Positive about Change?

'Learning is the discovery that something is possible.' 

Fritz Perls

'The problems of the world cannot possibly be solved by skeptics or cynics whose horizons are limited by the obvious realities. We need men who can dream of things that never were' 

John Keats

Dr Martin Seligman is a Professor of Psychology at the University of Pennsylvania. He is famous for his work in the field of Positive Psychology. This school of psychological thought doesn't seek to replace mainstream psychology but complement it through the study of what gives life meaning and what makes it worth living. It asks how we can extend and amplify the good that is already working in our lives and shining the light on our creative assets and seeking their growth and unfolding.

One of the authors at the beginning of his academic career attended a presentation where Dr Seligman outlined his early ideas about the need for Positive Psychology. Dr Seligman received a series of challenging questions around 'why bother with all this positive stuff?', Dr Seligman replied that he had to because he was a born pessimist. He said he needed a practice that helped him see through problems to positive options and be more optimistic about outcomes. His natural temperament would lead him to be locked in the problem. He needed a key to unlock this process and move to another place to address the issue. This echoes well the comments of Einstein and Jung that we often cannot solve problems on the same level of consciousness that generated them. We need new spaces and thinking to break the code of the problem.

This positive, more optimistic approach echoes much of what we see crossing our services and on forums like Twitter. People and networks are sharing fresh, kind and affirming ways of being and doing as the future framework for change. These new movements offer such promise, potency and energy. Yet it is not always an easy walk although a much needed one, especially if we are talking about the deep, sustainable change that so many of us see as possible and work so hard to achieve. All too often we have experienced changes in services that only touch surface structures, policies and procedures rather than going to the heart of the issues. And sometimes people propose a ‘be positive approach’ as part of these initiatives, failing to really appreciate the complexity of issues, acknowledge the scale of the challenges or engage the difficulties that the people involved deal with on a day to day basis when they see the potential of what could be possible in the face of a reality that seems intractable.

The kind of positivity Seligman is promoting has nothing to do with creating false positive-ness that can only ever skim along the surface of change. Rather, a Positive Psychology approach invites us to name the problems and the pains and see how we can learn from them to work them through in constructive and compassionate ways. Positive Psychology offers much for us to learn. It is not just about being positive, its about engaging with the complexity of a challenge and bringing positive approaches to working with it. Authentic listening, mutual support, empathy, knowing we don't have all the answers, a commitment to deep and open dialogue and the creation of new ways to think and do health and care is the DNA of these new movements. At it’s heart is the belief that all of us have tremendous goodness, gifts and potential. We believe that is from the activation of these wellsprings that the solutions and new forms of service will emerge.

- John Walsh. York Street Health Practice, Leeds Community Healthcare NHS Trust

- Dr Andrew McDowell  http://www.theperformancecoach.com

(The authors of this met recently at an initiative of the NHS Health Trusts and Public Health in Leeds. They have brought Health Coaching into the city so we can look at and change the quality of our health conversations with patients. The old model is where the patient is the passive recipient and the clinician the expert. This is a move to a new terrain where both are experts and co-create health plans and solutions together. At the heart of this approach lies a view of people as not problems but as people with assets, gifts and potency. This more humanistic and positive model offers great promise to people and the city.)

Flying High

Humankind has been interested in flying for a long time. Leonardo Da Vinci in the 15th century drew pictures of what a flying machine might look like. He had studied the flight of birds for his work. In the early years of the 20th century the Wright brothers managed to get a plane they had built to fly a few hundred feet. Before the century was out we were not just flying planes in the air but space ships to the moon. The ancient literature of the world also speaks of flight in powerful engaging ways. In ancient Greece there is the story of Icarus who flew with wings made by his father. He ignored his father's instructions and flew too close to the sun and fell down into the sea. The Book of Psalms also speaks of  flying. It says, 'Oh, that I had the wings of a dove! I would fly away and be at rest.  I would flee far away and stay in the desert;  I would hurry to my place of shelter, far from the tempest and storm.' (Psalm. 55:6-8).

 What is this attraction to flying and rising up to the heavens? It marks the centuries and as a race we have dreamed about, written about and worked to fly. There are probably multiple reasons for this interest. One as the Psalmist records is to escape from problems and dangers and find a place of rest. Another is that we have an inborn ( it seems ) need to rise and reach out. To ascend and transcend. To fly a bird needs wings. If a wing is badly broken it may not be able to take flight or fly again. While we do not as humans have wings the analogy is an interesting one connected to work and work values. It is a useful framework in which to ask the perennial question of what is a good health worker. What does great nursing and GP work look like? What are its component parts? What makes the difference between the average and the exceptional?

Louise and myself met recently and talked about the themes of this post. Louise is a third year nurse student at Wolverhampton University and I, a manager at York Street Practice, part of Leeds Community Healthcare NHS Trust. We will try to point to the two wings of good health work. We reckon that there are also the wings of good social work, care work and every valuable human endeavor. We believe these two wings enable those who discover and exercise them wisely and well to soar and move forward. This post is a distillation of the words of the emails and tweets we have sent to each other. In them we were asking what makes us fly - what makes us do the incredible.

The first wing is compassion. Compassion means to care for another. It means that heart connection that moves us to help and support another. The word compassion is from the Latin words for 'with' and 'suffer' or 'suffering'. So we have the idea of suffering with or being alongside someone in pain or difficulty. Recently I attended the NHS England event on NHS Citizenship in London. This event was to support and develop the public voice in the NHS. We broke into small discussion groups and our first task was to draw what the NHS meant for us or what we wanted from it. In a group of 6 people (mostly public and patients) three of us drew a heart. Another person drew a picture of matchstick men and women all holding hands in a circle. We know instinctively our service is all about compassion and care. The NHS in its intent, constitution and purpose is founded on principles of compassion and care where need is the basis. 

In response to the question of why she was wanted to be a nurse, Louise offers three reasons: 

 (1) "To care for patients and their families in time of need. no matter what their social background,ethnicity or choice in life. I believe we all need someone to care and who cares."

 (2) "To make a difference. I am keen to become a change maker, in that I really want to help and guide others, not just stand for the norm, be proactive in the face of adversity. I really want to make that difference, and inspire many who doubt that they can. If I can they they can! We can all be change makers. To stick our heads above the parapet is an immense feeling; one that at times I would love to hide from. But I myself am out there now, and I will make a difference, somewhere, somehow."

 (3) "Because this is all I have ever wanted to do! If I can help then it would really make me happy
  These sentiments are not rare. We find them across the NHS and in many places. Compassion is the heart we bring to a world in pain and worry. We really can be that difference. Healthcare without compassion has no values, focus or future."

The second wing is true leadership. We say true as there is unfortunately some confusion around leadership. People think leadership is management. We would rather say that the difference is management deals with systems and leadership works with people. One can be a good manager and poor leader and vice versa. To place an equals sign between manager and leader is a mistake. Leadership is a presence which we bring. Leadership is about people. It's seeing the best and bringing out the best in others and also seeing the best in ourselves. The best leaders are people of vision, values, care and compassion. It's what we learn and give that makes good leadership. Some leaders are quiet, some are not. Leadership is a possibility to us all. Like the cosmos with its stars, meteorites, suns , planets and galaxies it takes a myriad of forms and expressions. The trick is to see the possibility of leadership and keep our minds open to this and see what happens. We may find doors open today, tomorrow or in the future. We may not sometimes be the first to see it. People (usually fellow leaders who instinctively know it when they see it) may see in us what we may not at that moment see in ourselves. Leadership like life is all about us seeing, owning and releasing our gifts.

When people start to see our leadership emerging they will often say very nice and affirming things. We may find this difficult to see and accept. We may struggle with their compliments and affirmations. This is understandable. It is a sign however that our gifts and identity are starting to express themselves in visible and effective ways. We need to listen to the praise and compliments others give. We are always greater than we think ( much much greater, despite all our faults and flaws ) but we need to remain modest and humble when we start to see it too. So authentic leadership is the other wing. These wings fly together. Great leadership is compassionate and to inspire others is a truly compassionate act. Compassion feeds good leadership as fuel a fire.

Compassion and true leadership offer a vision of what the NHS is and can be. It offers the greatest perspective of all. That is transformation. The spiritual writer Richard Rohr talks of how it is transformed people who transform others. It's those who are themselves transformed that transform situations and support others to make that journey also. When we find our wings we find energy, meaning and direction. When compassion and good leadership are our wings we fly and fly high.

John Walsh. York Street Health Practice. 

Louise Goodyear, Student Nurse at Wolverhampton University