Attitudes, beliefs and limitations

Today, thanks to a seminar with Malin Skreding Hallgren, Improvement Leader at Qulturum, Jonkoping, Sweden, I learned about Restrictive Norms. This was not something I had heard of before, although something I had experienced and almost certainly applied.

Malin

These are the norms – the preconceptions we carry about ourselves and other people, that we apply in all sorts of places and situations, in other words, the ‘typical’ that is in our heads; another word for this might be stereotype.

Playing games of word association can allow you to discover if this applies – our lecturer today described the ‘Teflon Test’ – what images, ideas and preconceptions stick; man – male – masculine – heterosexual – dominant – football – beer – whatever, and it is these preconceptions that limit our abilities to see other people, that act as blinkers to diversity.

Old – frail – weak – forgetful – disempowered – dependent; young – inexperienced – naïve – beginner – healthy – strong; they set us up to fall into cognitive traps

And what are the pitfalls of these traps? Beyond the restrictive biases that arise from stereotyping, the racism, fear and restriction, they exist on a level that is perhaps more subtle than tabloid headlines. You don’t have to be Donald Trump to be caught by restrictive norms.

And this is something we need to consider when meeting people, when going new places, talking, listening, designing services, delivering care, when accepting thanks and providing relief.

Our existence has an effect on how others behave, on how they receive us, on whether they are at ease, whether they listen, what they hear, how they respond and react.

Like molecules bouncing around a Brownian fog, we all have effects, and in healthcare, it is vital that we acknowledge these influences, that we are aware of the actions of our thinking and our behaviour.

We cannot assume; we need to move cautiously, with care, like the footsteps of a shadow puppet, for, unless we proceed with care we are likely to hear what we want and for others to find themselves unable to communicate freely with us.

Does it hurt? When did it start? How often? Do you take the medicine? Would you like the test? All these questions, which carry different meanings depending on how they are communicated and how the responses are heard, dependent on the lens, the filter of our senses and those of the other.

Much of this exists within the realm of being human, as Nietzsche said, we are Human, all too human, despite what we are told, despite what we want to believe. Only by accepting with humility the limits of our ability can we hope to effect change, treatment or care that is real, that is significant, that is desired.

Do not go gentle into that good night …

Do not go gentle into that good night, Dylan Thomas

Do not go gentle into that good night,

Old age should burn and rave at close of day;

Rage, rage against the dying of the light.

Though wise men at their end know dark is right,

Because their words had forked no lightning they

Do not go gentle into that good night.

Good men, the last wave by, crying how bright

Their frail deeds might have danced in a green bay,

Rage, rage against the dying of the light.

Wild men who caught and sang the sun in flight,