – but, all in all, it felt like this was a book about how to be a good teacher that got wrapped in a thin veneer of language that seemed “hot” to make it interesting.

If you’re a teacher and want to know how to be better, then by all means, pick up The Burn Book. If you’re looking for an understanding of research on burnout or different perspectives on burnout, there are better options.

Book Review-Solve Employee Problems Before They Start: Resolving Conflict in the Real World

Every once in a great while, you get to experience serendipity – a happy accident.  In this case, we had asked Scott Warrick to review our book, and in the follow up we got to see his latest book, Solve Employee Problems Before They Start: Resolving Conflict in the Real World.  Terri and I have taught conflict resolution for several years, and the opportunity to look at it from another point of view was welcomed.  When you’ve got a chance to look at how another expert looks at the challenges, the smart person jumps at it.  That’s what I did.  Despite the backlog of books coming out of the SHRM annual conference, I read it quickly and found, while there were definite differences in our points of view, the similarities dramatically outweighed the differences.

Emotional Intelligence

Early on in our work with conflict de-escalation and resolution, we started with emotional intelligence.  (For more, see my review of Emotional Intelligence.)  We certainly believe that the ability to develop emotional intelligence in employees is critical to changing the frequency with which you’ll need focused conflict resolution skills.  We maintain it as the first set of lessons for every employee in our Discovered Truths program, but, in conflict resolution, we took a step back from it.

The feedback we got was that it is like using a slow cooker to cook a burrito.  Our customers needed something that they could bring to bear directly against the conflict, not a preventive plan that they could develop over time.  However, as Warrick points out, emotional intelligence is a foundation.  If the people you’re working with don’t have a basic level of emotional intelligence, it’s very hard to get to any sort of a resolution.

I view teaching emotional intelligence in your organization as a sort of vaccine against poorly managed conflict.  The greater the emotional intelligence, the less likely it is that you’ll need to mediate conflicts to get to a good resolution.

Emotional Intelligence Defined

Like many contemporaries, Warrick pulls from Emotional Intelligence 2.0, Travis Bradberry’s and Jean Greaves’ work.  However, the model he uses for emotional intelligence includes components that aren’t a part of the familiar, four-part model.  He leans on Reuven Bar-On’s emotional intelligence model which consists to 15 scales divided into 5 major areas:

  • Self-perception skills
  • Self-expression skills
  • Interpersonal skills
  • Decision-making skills
  • Stress management skills

The model is the one that MHS sells as an assessment that is based on Bar-On’s original research. It is an impressive test.  However, while I agree that these skills are important, the definition of interpersonal skills seems nebulous, and the relationship to decision-making skills seems to be unclear.  (See Klein’s work in Sources of Power and Seeing What Others Don’t for how we really make decisions.)

In a follow up conversation with Warrick he and I were able to drill into empathy and how to teach this component of interpersonal skills.  However, my primary concern is the interpersonal skills is in the area of Interpersonal relationships.  I’m not sure there’s a way to assess this in a way that makes sense universally.

More broadly, I struggle with the complexity of the Bar-On model since it creates a level of complexity that I don’t know that most people cannot internalize.  It’s one of the reasons that even though I love Reiss’ work on the basic motivators (See Who Am I?) that I don’t expect people to be able to use it without a productivity aid.

Neuroanatomy and Homicide

Warrick incorrectly limits the use of CT and magnetic resonance imaging (MRI) technology to structural views of the brain.  In a follow up conversation with him, he made it clear that he’s not talking about functional MRI (fMRI) and that some of the most powerful advances in our understanding of neuroanatomy come from functional MRI (fMRI) systems, which indicate the flow of blood in the brain – indicating a recent consumption of oxygen and glucose.  In other words, it can show what is and isn’t active in the brain.  (See How Dogs Love Us for one way that an fMRI was used to understand emotions.)

He also limits the use of Computed tomography (CT) to structural scans as well, however, computed tomography angiography (CTA) is used to show the flow of blood.  It does this by taking multiple images and comparing the results.  This leads to an understanding of how the blood flows.  At some level, you could consider this structural in that it’s showing the pluming of the body, however, at another level it’s demonstrating the flow of blood through the body – which is one part structure and one part about the way that the body is constricting blood vessels to route blood.

Warrick is a big fan of a SPECT (Single Proton Emission Computed Tomography).  It’s essentially a positron emission tomography (PET) scan that uses substantially lower doses of radiation.  From a numbers perspective the costs for a SPECT seem to be 30% higher than the cost of an fMRI with limited discernable advantage.  fMRIs appear roughly ten times as frequently in research than SPECT.  His comments were that SPECT were more often used in clinical observations and fMRI in research applications, but I couldn’t support this with any data I could find.

There’s also references to the inhibiting function of the left frontal lobe on the amygdala.  This is a generalization based on the famous case of Phineas Gage, who had a tamping iron get driven into his skull, thereby destroying some of his ventromedial prefrontal cortex.  (See The Blank Slate for more.)  There are places where one brain area inhibits or regulates another, but nothing as coarse as is suggested here.  (See The Hope Circuit for a specific example.)

Similarly, there are some conclusions regarding the relative tendencies of humans to be homicidal as compared with the murderous nature of our animal cousins.  Surprisingly, the research here, in general – not Warrick’s — has been awful.  12 Rules for Life points out that humans appear to be becoming less homicidal as time progresses rather than more, as is sometimes reported.  Even simulation models, like those discussed in The Evolution of Cooperation, point towards humans having been successful due to their cooperation – and, at times, the need to punish freeloaders.  Jonathan Haidt reaches the same conclusion through different means in The Righteous Mind, where he attributes our dominance of the world to our ability to “get along.”  The Nurture Assumption speaks about Jane Goodall’s observations of the violence.  The quick summary is “chimpanzees don’t cotton to strangers.”  All-in-all, we’re a violent species, but whether we’re more violent than our primate cousins seems to be subject to some disagreement.

Two Systems

Warrick explains that we have two different factions in our brain fighting for control.  One faction is led by the amygdala and the other by our frontal lobes (or neocortex).  Kahneman explains the struggle in Thinking, Fast and Slow.  Kahneman and Warrick reach the same conclusion that the automatic, lizard, emotional brain, can lie to the neocortex, primate brain.  Further, it’s possible to become emotionally flooded, where the neocortex is effectively taken out of the picture.

Jonathan Haidt’s view is slightly different with his Elephant-Rider-Path model, which has the emotional elephant always in control but usually ceding this control to the rational rider.  (See The Happiness Hypothesis and Switch for more on this helpful model.)

Warrick’s neuroanatomy isn’t precise here.  Recent work indicates that the limbic parts of the brain – including the amygdala – receive a copy of some sensory data that arrives ahead of the data being provided to the neocortex.  (Neocortex means new brain or the primate brain.) This means the limbic portion of our brains can literally react quicker.  Warrick uses a conceptual model like Kahneman’s, where the data is processed by the limbic system and then forwarded to the neocortex – but that doesn’t appear to be technically accurate.  (See Incognito and The Hidden Brain for more about the way that we process signals in our brains.)  Still, the conceptual model is enough to address the point that we can become emotionally hijacked.

The Silent Scourge – The Retreaters

One would think that, in a book dedicated to solving employee problems, the people who were conflict-avoidant would be the heroes.  However, the opposite is true.  Much like how John Gottman explains in The Science of Trust how stonewalling is one of the worst things that could be done to a relationship, so, too, does Warrick believe that those unwilling to say what they’re truly thinking are tearing the culture of the company apart.

The pressure must go somewhere.  When someone doesn’t agree and doesn’t speak, they experience an intrapsychic pressure that needs to be dissipated.  Though it’s technically possible to safely channel this into other outlets, few people do this.  Most either complain to others, thereby creating a culture of talking behind people’s backs and eroding the trust necessary for organizations to function, or they eventually blow up, breaking the feeling of psychological safety.  (See Trustology for more on trust, and The Fearless Organization for more on psychological safety in the organization.)

Understanding and Agreement

Warrick makes the point that you should listen to the opponent – and that no one in 30 years of conflict resolution work has been able to accurately explain the other party’s point of view.  He also explains that you should listen so at least you understand the other party.  Too few people do this.

We mistakenly confuse understanding for agreement, and we can’t agree, because ours is the “right” answer – because it’s ours.  (See Thinking, Fast and Slow and Mistakes Were Made (But Not by Me) for some of the hidden biases that influence us.)  Because we’re so focused on reaching agreement, we don’t make time for understanding.  The truth is we’re afraid that, if we understand the other person’s point of view, we might lose our sense of being right.  Learning – which is what we’re doing when we seek to understand someone – is an inherently risky process, and it’s one that we’ll only take when we feel safe enough.  (See The Adult Learner for more.)

Disagreeing with Tact

Warrick also explains that it takes a great deal of tact and thoughtfulness to disagree with someone else.  We need to be careful not to attack them and stay focused on the ideas.  We need to reward them with places where we see eye-to-eye or value them.

During this review, I’ve been trying to do just that.  To share where I disagree with Warrick while recognizing the value in his messages and the great value that his book has for everyone that reads it.  If you can find ways to disagree with tact and thoughtfulness, perhaps you’ll learn how to Solve Employee Problems Before They Start.

Book Review-Emotional Intelligence 2.0

There have been many references to Emotional Intelligence 2.0 in my world over the past several years, but they hadn’t managed to break through and cause me to read it. I had read Daniel Goleman’s Emotional Intelligence some years ago and it had stuck with me. In the intervening six years much of what I struggled to process became clearer. I added input from others, studied Buddhism, and worked on better understanding neurology. The problem wasn’t that Daniel Goleman didn’t have it right or that he didn’t understand it. The problem was that the content wasn’t very accessible.

Even in my review I commented that I could not fully process all of the content. This is probably the biggest difference between Emotional Intelligence and Emotional Intelligence 2.0. The former is focused on depth and accuracy where the latter is more focused on clarity and understanding.

The EI Model

The fundamentals of emotional intelligence are two dimensions:

  • Self and Other
  • Awareness and Management

These form a 2×2 matrix of self-awareness, self-management, other awareness (called “social awareness”), and other management (called “relationship management,” since you don’t really manage others, you manage your relationship with them). The model is the same one is used in Emotional Intelligence.

The Strategies

Much of Emotional Intelligence 2.0 is spent providing specific strategies to enhance your emotional intelligence in one way or another. There are 15 strategies for self-awareness, and 17 each for the remaining three categories. The 66 strategies move emotional intelligence from something that’s interesting to something that can be tried. One could argue whether the use of a strategy artificially inflates the perception of emotional intelligence or changes it, but the goal is to make it a habit. With continual use, it can become one.

Individually, the strategies are not particularly profound. Most of the strategies we’ve heard before and have implemented at some level. However, what is profound is having a catalog of things to try when you’re trying to get better.

The Test

Much like Strengths Finder 2.0, Emotional Intelligence 2.0 comes with a code, so you can take a free test to evaluate your emotional intelligence. The test has 28 questions, in which you’re asked to rate each statement for whether it happens never, rarely, sometimes, usually, almost always, or always. From this, scores are created in each of the four categories as well as an overall score. Unlike Strengths Finder 2.0, the scoring is relatively trivial to see. There are a handful of reverse-scored items (where never is the best answer), but, mostly, the idea is you would pick always to get your perfect score.

This is a problem for me, since, once you reach a level of self-awareness and maturity, you’ll not rate things as always or never. In my review of Dialogue (speaking of The Inner Game of Dialogue), I recounted a quote from Richard Moon, an aikido master. “It’s not that the great masters of Aikido don’t lose their center, it’s that they discover it sooner and recover it faster than novices.” Even the Dalai Lama admits in his writings and conversations with others that he’s not perfect at his emotional intelligence. His work to be more connected with himself and others is something that most of us couldn’t do – and yet he remains a student and a practitioner. (Practitioner in the sense that he’s still practicing.)

So, while the test may be able to provide you some direction on what strategies you could employ if you find that you struggle with a particular aspect of emotional intelligence, I was frustrated with the lack of precision on the high end of the scale.

Why Emotional Intelligence 2.0?

Why would someone want to read Emotional Intelligence 2.0 instead of the classic Emotional Intelligence? Simply, it’s easier. It’s a simpler, less-nuanced, and biologically-connected view of the need for humans to understand themselves and others. My suggestion is that, if you’re new to emotional intelligence, or you want something with practical tips to get you started with emotional intelligence, start with Emotional Intelligence 2.0. If you’re looking for something deeper, Emotional Intelligence is a great – but difficult – read.

Book Review-Daring to Trust: Opening Ourselves to Real Love and Intimacy

Trust isn’t earned. Trust is given. Trust is us daring to be vulnerable so that we can enrich our lives and the lives of others. David Richo explores trust and its necessity in Daring to Trust: Opening Ourselves to Real Love and Intimacy. I’m familiar with Richo’s work through How to Be an Adult in Relationships – a book that I still heartily recommend. (Occasionally, the title gets me in trouble with folks, but it’s worth it if they read it.) He definitely has a deep understanding of human nature and what it takes to help us find our own path to healthy happiness.

I’ve also got a long history with trust. I just recently revisited an old post with Trust => Vulnerability => Intimacy, Revisited. The original post and the revision tie together the work of numerous authors to explain how trust leads to safety, which leads to vulnerability and, ultimately, intimacy. Richo connects trust to intimacy and our need to be connected to one another, so I resonated with the points he was making about our need for trust and how it moves us forward.

Time to Trust

Richo says, “Trust happens in the present and connects past experience with future probability.” In one sentence, he explains how trust is a bridge across time. It’s how we gather up our past experiences and use them in the present to make a bet for a better future for ourselves and others. Trust is a decision to take a risk that someone will betray us, because, if they do not, the rewards are so much greater.

Our past experiences greatly influence our ability to trust ourselves and, ultimately, others.

Learning Trust

We learn to trust just like everything else in life. Our first teaching comes from our parents and their ability to provide for our needs. We arrive on the planet totally dependent upon our parents for their support. We need clothing to keep us warm, food to allow us to grow, grooming to keep us clean, and protection from the many evils that lurk behind every corner. It’s during these early formative times that we begin to develop a sense for how the universe operates. Through our parents’ actions, we extrapolate about how the world at large works.

If parents are attentive to our needs, we believe that the universe wants good things for us. If we’re neglected or abused, it becomes hard to trust in the goodness of the universe. Our focus will be on survival and how we must protect ourselves, since no one else seems to be willing – or able – to do it.

Mary Ainsworth observed the way parents and children interacted and came up with three basic attachment patterns. The patterns she observed are:

  • Secure – The child is comfortable whether with or away from their parents. As adults, they’re self-confident and appropriately independent.
  • Anxious-avoidant – These children need constant affirmation and support from those around them. As adults, they’re demanding of their partners and peers.
  • Anxious-ambivalent – As children, they’re compulsively independent. As adults, they may become victims.

Ainsworth discovered that parents who were attuned to their child’s needs – but not enmeshed with the child’s feelings – produced children whom she would describe as secure. Others have estimated that only 50-60% of adults are securely attached.

Trusting Ourselves

Some of us won the parental lottery. Our parents gave us a belief that the world was good and helpful. Our worldviews are shaped by opportunity, relative safety, and trust. This worldview often translates into our capacity to trust ourselves.

We see and celebrate our successes realizing that we can do anything we set our minds to. We’re not afraid of hard work, and we’ve seen many successes as a result. (See Peak and Mindset for more about the role of hard work.) The successes and our recognition of them creates an experience that leads us towards trusting ourselves.

Others aren’t as lucky. Their parents didn’t respond to them well, and they’ve developed a mistrust for the universe. The result is someone who is closed down. They don’t take risks, because they expect something bad will happen. And because they’ve taken few, if any, risks, it’s hard to find good things they’ve accomplished to celebrate. The net effect of this is a low degree of trust in oneself, because there is little or no experience to build that trust from.

The everyday slings and arrows that we must accept overwhelm the few things that could drive trust in ourselves. We forget a commitment. We fail on our New Year’s Resolution. All of that weighs on us and our ability to trust ourselves.

Trusting Others

It doesn’t take a specific betrayal to resist trusting others, though it certainly doesn’t help. Trusting others may be the hardest and most necessary thing that any human can do. Gone are the days when a person could stand alone. Those who think they’re independent now don’t know how to kill and prepare their own food, create electricity, build homes, purify water, or any of the thousands of things that we rely upon for our safe living. If we know how to do one or two of these things, that’s great. However, the reality of today’s modern living is that we don’t have any idea how to really survive on our own.

While our reliance on others is a matter of fact, our decision to trust others isn’t necessarily a forgone conclusion. We don’t have to trust others. We can decide that vaccines are evil and should be avoided. We don’t have to trust our doctor or the mountain of evidence that says vaccines have few harmful side effects and dramatically improve resistance to viruses by making our own immune system more capable of fighting it. This would, of course, be a bad decision, but we have the freedom to make it.

Love

Once, it may have been the only emotional force that showed us we were truly alive was fear. However, love has crept in as another way for our emotions to show us we’re alive. Certainly, when we’re in love, we often feel it with a mix of fear. In the initial stages, we are concerned the other person may not love us back. As love becomes more mature, we may fear we’ll lose our love for the other person, or they’ll lose their love for us.

From an evolutionary perspective, love coming after fear makes sense. We needed fear to allow us to avoid things that would be harmful to us. We discovered the first kind of love – infatuation or sexual love – to reproduce. The kind of love Richo’s talking about, a sustained commitment between a male and female, came later. It came, evolutionary biologists believe, when it became necessary for two parents to help with the rearing of children, as has certainly been the case for human development. Evolution taught us that we needed to have a commitment to one another to support our children.

When evolution needs something to happen for us to survive as a species, it has at its disposal powerful neurochemicals that can truly make us feel alive. Sometimes, that’s enough to commit to years of child-rearing – and sometimes it is not.

Performance-Based Love

When we speak of “love” in English, we have to detangle several different kinds of love. C.S. Lewis tries to do this in his book The Four Loves. Our global love for all is what the Greeks called agape. Our love of our brother was known as philos. Our sexual urges were known as eros. These are great, but none of them are really what we mean by the kind of committed love that Richo’s talking about.

Making things even more complicated is what some call “performance-based love,” which isn’t love at all. In fact, Richo acknowledges that our brain doesn’t even process it as love. Performance-based love says that I’ll love you as long as you’re performing. If I feel like you’re making me look better or enhancing my reputation, I’ll be “in love” with you. Of course, love is a choice, a decision, a commitment, so performance-based love isn’t love at all. (See Love, Acceptance, and Forgiveness for more on love as a commitment.)

Reality

The Buddha said that everything is impermanent. It is a central tenet of Buddhism that nothing is permanent, and when we try to make it so, we increase our suffering. Too often, we seek to maintain things the way they are, to expect that trust will continue the same way it always has. This is a fiction. It’s a failure to accept the impermanence of anything in this life.

Our wishes and desires, no matter how convicted, do not make reality. We must accept reality for what it is rather than what we desire it to be. When we allow our desires to prevent us from seeing the truth of reality, we’re harming ourselves. We cannot exist in relationships with others when we’re trying to be in our own little bubble of our reality rather than the one which we all share.

The Erosion of Trust

The reality is that trust isn’t always broken in one betrayal. Sometimes, trust fades slowly because of misses and delays. Parents sometimes struggle with children. They ask them to do something and later “remind” the child only to have them insist they were getting ready to do it. In these times, children need to be taught that a delay in responding or doing what was committed to or expected will erode trust.

As adults, it’s very normal to struggle to meet our commitments at times. That’s why renegotiating our commitments is a critical part of every adult’s tool bag for developing and maintaining trust.

Hurts and Harms

An interesting point that Richo makes is that being hurt and being harmed are not the same thing. One person can hurt another without harming them. Richo explains that a surgeon’s cut may hurt, but it doesn’t – in the end analysis – often harm the person. The hurt is necessary to be able to heal.

Recovering after surgery often means painful physical therapy. It’s hurt that enables healing. Those who want to build muscle must accept the pain that accompanies the muscles being torn down so that they can be rebuilt stronger.

When we trust, we’re exercising our trust muscles. Occasionally, we’re going to be hurt by betrayal. However, we strengthen our ability to trust by exercising it with more people and in more ways.

We often confuse pain as a warning of something to be avoided. The truth is that pain is a signal. It can indicate that there’s something to be avoided, but in other cases, it can encourage you to pay attention.

Learning to Be Porous

Our sense of ourselves is somewhat of a mystery. We believe our edges extend to our clothes unless we pick up a tool, and then the tool becomes a part of our self-image. If we get into a car or airplane – particularly if the car or airplane is small – we begin to perceive the car or airplane as a part of ourselves. Because we believe we have control over it, we extend our sense of self to accommodate it.

So, in this way, our sense of self is variable. We can sometimes feel as if we’re larger or smaller. However, our sense can become variable – or, as Richo explains, “porous” – by adopting different beliefs about ourselves.

The problem with extending ourselves to our cars is that, when someone scrapes our car, dents our doors, or gets into an accident with us, we believe that we’ve been harmed. In truth, most of us have insurance, and these “assaults” on our car will not really impact us. However, if you’ve seen people leap out of their cars after a minor fender bender with tempers flaring, you’ve seen the “assault” become a personal affront.

If we’re willing to accept that most things that happen don’t threaten ourselves – and we’re not defined by titles or external things – then we no longer need to defend the trappings of our identity. We can let go of the things – and pick them back up when it’s safe to do so. In doing this, we’re more able to feel safe and to trust others. We don’t have to protect as many things.

When Not to Trust

Trust is, in general, a good thing. However, there are cases – such as in the case of continued abuse – where it’s not a good idea to trust. The problem when we continue to trust others, and those who we trust abuse us, is that we necessarily lose trust in ourselves. We lose trust in our ability to protect ourselves by entering into relationships and situations that are unsafe.

As we face continued abuse and we fail to take action, we no longer trust ourselves to take action. This spreads into every aspect of trusting ourselves and others. The good news is that there’s a relatively simple and direct act that can begin the process of restoring our trust in ourselves and in humanity: to separate from the abuse.

Treading carefully to avoid offending anyone, there are three accepted reasons for divorce: adultery, abuse, and abandonment. (See Divorce for more.) You can – and should – divorce yourself from anyone who routinely or habitually abuses you. At the same time, relationships and friendships are necessarily fraught with imperfection. Only you can decide whether the abuse is an accidental and isolated incident that will not happen again. In these cases, there’s a decision to be made about whether it’s worth it to trust again and make the relationship work – or whether it isn’t safe enough.

So, there are times when it’s appropriate to not trust. Another way to view it is there are times to trust yourself in knowing the other person cannot be trustworthy and therefore shouldn’t be trusted.

Everything Can be Mended or Ended

There’s a peace in knowing that every relationship can either be mended or ended. It provides some definition to the vagaries of human relationships. There are only two outcomes, and it’s up to you to decide which of the two outcomes is the right one – and you can change your mind later if the situation changes.

I know a man who cheated on his wife years ago. Her decision was to end the relationship – but not the marriage. He continues to behave faithfully and supports her and the children while living separately. There’s no guarantee that she’ll change her mind and decide the relationship can be mended, but he’s doing everything in his power to demonstrate that it’s possible.

The Wisdom of Open and Closed

There’s a definite wisdom to understanding what experiences and feedback we allow into ourselves. We need feedback from others to calibrate our understanding of the world and learn how we should adapt or change to better align with the world. At the same time, much of the feedback that we’ll receive from will be wrong. It may be well-intended, but it will be wrong.

What would have happened if Edison listened to the people who said he’d already failed 500 times and was no closer to creating a lightbulb? What if the Wright brothers had listened to the folks who said they’d never be able to accomplish heavier-than-air flight? Clearly, we’d be worse off as a society. The problem is that we never know which feedback is right and which we should ignore.

That’s why the wise are open to what’s happening around them, including their experiences and the feedback, without accepting the feedback that would stop their success.

Grounded in Reality

A key to trusting others is realizing that we need to remain as grounded in reality as possible. Imagination is a wonderful asset but can be harmful when our imagination crowds out reality. (See my review of Incognito and the discussion of John Nash.) Our imagination allows us to create what doesn’t yet exist, but we shouldn’t confuse what is possible with what is.

Our imagination allows us to imagine a space where we’re reaping the rewards of trust. In short, it shows us the rewards we can get when we’re willing to be daring – Daring to Trust.

Book Review-HR On Purpose: Developing Deliberate People Passion

Why do professionals decide to go into human resources? For most, it isn’t a lifelong dream. I’ve met plenty of children who have said they wanted to be firemen or astronauts. I’ve never met someone who, at five, said they wanted to be a human resources manager. Somewhere along the line, people just ended up there – or they recognized their potential to help everyone become more effective. HR On Purpose is a book that can help you find your passion for people, whether HR was the destination or just where you ended up.

It’s All About the People

It’s easy to get confused. There are so many regulations and requirements. It’s easy to believe that the joy is about the implementation of policies and procedures. It’s easy to be deluded into thinking that it’s about the regulations and requirements. However, the job of human resources has always been – and always will be – about the people. Professionals can’t ignore the paperwork or the legal bodies; however, it’s not the point of the job. It’s like saying the freedom of driving a car is about the rules for getting the title.

If you can’t find a way to make the people the most important part, then you’re in the wrong spot. If people aren’t the most important thing, then you may need to look for other opportunities for yourself – inside or outside of the organization.

Dumping Grounds or Counselor

Counselors are paid to listen to other people’s problems. (There’s a myth that they’re paid to solve them as well – the reality is they’re paid to help people learn to solve them themselves.) It’s well known that bartenders and hairdressers often serve as informal counselors. Many churches have lay ministers that serve as counselors too. However, when they’re at work, employees are likely to come spill their problems at the door of the human resources professional.

Listening to other people’s problems all day is exhausting. That’s why psychologists and psychiatrists work so carefully to ensure that they’re doing the kind of self-care they need. That works well for them when their pay is higher and their only job is to listen. When the human resources professional is done listening to an employee vent, they’ve got to get back to that job requisition, health benefits plan, or one of the thousand other tasks that they have. The result is that, too often, human resources professionals don’t take the time to do the self-care they need to keep sane.

Sometimes, the result is, instead of feeling as if they can support the load of employee problems, they feel dumped on. It is possible to learn from counselors and their detachment from problems to ease the load. (See Creativity, Resilient, Burnout: The Cost of Caring, and The Happiness Hypothesis for conversations about detachment.) Whether or not we can find a way to detach from employees’ problems, we need to find ways to bear the load of them.

Confidentiality

If you’re alone in your position in HR – as most practitioners are – finding a way to seek input and maintain employee confidentiality is difficult. In addiction circles, they say, “You’re only as sick as your secrets.” Unfortunately, there are some jobs – HR being one of them – in which you must keep secrets. The good news is that they’re not secrets about you. Still, the need to maintain confidentiality can be a heavy load to bear. It’s coupled with the necessary uncertainty about whether you’re doing the right thing or giving the right advice.

Employees Are Not the Enemy

Sometimes corporate executives develop the perspective that employees are the problem. They’re defiant. If the employees would just do what they’re told, everything would be good. The plans that the corporation makes would work if only the employees would follow through. This perspective is not correct. While some organizations have some employees that are actively working against the organization, most employees want the organization to succeed and are doing their best to fulfil their roles.

How successful would it be to ask your five-year-old child to drive you to another state? Ignoring the legality of this question, there are numerous gaps that make such a request impossible. There’s the obvious fact that they can’t reach the pedals and the steering wheel and look over the dash at the same time. There’s the fact that they don’t know how to shift into gear. However, more than that, there’s the fact that they’ve never navigated before. They don’t understand maps. They can’t plan for gas. There are numerous reasons why such a plan might fail.

We sometimes do this to employees and then wonder why they fail. We ask them to drive and provide them with the blocks to be able to reach the pedals and the wheel but fail to realize all the other gaps in knowledge and capability that they have. In the end, rather than blaming ourselves for failing to support the employees properly, we blame the employees for failing to accomplish our request.

It’s natural. Calling it fundamental attribution error, as Kahneman does in Thinking, Fast and Slow, doesn’t change the fact that it happens, and it’s natural for executives and HR professionals. It’s our job, as HR professionals, to fight our natural urges and to continue to support management in understanding that a failure to follow doesn’t necessarily mean defiance. It can mean a lack of understanding or a lack of skill.

Communicating

Communication may be our greatest advance as a human society. It’s also one of our greatest challenges. Our ability to share our thinking allows us to work together in ways that even our closest primate cousins cannot. Despite this, we find ways to obscure our thinking and communicate in ways that make us feel superior, but we do so to the detriment of those that we are there to support.

We’re all familiar with legalese. We know it when we hear it – generally lower and faster at the end of the commercial. We see it in contracts. It’s a way that attorneys sometimes hide their true intention from one another in writing contracts. If you’ve ever had attorney friends, and you’ve asked them what something means, only to have them say, “I don’t know,” you’ve seen this in action.

When we communicate in corporate or HR speak, we’re intentionally making it more difficult for someone to understand us – and employees are necessarily suspicious. You are, too, when people adopt overly formal communication approaches with you. While the lexicon of a profession is important to use with other professionals, it’s not useful in communicating with non-professionals. (Lexicon is the specific vocabulary used by a profession to convey precise meaning.) When communicating, our goal should be to communicate, not demonstrate how smart we are.

Seat at the Table

In many organizations, HR isn’t strategic. There isn’t a seat at the executive table for the HR professional. Most HR professionals presume that this is because of their organization. Browne gently challenges the HR professional to start behaving in the right way and the seat will come. Rather than lamenting that you can’t be strategic or a part of the executive conversations, simply behave in a way that’s intentionally strategic and, eventually, the organization will notice.

In my experience, HR professionals are so caught up with the tactical execution that they fail to insist on the development and execution of a strategic plan. One of my technology clients in the long-term care industry has 120% turnover in their front-line workers every year. Admittedly, it’s a relatively thankless job, and the industry’s turnover rate is somewhere between 60-80% per year depending on which numbers you want to believe. Rather than working on the reasons why their turnover is so much higher than average, the professionals are focused on optimizing the onboarding process.

Optimizing the onboarding (and offboarding) process is important, but it’s not strategic. It’s operational excellence rather than strategic insight. Operational excellence doesn’t get you a seat at the executive table. Strategic insight to what must be done to stop the high turnover rate can.

The risk in sharing this is that someone will think strategically and perhaps even work on an execution plan for a few days or weeks and will wonder why the seat at the table isn’t coming. The problem is that the seat at the table isn’t a reward – it’s a natural outcome. When you’ve demonstrated strategic thinking for long enough, the executive team will want you at the table not to reward your efforts but because your perspective can help the team make better collective decisions.

Management by Wandering Around

Tom Peters in In Search of Excellence advocates management by wandering (or walking) around (MBWA). The idea is that, if you really want to know what is happening, you should go to the floor. If you really want to have a connection with people, you have to be willing to spend time to get to know them. Browne shares stories where his commitment to support the employees got him in trouble with the people in the office who felt his time was better spent doing other things.

At the heart of MBWA is a desire to “be with” people and to meet them where they are. That applies to the normal situations not just the crisis. It applies to how people want to be recognized for years of service. It applies to every aspect of working with people. Meeting them where they are at is an important aspect of demonstrating caring and one that few people overlook.

Self-Development

In my technology world, I heard a startling quote decades ago. Steve McConnell was speaking about the state of the industry and said that few developers had even a single book on their craft. I glanced over to my bookshelf and realized that I, thankfully, wasn’t in that category. While books may no longer be the only way to demonstrate that you’re staying up on your profession, they are still a way.

HR professionals rarely spend time investing in their personal development to get better at their craft. Too few professionals are certified. Those who are certified have continuing education requirements to help ensure that they continue to develop. Those who aren’t certified may – or, more often, may not – work towards ensuring that they’re developing as a professional.

The saying that sticks with me – perhaps because I travel too much – is “put your own mask on first before assisting others.” It’s a standard part of the safety briefing for a commercial airline flight. It’s an acknowledgement that, if you’re passed out due to the lack of oxygen, you can’t help others. If you’re always clear about ensuring that your needs are met, you’ll be able to give to others. If you don’t, you may find yourself burned out and unable to do anything to help the people you’re there to support. (See ExtinguishBurnout.com for more on how to protect yourself from burnout.)

Busy

We’re all busy. We’ve all filled our lives with stuff. It’s hard to find someone who couldn’t describe themselves as busy. Even retired friends report themselves as busy. In fact, many of them wonder how they had time to do a job given how busy they are in retirement. We must accept that we’re always going to be busy. The question isn’t busy or not busy. The question is whether our life is filled with the right or the wrong things.

If busy is getting in the way of your self-development, what can you do to remove things to give you space? There are some people for whom there is no margin left. They literally can’t take on one more thing. However, for most of us there are things that we do to waste time or enjoy ourselves that could be refocused on self-development or on more powerful opportunities to connect with our fellow human beings.

You may feel like you’re too busy to take something else on, but I’d encourage you to find space to do HR on Purpose.

Book Review-Trustology: The Art and Science of Leading High-Trust Teams

Why does trust matter anyway? Trust in our teams and our organizations can make the difference between poor performance and stellar performance. Trust is essential to creating and leading high-performance teams. Trustology: The Art and Science of Leading High-Trust Teams is here to help us create and lead high-trust teams.

The impact of trust shows up in every aspect of our lives. Amy Edmonson speaks of the need for psychological safety in The Fearless Organization. Psychological safety is a trust in the organization that it’s safe to speak up. According to Trust: Human Nature and the Reconstitution of Social Order, trust and how it’s focused shapes how everything works in societies. In our personal relationships, The Science of Trust explains its profound effect on our ability to remain connected. Our ability to build and maintain trust isn’t confined to just our work lives. Our ability to build and maintain trust impacts us at nearly every level.

Why Trust?

Trust is a gift that we give other people, and it’s risky. No one can earn our trust. There are no guarantees that our trust will be well placed. There’s always the risk that we will be betrayed and we’ll need to cope with the consequences. Leaving our soft underbelly open to attack has its risks, but it also has its rewards.

Life is exhausting. The need to constantly defend ourselves from other people and unknown threats can wear us down. When we create sanctuaries, we can recharge. In a sanctuary, we can take the time to recharge without being on the lookout for the next threat. Sanctuaries are places that we trust to protect us against the evils of the outside world. People can be sanctuaries, too. You can have trust in people that is so powerful that you know you’ll be recharged every time you’re with them.

You can build and lead teams that feel like a joy to be a part of instead of always worrying about who is going to stab you in the back.

How to Build Trust?

I had the honor of spending time with some people in some of the darkest times of their lives, whether they were fighting their way back from addiction or standing in the middle of the wreck that once was their marriage. What I learned from these great people is that trust is hard to repair. Once the bond of trust has been broken, it takes a courageous person to trust again. Just as I explained in my review of The Fearless Organization that organizations can’t create total psychological safety but should create as much safety as possible, so, too, did these struggling individuals need to create as much safety as possible for the people in their lives.

It was during this time that I wrote a simple post, Building Trust: Meet, Renegotiate, Make. It’s a simple approach of making small commitments – that the other people in our lives will accept – and then meeting them or renegotiating them before they’re due to be completed. No doubt the author of Trustology would struggle with this approach given his insistence that trust can’t be earned. However, the point is not that you earn trust – after all, you can’t earn a gift, and trust is a gift. The point is that you create the conditions of perceived safety that allow people to give you the gift of trust again.

Trustology offers another approach to building trust, which can work in the context of larger teams and people that you don’t know well. People tend to trust people who are interested in them. If they ask about your children, your hobbies, your pets, then you believe they have your best interests at heart. As a result, you’ll be more likely to trust them. Therefore, the recommendation is that you be interested in other people’s lives.

The Three-Legged Stool

Trustology conceptualizes trust as a three-legged stool that is built upon integrity, competence, and compassion. Here, I struggle, because I don’t believe that the legs are quite right, and I’m afraid the stool will fall over.

Trust and Betrayal in the Workplace indicates that there are three kinds of trust: contractual (based on expectations), communications (based on authentic communications), and competence (based on skills or talents). There is obvious overlap in competence. However, contractual trust only loosely aligns to integrity, and compassion and communications don’t align at all.

Integrity is a big word. Not in terms of letters but in terms of its psychological weight. The morality and predictability of integrity are both challenging. As Jonathan Haidt explains in The Righteous Mind, what is moral for one isn’t moral for another. The foundations of morality are the same, but the way that one person prioritizes those foundations may be different than the next person, and that creates a difference of opinion about what is and isn’t moral.

Reiss, in speaking of the sixteen behavioral motivators in Who Am I?, acknowledges the challenges of predicting behavior when motivators are in conflict. At the end of the day, trust is our prediction about how someone will behave. We believe that our mental model for them is accurate enough to predict what will happen. (See Sources of Power for more on mental models.)

As a result, I can’t agree that integrity is the right word here. While contractual isn’t perfect either. because it implies a level of formality that isn’t right, its more accurately constrains the prediction of someone else’s behavior to something more manageable.

Compassion is a desirable virtue and one that I agree is critical to life. The ability to see others suffering and a desire to alleviate it is, I think, essential to our survival as a species. (See The Evolution of Cooperation and Spiritual Evolution for more on compassion and its importance in our evolution.) However, I’m not convinced that this is an essential component of trust.

Communication trust is admittedly on shaky ground, as it seems like a special case of commitment. It seems like it’s just that you’re agreeing to communicate on intervals or in the case of a problem. However, there’s a subtlety here. You expect the person you trust will communicate that there is a problem without having to be explicit. We’re more willing to delegate and trust others when we know that, if there’s a problem, they’ll come back and tell us that there’s a problem.

Ultimately, I feel like Trustology’s stool may be a little wobbly.

Cause, Participate, Allow

When we teach conflict resolution, we explain that everyone can have the role of participant, mediator, or observer. Problems, Trustology explains, can also place you in different roles:

  • Cause – You’re creating the problem
  • Participate – You’re a part of the problem (but you didn’t create it)
  • Allow – You’re allowing the problem to happen

When it comes to trust, it doesn’t matter what role you play in a problem. As long as you allow it, you can’t be trusted to prevent it.

Our Differences

In Trustology the authors assert that we go through four levels of social awareness:

  • Sandbox: Everyone thinks like me.
  • Awkward: No one thinks like me.
  • Enlightened: I think differently than others.
  • Wisdom: We all think differently, and that is good.

Young children aren’t capable of believing that others think differently than them. (See Mindreading for more.) This may transition to a belief that no one thinks like me and can be the source of great consternation – particularly in the teenage years. Our awareness – and perception – of others’ thinking can change two more times, from acknowledging the difference of thought to recognizing the value of different thinking.

I still struggle with balancing the good with how I think differently than others. My post Straddling Multiple Worlds exposes what I believe we all struggle with as we seek to keep our identities integrated. After all, we are all a part of multiple worlds that approach problems and think differently. I can acknowledge the value in thinking differently and, at the same time, yearn to have others who think more like me that I can connect with.

Maybe there’s an answer hidden in the pages of Trustology that will allow us all to think a bit more like one another – just enough to drive that connection – while remaining open to new opportunities. However, you’ll never know unless you read Trustology and see for yourself.

Book Review-The JoyPowered™ Team

Sometimes, I get to know some truly amazing people. I get to spend time with other speakers and authors who have messages to share with the world. One of the people I’m privileged to know is JoDee Curtis and her team at Purple Ink. The latest book that she and her team wrote is The JoyPowered™ Team. Like the heroes of The Justice League, the team works best together – in this case, as they shared the work of writing the book.

A Team’s Personality

Everyone has a personality – obviously. What is less obvious, perhaps, is that a team has a personality. Surely, the organization it fits in has a personality, too. The team personality is formed not just through the individuals that make up the team but also in the way that the team members interact with one another and how they set their goals and fundamental values. Teams, it turns out, can have as rich of a personality as a person.

The amorphous nature of the team means that, invariably, new people will join, and a few people will leave. These changes will cause the personality of the team to shift – but, in most cases, not radically change. Perhaps the most iconic example of how a team can change and remain the same is found in the experience of the band Van Halen. A band is a team by every definition imaginable. (See Collaborative Intelligence for more on defining teams.)

Van Halen, over its very successful career, has had three different lead vocalists and three bassists. Despite this, the band is fundamentally the same band. Eddie Van Halen, who plays lead guitar and sometimes performs vocals, as well as the drummer, Alex Van Halen (Eddie’s brother), held the group together even as some members changed. This allowed fans to know (mostly) what they would get.

Knowing What You’re Getting Into

Everyone has had the experience of wondering what they’re getting themselves into. Every employer is looking for a good candidate, and every candidate is looking for a good employer. While employers look at candidate resumes and call references, candidates check out the company website and sites like GlassDoor.com. Even with all the information that candidates have available today, it’s sometimes hard to understand what the personality of the team is from the outside. The company itself can be fundamentally sound, but the team the candidate is joining may be led by a poor manager.

A truism of human resources is that candidates join companies and employees leave bosses. That’s even more reason for candidates to interview their new potential boss to understand how they work. It’s also why managers who want to excel in their career need to study how to develop employees. No one wants to be the manager that no one wants to work for, because eventually that will be discovered, and it may be enough reason to encourage them to find opportunities outside the organization.

Not all the reasons why managers and employees don’t get along can be chalked up to poor management. There’s also the issue of fit. Does the candidate have the right skills and temperament to be effective at the role they’re being asked to fulfil? In some cases, job descriptions are just placeholders. They’re something that HR requires – rather than a fully thought-out plan for how someone new can plug in and make a difference to the organization.

Healthy Conflict

I believe strongly in healthy conflict. Conflict isn’t good or bad. How conflict is handled can be good or bad. I’ve been a troublemaker my entire career. I’m conflict apathetic, and so the conflict avoidant personalities are concerned about me. I’m also capable of holding my own in a disagreement, so the conflict initiators are wary of me, because they’re not sure whether I’ll engage or not. It’s because I’m so open and apathetic to conflict that I rarely decide to keep thoughts to myself rather than finding a healthy way to express them.

However, many team members will have reasons to be fearful and that fear will prevent them from speaking up when they need to – for their sake and for the sake of the organization. (See The Fearless Organization.) It’s about getting into it – not about getting over it. We need to make it safe for people to express themselves in disagreements where possible, because it’s critical that we hear every voice.

Diversity

Diversity and inclusion are very important today. It should have been very important before now, because we’ve known that diversity can greatly improve the kinds of solutions that teams come up with. (See The Difference for more.) Erin Brothers makes a statement, “One person can’t be ‘diverse!'” But I disagree. Walt Whitman wrote, “Do I contradict myself? / Very well then I contradict myself, / (I am large, I contain multitudes).”

I think the rub is in the word “diversity.” Whitman is speaking of diversity of thought, and Brothers seems to be discussing diversity in the sense of race, religion, sexual preferences, etc. The creativity and innovation that organizations seek comes from diversity of thought not diversity of skin color.

In my post “Diversity and Inclusion Start with Acceptance and Appreciation,” I explain how I view the challenge of diversity and inclusion today. I explain how I’m rather pathologically incapable of seeing most differences – and I’m grateful for it.

I can’t leave the topic of diversity without repeating the quote from Verna Myers: “Diversity is being invited to the party; inclusion is being asked to dance.” We need different points of view fueled by different experiences. However, we need to find ways to engage and test those different points of view. It’s one thing to hear the crazy ideas. It’s quite another to do something to test them.

Strategy, Brand, and Culture

Jenn Lim, the CEO of Delivering Happiness says, “Strategy is the thinking, brand is the talking, and culture is the doing.” These are three important components to a successful organization. We need strategy like we need a rudder on a ship to steer us to the right port. We need a brand that communicates a core message about our value or our values. It’s what we print on the sail of the ship to inspire us and communicate our value. It’s in our culture that we make the decision to set sail and go somewhere.

The best strategy with the most articulate branding can fall short if the culture of the organization is unwilling or unable to go where these two lead.

Making of a Team

Teams are fundamentally built on trust. We must trust one another to be effective. (See Trust => Vulnerability => Intimacy, Revisited for more on trust.) Our incentives must be aligned so that the teams aren’t rewarded individually but are instead rewarded collectively. When we goal people, individually no matter how much desire they have to be a team, they’ll invariably revert to their individual goals over the team.

The rebel that I am is the exception. I was led a team of developers many years ago, and I had a personal utilization goal – I was within a whisper of reaching the goal. I had two members on my team that were close as well and that we made better margin on. I gave work to them that I could have easily done myself to get my bonus. Instead, they both got their utilization bonuses, and, as a team, we exceeded our profitability goals. The organization didn’t pay me my bonus, but that was OK.

Managing Expectations

Managing expectations in a team can be hard. You want to do everything and at some level realize that “everything” just isn’t realistic. In Extinguish Burnout, we speak about the gap between productivity and expectations and how this can drive burnout. Managing expectations on a team comes in two parts. The first part is an aspirational goal that everyone wants to hit. The second part is the minimum goal that must be hit. These two goals are powerful because they allow for expansion to the greatest capacity of the team and simultaneously protect the team from feeling like they are never able to meet their goals.

If you can’t meet your goals as a team even if you’re focused on strengths, it may be difficult to find your way to becoming The JoyPowered™ Team.

Book Review-12 Rules for Life: An Antidote to Chaos

“Freud had a point. He was, after all, a genius. You can tell that because people still hate him.” That’s what brought me to 12 Rules for Life: An Antidote to Chaos. I’m a part of a list where folks discuss various aspects of positive psychology. A 20-page, academically written paper was sent to the group criticizing Jordan Peterson’s work 12 Rules for Life. Ultimately, as I skimmed through the paper, I felt like it sounded like sour grapes (see the fable). Peterson had sold two million copies of the book and been on the talk show speaking circuit. It felt like the people criticizing his work were frustrated that he wasn’t clear enough in his message (he was “opaque”) or that he was seemingly contradictory. That was enough to cause me to read it. Anyone who can create enough of a stir to get someone to write and cite for 20 pages was interesting to me.

The Backstory

In order to understand the context of the book, we need to understand that it started from a Quora post. Quora is a website where people can post questions and answers. Peterson answered a question “What are the most valuable things everyone should know?” with a mixture of dead serious and tongue-in-cheek answers that the readers of the site loved.

As I was pondering the 20-page paper, I began to realize that, if you read the entire list with the dead-pan seriousness of an academic, it would be very confusing. Sarcasm is very hard to pull off in writing. Often, humor is attempted, and it’s lost on the audience. If you’re literal, you’ll miss the subtlety of how the structure is nonsensical. It’s like handing a builder one of Escher’s drawings and telling them to get to work building it. It can’t be done. So, I donned my humor cap, kept my sarcasm wand handy, and dove into the 12 Rules for Life.

The Chaos Within

The world is a messy place. It seems to define chaos, as everything that we attempt to control wiggles its way out of our control and eventually goes sideways. From Chernobyl, Three Mile Island and Fukushima Daiichi to the explosion of the space shuttles Challenger and Columbia to more mundane bridge failures, we cannot escape the fact that there is a chaos of our world that is hard to control. However, each of these disasters – and many more – are born not of external chaos but the chaos inside the hearts and minds of the people involved with the projects. This chaos – the chaos inside – is challenging to address and all too often overlooked.

The chaos comes from the ways that our images aren’t fully integrated. The ways that we see ourselves is fragmented and disjointed. We’re afraid of many things – most of which aren’t real. Hitler killed millions for fear that the Jews would somehow overpower his Aryan race. (See The Holocaust.) One can frame the event as a power move or as Hitler’s desire to make the world a better place. I see it as fear that, if he didn’t do something, the Jewish people would take over. That was apparently only one aspect of the chaos within him.

Iconoclasts believe they can make the world better. However, often they find themselves conflicted, confused, and disjointed. They cannot see the world as it is because they cannot see themselves as they are.

Take Responsibility First

Before you can set upon the journey of enlightenment, you must carry the burden of responsibility. You are responsible for yourself. You are not defined as a victim though you may have been victimized. You are responsible for your own healing just as you’re responsible for the results you receive. We can’t move forward if we’re spending all our time looking back at others to blame them for our misfortune.

The fact of the matter is that we’re all privileged. If we can read, we’re privileged. We’re privileged both that we have the skill and also that we have the time to exercise the skill. Too many people are burdened with the needs of basic survival and have no use for such frivolities as reading. Though Socrates wasn’t a fan of writing (and therefore reading), he did believe that leisure was a time for studying. Where leisure for us may be something totally trivial and useless, to the ancient Greeks, it was an opportunity to be more learned. (See Finding Flow for more.) It was something they aspired to be.

It’s not that there aren’t going to be uncontrollable things that negatively impact us and our world. It’s that no matter what they are, we must take responsibility for our part of the situation and commit to the process of healing ourselves whether there are others there to help us or not.

Chaos Within Order

Everything in life is made in layers. Our forests are made of trees, and our trees of leaves. There are patterns everywhere if we’re willing to look. Our seasons come and go, but, ultimately, they are just a cycle. Leaves are each different, but, together on a tree, they appear orderly as a part of the tree. So, too do trees seem orderly when viewed from the context of a forest.

Order or chaos often is a result of our perception – not an objective reality. David Bohm in On Dialogue explains that an acorn is not an oak tree. It’s the aperture through which an oak tree emerges. Chaos emerges from order – and order from chaos. We perceive only a small slice of what reality really is – one example is that we only perceive a moment in time.

Fear and the Lack of It

If we can delude ourselves into believing in order and our ability to control, then we can believe in our capacity to shelter our children from the realities of life. (See Compelled to Control for more on the illusion – or delusion – of control.) The problem with this delusion is that, when something happens outside our control, we’re ill prepared for it. While the high anxiety of low income and the instability of it isn’t good for us, neither is feeling too safe and too orderly. We can’t learn to cope with the real evils of life if we’re unwilling to confront the reality that we live in.

Those who live without any fear in their life are bound to find a time when fear asserts itself. Without any skills for coping with fear, it can crush the uninitiated. Chicks that are “helped” out of their shell are likely to die, because they didn’t learn to struggle. (See The Psychology of Recognizing and Rewarding Children.) So, too. can children die a psychological death if they’re helped to avoid real conflict and fighting and are suddenly thrust into a frightening situation. It turns out that the absolute absence of fear isn’t good for us. So, parents, would you prefer to make your child safe – or strong?

Strong Partnership

When we move from our childhood relationships and the reverse when we’re parents ourselves and instead focus on the relationships of peers, we’re confronted with the realization that partnerships work best when both parties are strong. A team of oxen will pull at twice the effort of the weaker ox. Yoked together, the stronger must stay in lockstep with the weaker, and therefore can’t take on more load than the weaker ox.

Our relationships are like that. We can’t carry the other person in a relationship of peers. We’ve got to find ways to be strong together.

Faulty Tools

Standing at the firing line trying to hit a target 20 feet down range, it seems like there’s no way to hit the bullseye. All the bullets are going in low and right of the target. Even fully supported on a gun rest, the shots are going low and right. No matter how still the gun is or how many attempts are made with the sights pointed right at the bullseye, the problem persists. Faulty tools will result in a faulty outcome. In this case, the sights can be adjusted to bring the bullets closer to the bullseye, but that’s not always the case.

Sometimes, when we’re looking to improve ourselves and our situation, we use the wrong tool – like trying to use a hammer to drive in a screw. Using the wrong tool won’t give us the right results. If you’ve been around tools for long enough, you’re bound to break one or two. Whether it’s a wrench that splits in half in your hand or a carabiner that snaps while you’re pulling a stump, faulty (or improperly used) tools fail to deliver the results. Once you’ve failed with the faulty tool, you’ll have to find one that works.

Delinquency Spreads

It seems to make sense on the surface. Bring in ex-convicts, who know what it’s like to get convicted of a drug-related crime, to talk to students about the horrors of drugs and how they can mess up your life. The result should be that the students should want to avoid drugs, right? Drug Avoidance and Resistance Education (DARE) thought so. However, the results said differently. In many cases, DARE students turned out to be more likely to use drugs. (See Science and Pseudoscience in Clinical Psychology for more.) So much for the idea of scaring kids straight.

Delinquency tends to spread more than stability. If you don’t believe me just ask the Kelloggs, who found that their adopted chimpanzee was teaching their son to bite the walls. Delinquency even spreads across species (see The Nurture Assumption for more).

Children Are Damaged

They’re damaged when the people who are supposed to care for them are unable to correct them for fear of alienating their friendship. Instead of being focused primarily on their responsibility to instruct, guide, and raise up, some parents seek a friend in their children.

Peterson continues beyond just saying that children are damaged by this parental failure. He says that discipline is a responsibility. It is not anger nor revenge, it’s a careful combination of mercy and long-term judgement. Failure to hold children accountable dooms them to having to learn important lessons of responsibility and consequences later in life, when they will be much more costly. (See The Psychology of Not Holding Children Accountable for more on this.)

The Growth of Resentment

Mass shootings are a tragedy. Any shooting is a tragedy, but mass shootings seem to have a sense of pointlessness to them. By June of 2016, there had been over one thousand mass shootings in the United States. It’s far more than just Columbine. How these events happen isn’t a mystery. They happen as resentment grows until hatred spreads to everyone instead of just the people who have “wronged” the attacker.

Just as the Dalai Lama recommends exercises to bring about more compassion (see My Spiritual Journey and Sympathy, Empathy, Compassion, and Altruism), so, too, do the attackers replay their perceived victimization and rehearse their feelings of resentment until those thoughts expand beyond the anger with few people and encompass all of humanity.

Bargaining with the Future

Mischel did a simple test of delayed gratification with preschoolers. A single marshmallow now, or two in a few minutes. His simple test had ripples down the lives of the preschoolers. Those who could delay gratification ended up more successful in life. (See The Marshmallow Test for more.) Peterson agrees that the successful among us bargain with the future. That is, we’re willing to make sacrifices today for rewards tomorrow.

This can’t happen until the environment comes stable enough that the investments we make for the future can pay off. In a world filled with uncertainty and chaos, there’s no point in investing in the future, because there may not be one. Stress is evolution’s ultimate solution to the problem of short-term needs and making debts into the future. Stress allows us to consume more resources quickly to avoid the lion but at the expense of our immune system, digestive system, and others. (See Why Zebras Don’t Get Ulcers for more.)

Self-Trust

Veterans sometimes come home from war with post-traumatic stress disorder (PTSD). Peterson explains that most PTSD comes not from what was veterans saw but instead from what they did. The break, it seems, doesn’t come from the stress outside of the veteran but instead from the lack of self-trust that comes from realizing they did something that they now find morally reprehensible. Certainly, this isn’t what happens in every case, but it seems to be happening in some.

How can you trust that you’ll do the right thing if you find that your best thinking led you to doing something that you now deeply regret? There may be an answer in Milgram’s work. He showed that most people would issue what they believed to be potentially lethal electrical shocks with very little manipulation. Perhaps when they’re able to see that they’re not alone in their capacity to do evil things, they’ll realize that they should accept they’re not perfect. (See Mistakes Were Made (But Not By Me) and The Lucifer Effect for more on Milgram’s work and How to Be an Adult in Relationships for more on acceptance.)

Willful Blindness

Sometimes we don’t want to see. Sometimes seeing is uncomfortable and disconcerting. It disrupts our view of the world and in doing so makes us question everything – or at least many things. Rather than moving forward into the darkness, we turn back into the safety of what we know or what we believe we know. The problem is that this willful blindness distorts our perception of reality, and it dooms us to be held in a prison of our own making.

The early Christian church believed that everything revolved around humans. God created the heavens and the Earth, and his crowning achievement was mankind. It goes to reason, then, that we were placed in the center of the universe, and everything else orbited around us. Galileo was shamed, imprisoned, and punished for what we know now is the truth, that the Earth orbits the Sun – not the other way around. The beliefs of the church made them willfully blind to the reality of the observations that were being made. In contrast, the Buddha said that we must accept fact. If our belief contradicts facts and observations, then our beliefs must change, not the facts.

The prison happens when we refuse to go past the edge of the light of what we already know. If we refuse to explore into the darkness for fear that we might learn something that will change our beliefs, we’re necessarily trapped with a more incomplete view of the universe. Only with willingness to go forth in courage and learn can we begin to apprehend the universe. Nietzsche said that a man’s worth was determined by how much truth he could tolerate – and that means letting go of willful blindness.

The Past is Alive

Have you ever been reminiscing with old friends or your family and come across an event that you remember one way and they remember another? Maybe it’s what car you were in. It could be that you thought you were at the lake instead of stuck at home. It could be the people who were there at the event. Whatever the discrepancy, have you been surprised to find out that your perception was wrong? Maybe there’s photographic evidence. Maybe there’s a record of what happened. But in a moment, you realize that your perception of the past isn’t objective reality.

Our memories are not, unfortunately, dispassionate observers recording all the details like a video camera. Our memories are reconstructed and ephemeral. They don’t really exist for more than the moment. Each time we access a memory, we either impart new emotional residue to it or we take some away. Because of this, the past isn’t a fixed point that we can reference in our journey through life. Our past is a drifting dreamland, where what seems solid reveals itself to be nothing but smoke.

It’s not just our past and memories that change. What we know and what we knew are changing. Ancient cities are discovered that were thought to be made only of story and legend instead of clay and stone. The victors write the history books, and they can write them from their slanted point of view – whether that accurately conveys the real situation or not. Our views in the present about the evils of racism, slavery, nuclear power, and greenhouse gases influence our perception of the past.

Many elderly people look upon their youth with fondness and yearn for simpler times when things were better. Rewind the clock 100 years, and you increase suffering, death, and struggle. However, somehow, these objective realities are no match for the way that the person perceives the past. They can hold onto the best parts of the past – and maintain the best parts of today. The problem with this is that it can’t possibly be that we’d have advanced medicine of today back then and the simple, less-hectic life. You can’t have one without the other.

Risk Optimization

Have you ever done something just to feel alive? Did you take a measured risk because you were tired of the relative safety of your life? Maybe it would help if I provided some ways that people seek the appearance of danger. Maybe you got on a roller coaster at your favorite amusement park. Intellectually, you know it’s safe, but your vestibular system is screaming to the rest of your brain that this isn’t normal and therefore can’t be safe.

What about that corner that you rounded at twice the recommended speed just to see what would happen? Or the fight you picked with the bully at school, because you knew the teachers were standing close by?

The fact of the matter is we don’t seek to eliminate risk. Many would say that we cannot eliminate risk, that it’s a fool’s errand. (See The Black Swan for more about risk.) If we can’t eliminate it, we must seek to optimize it. We seek enough risk to motivate us – and not so much that we find ourselves overwhelmed by its presence. As we look at our life, we must realize that we’re not looking to totally eliminate risk, we’re looking to optimize the amount of risk we take into a comfortable range. (See Who Am I? for more about the motivator of savings – which is how we mitigate risk.)

Oedipal Mother

Peter Pan is an idealistic character, whose story of never growing up has enchanted many. However, the story behind the story is tragic. James Barrie’s story starts when he was six, and his mother’s favorite son, his brother, David, dies in a skating accident at thirteen. James becomes his mother’s confidant and supporter, entangling his view of himself with his mother’s views. His mother’s mental illness trapped David at the age of thirteen while James aged. Ultimately, this caused James to desire to remain at thirteen as well and gave rise to the story of Peter Pan. (See The Globalization of Addiction for more on this story.)

This is but one tragedy of many where a parent refuses to allow their children to grow up. They believe they live only for their child, and therefore their child’s appropriate attempts to distance themselves threatens the very existence of the parent. The bargain that is made is that the parent will do anything for the child, and, in return, the child will never leave the parent. The result is that nothing is ever the child’s fault. Everything wrong is because someone other than the child made a mistake. It’s a very dangerous bargain.

It’s at the heart of why I wrote The Psychology of Not Holding Children Accountable. I didn’t want to see more children damaged by unhealthy relationships with their parent, which choke the children like an emotional boa constrictor.

Meaning

Philosophers have debated the meaning of life for millennia. There is no found or agreed upon answer to the grand question. However, finding the meaning of our lives is an important part of learning to cope with the challenging nature of life. It’s how Simon Sinek explains to motivate people in Start with Why. Peterson explains that a person who has a “why” can endure any “how.” Why we’re doing things at a global level, at a work level, and at a personal level makes all the difference to our willingness to persist when things get difficult. (See Grit for more on persistence.)

Perhaps if you’ll find your “why,” your meaning, in 12 Rules for Life.

Book Review-Compassion Fatigue and Burnout in Nursing

I’m not a nurse, but I’m married to one. My daughter is also a nurse. If nursing could rub off onto someone, I’d be covered in it. That’s one of the reasons why I was so curious about what Compassion Fatigue and Burnout in Nursing had to offer to help me understand.

When Terri (my wife) was working in a pediatric intensive care unit, there were days I knew she would come home to go directly to our room, and I knew I needed to just hold her and let her weep. The things she saw were horrific. How she was able to face it day after day was beyond me. While I can’t say I understand compassion fatigue directly, I can understand some of the burden that is borne by healthcare workers trying to ease the world’s suffering.

I also understand burnout and largely see it as an overarching container that includes compassion fatigue as well as other specific types of burnout. While this view isn’t uniformly held, it’s one that many people agree with.

Compassion Fatigue

Compassion fatigue is the experience that workers sometimes get while caring for others who have experienced trauma. It happens in nursing and other workers who have care at the center of their lives. It’s sometimes called “secondary trauma,” because it’s the trauma suffered by people caring for those who experienced the trauma directly. However, care must be exercised to not minimize the trauma or dismiss it because it’s not primary.

Our egos are amazing things. They allow us to ignore the very real and present fact that we’re all vulnerable. We’re not nearly as powerful as we’d like to believe. Our psyches couldn’t cope with the idea that, at any moment, an asteroid could come raining down and destroy our lives as we know it. (See Change or Die for more along this line.) When you witness the harm that happens to others – particularly when that harm comes at the hand of other human beings – it forces you to confront your own vulnerability and recognize that there are many intentionally and unintentionally cruel people on the planet. The only way to blunt out these feelings is to stop caring about others. You can still care for their physical needs but disconnect emotionally to protect yourself. This is the heart of compassion fatigue.

Burnout

Burnout, on the other hand, is a result of the gap between our expectations and our results. When we expect that we can do much and then see results that are not much, we’ll eventually experience this as burnout. Another way to think about burnout is as the exhaustion of our personal agency. (See Extinguish Burnout for more about these and other aspects of burnout)

For most caring professionals, the expectation is that they can prevent, alleviate, or heal the trauma that others experience. When the patients keep coming, it takes great strength to maintain the belief that you’re making a difference. When the traumatized doesn’t seem to be getting immediately better, the caregiver is faced not only with their own vulnerability but also the understanding that their expectation of their capacity to help others was likely very over blown.

Compassion fatigue is viewed as an acute event associated with the care of others, and burnout is more frequently viewed as a chronic condition that doesn’t have a precipitating event. However, burnout is often triggered by an event that causes someone to question the gap between their expectations and their results. In this context, it makes sense that compassion fatigue is a form of, and triggering factor for, a broader condition of burnout.

The Unseen Impact

Combatting burnout often means recognizing the impact we have that might otherwise be ignored or overlooked. The patients who get better don’t come back, so the only observations are that patients don’t get better. We begin to believe that what we see is all there is. (See Thinking, Fast and Slow for more on this.) The most prevalent image in our minds is the image of the person who didn’t recover and is back again.

Combatting compassion fatigue is a bit different. Our natural tendency will be for our ego’s defenses to attempt to “right the ship” and make us feel as if we’re more powerful than we are. However, this takes time, and when you’re bombarded by pain and suffering, it may not be possible for our egos and our faith in humanity to get a foothold. For that, we need to create space by focusing on the beauty, joy, and compassion in the world.

It’s easier said than done. But the more we can find comfort in the fact that most people are decent human beings, and few people face the kinds of trauma that caregivers witness every day, a sense of balance and normalcy can be regained.

Care and Compassionate Care

It’s entirely possible to do one’s role as a nurse and not care. The technicalities of the role can be learned and executed, like a robot making their millionth widget. However, that’s not the role of nurses – or any caregiver. The technical aspects of care are necessary but not sufficient to be a good nurse. Good nurses have a genuine concern for those in their care. They don’t become overly involved with the patient’s (and the family’s) needs, but they do adapt their way of working to maximize the things that are important to the patient and the family.

Without losing their own identity, they place themselves in the position of the patient and respond from a place of compassion – the same place that drew them to the career in the first place. Compassion is empathy – understanding another’s situation – and the desire to alleviate suffering. (See more about compassion in Sympathy, Empathy, Compassion, and Altruism.) When a caregiver suffers from compassion fatigue, they no longer have the strength to connect with someone – to understand them – and protect themselves from becoming overwhelmed with their circumstance.

As a result, the best care that nurses offer, the kind of care they all became nurses to give, cannot be done while experiencing compassion fatigue. Organizations are well served to identify and support nurses in resolving their compassion fatigue for better nurse retention and patient outcomes.

Moral Distress

If you want to find something that will steal the motivation and personal agency for someone, put them into a situation of moral distress. Moral distress is knowing the right thing but feeling as if you can’t do it. There are times when this moral distress is real, times when it is perceived, and, unfortunately, times when there should be moral distress but is not.

Shortly after the second World War, the world was asking how it was possible that so many German soldiers were able to assist with the mass extermination of Jews. Milgram devised an experiment where a test subject thought they were shocking another test subject –even when the shocks were presumed lethal. Milgram showed that many people could be coerced into these acts. (See Moral Disengagement and The Lucifer Effect for more on this set of experiments.)

For those cases where a nurse feels moral distress because of a difference in point of view, perspective, or diagnosis, the pain they feel is real. The organization (and the nurse) are missing an opportunity to understand the problem more fully so that the moral distress can be alleviated. In medicine, there’s rarely one right answer. The truth is that most patients are complex, and there are a variety of risk factors that the team navigates to try to return the patient to health. When the whole team – including the nurse – can openly discuss the challenges and agree upon a plan, the moral distress of some situations can be addressed.

There are, however, some cases of moral distress that are real. A surgeon won’t scrub up when walking into the operating room or picks up an instrument after it’s been dropped to the floor and continues to use it. Providers ignore nurses’ pleas for more pain medications or a different course of treatment for patients who are suffering. In some cases, nurses don’t feel as if they’ve got the opportunity to safely communicate their concerns, and that is their moral distress. (See The Fearless Organization for more about creating a culture of safety.) In other cases, even after a nurse voices the concern, they’re ignored or minimized. These are organizational challenges that eventually need addressed, or they’ll rip the organization apart.

Emotional Violence

Compassion Fatigue and Burnout in Nursing contains more than a few semi-related nuggets of information, including the revelation that emotional violence is still violence. While this may seem obvious, our world treats our words differently than our actions. “Sticks and stones may break my bones, but words will never hurt me” just isn’t true. Most of our hurts in the modern world come from words and the emotions they stir inside of us. While there’s a law against striking someone else, there’s nothing protecting us from a tongue lashing.

Emotional violence, or the words we say to each other and the non-verbal ways we communicate our disapproval with another person, are a form of violence that is all too often ignored. They’re the kinds of senseless attacks that we see around us and do nothing about. Left unchecked, they’re also one of the ways that we encourage Compassion Fatigue and Burnout in Nursing.