Saturday, June 9, 2012

Bullying, ("resilience"; and other cop-outs)

OK, I need to be honest from the start. I think the idea of "resilience" in psychology is so flawed, the quicker it is abandoned the better. Don't get me wrong.. I am all for survival skills and for anti-abuse strategies. I just think resilience training has inadvertently become a distraction from caring for and about and with people. Worse still, it has become an excuse for abandoning, blaming and even further abusing people under the banner of "helping". How many times have we heard the term "tough love"?

The meme here is "if I train them to be tough then they will be better prepared for the tough world out there". Furthermore "better for them to learn it from me.. At least I have their best interests at heart" This meme isn't far off the justification used by sexual abusers. We recognize it as inappropriate in this context... But why not elsewhere?

Is not the difference in degrees of abuse and in the nihilistic belief that we can't change the way we treat others in our society?

Why would we put our efforts into toughening people up rather than behaving in a more gentle way with each other? Why would we put a victim of bullying through resilience training (even if we did counsel the so called "bully")?

Is the answer perhaps embedded in our history? Could we have fought, killed and invaded our way to dominance over other cultures if we didn't believe that strength was good and gentleness is associated with weakness? Could we continue to send our youth to war? Could we continue to label our traumatized returned soldiers as "sick" rather than deceived and abused?

A recent study of doctors revealed that three quarters believe that bullying is common in medicine, including nearly one fifth who believe it is part of being a doctor. This doesn't surprise me. Bullying, to me, seems to love an environment of privilege, exclusive knowledge, entitlement and self attributed benevolence. Medicine therefore provides the ideal culture medium.. A petri dish that I found petrifying.

What surprises me is that a number of doctors responded that they thought bullying was rare in medicine. How could that be? Medicine is pervaded by ideas that long hours must be endured, hard decisions must be made, people are responsible for their own plight, rationality must prevail over emotionality (do I hear the word "professional"?). "Some people are beyond help". The idea that a superior must be obeyed is as strong in medicine as it is in the military. The other idea is that medical training has prepared you to "carry the can" and this justifies giving young (and not so young) doctors an impossible workload in under resourced systems then blaming them for the mistakes that inevitably occur. If that's not bullying, I don't know what is. I certainly couldn't cope well with the demands and spent a lot of my doctoring life feeling anxious.. Don\'t get me wrong though..the privilege of collaborating with wonderful "patients" and feeling like my involvement was valuable and valued far outweighed the negatives.

Nevertheless, I would rather see our efforts and funds directed towards supporting our patients and health care providers so that they felt more supported,valued and less victimized by their health care system. We don\'t need more "resilience" or "time management" training. We just need more resources directed to human care and to let it trickle down to where it is needed.. Maybe some vulnerability training would help. My experience has always been better when I have said "I am struggling" compared with when I say "I can cope".

Maybe that's why I have so much hope and faith invested in the Australian Institute of Patient and Family Centred Care. ( one of my dear friends is heavily involved) Now there's a group of people who "get it"

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