How exactly does change come about?
As health and mental health practitioners, our calling is to help people change.
But I’m thinking about change on a number of different levels. There are the changes we help our clients make, as well as personal changes we might hope to see in our own lives.
I’m also thinking about change on a broader scale – change in our communities, change in our profession and, if I may be so bold, change in the world.
Stay with me, and I’ll get back to you on what I mean by that.
Recently, I decided to do some research into this question of how to inspire innovation and change. And I’ve come across a rather interesting perspective that I wanted to share.
In an article published by Harvard Business Review*, entrepreneurs John Geraci and Christopher Chavez used the illustration of an Amish barn-raising as a model for innovation.
The authors identified 5 steps in the barn-raising process that can help new initiatives succeed:
- Curate – Intentionally seek out and explore different perspectives
- Convene – Create a way to bring the curated group together – either in person or online to gather their input
- Commit – Get participants involved in sharing their expertise
- Cultivate – Encourage ongoing relationships and interaction
- Repeat – Find ways to continue these applications. Innovation is iterative.
But what does any of this have to do with the work you do as a health or mental health practitioner? Or changing the world for that matter?
Lately, my thinking has been drawn to how to inspire change within our profession.
For more than 25 years we’ve been creating programs that serve physicians, nurses, psychologists, social workers, and counselors – practitioners who have some of the most significant and life-changing missions on the planet.
And I’ve become convinced that the best way to serve practitioners is by refusing to settle for the status quo.
Instead, I want to keep pushing forward in our field toward innovation and ideas that will expand the circle of healing for more of our patients.
Because I firmly believe that improving outcomes for more of our patients can change our communities.
And that can change the world into a healthier, more compassionate place.
Earlier this year, we launched a program dedicated to helping practitioners reach the next level of innovation in their work with patients. It includes the above 5 steps that promote innovation.
In a few days, I’ll have more to say about how that program has been working out.
But for now, I’d like to hear from you. What have you found most helpful in inspiring change in your life, in the lives of your patients, or even within your broader community?
Please leave a comment below.
*Geraci, J. and Chavez, C. (2016, August) To Innovate, Think Life a 19th Century Barn Raiser, Harvard Business Review.
I said 5 factors … And I only gave 3. The other 2 are:
Personal will, and last – but not least – Professional medical help
I had a severe motorbike accident in my final year of secondary school (1986) that left me in a coma for 7-months. I’ve gone on to achieve 4 degrees in the Humanities because I wanted to find out why I recovered when the vast majority of people don’t.
After my first degree I put my recovery down to5 scientific factors. Genetics, Environmen, Parental influence (my father was in Auschwitz during WW2 and my mother really ‘drove’ my recovery-process).
Then I found the “X”-factor in my recovery: Logotherapy. It says that if people can attach meàning to their experience… then they can overcome anything.
Wonderful to hear your perspective and that you shared the Amish barn-raising model. I also come from Mutual Aid Network background and applied it to the 40-years of serving rural families with family-centered health promotion and rehabilitation from acute and chronic conditions.
Serving with alcoholics that have a stack of ACEs, Adverse Childhood Experiences, when we peeled the onion, requires a system of community service-learning so everyone can serve with their STAR power of current Skills, Talents, Attitudes, and Resources.
That simple act of acceptance and engagement with purpose recharges their STAR power especially when the points of the inner stars receive attention to the physical-intellectual-social-emotional-spiritual aspects that boosts our immune system and ups our resiliency.
Preschoolers and those that graduated from Quality Early Childhood Learning Centers or have parents that did and were supported to maintain their skills are excellent role models for social-emotional intelligence and healthy creative wonderous inquisitive learners…of any age.
The Ad Astra Pilot Project is preparing to launch from Kansas where the motto is “Ad Astra per Aspera…to the STARS through Difficulty.” The Menninger brothers were leaders in the advancement of psychiatry and where I first picked up “threads” about biofeedback, guided imagery, art therapy… Later I returnd to Topeka to take a graduate level course in “Wholistic Wellness” from Washburn University.
It is time to finish fleshing out the other pilot project layers to fully develop the best functioning WOMAN, the Wellness Oriented Mutual Aid Network. We are looking to attract innovative multidisciplinary therapists that are willing to collaborate and innovate using or linking to our HIPAA Compliant Cisco WebEx Event Center. If someone has the Training Center, we would sure like to have a “test flight” to use the systems for small group and large group work. Everytime we link a WebEx Event Center or Training Center account, we add 100 chatbox seats that can be polled…imagine decisions made by the people whose health and wellness it concerns.
Cisco WebEx offers three “umbrella” account categories (my term) for business is the Enterprise account, Education and Government are self explanatory. Imagine if we could actually connect families and care-givers to nursing homes & case management meetings…lean and green and HIPAA Compliant. What about actually offering courses for Social-Emotional Character Development to community adults and ways to deal with bridging out of poverty and finding support groups to help people engage in actual activities that support their new alcohol and drug-free commitments?
The last seven years have been spent curating, and I found your work to be on the crest of the wave. The webinars have replace the audio files. Now I see how beneficial if we could offer those webinars and support groups that allowed us to keep practicing skills till they were second nature.
We must continue to innovate fast with new vehicles that will allow us to accomodate the tsunami of Baby Boomers, people that are disabled, and those who are trying to work and trying to parent and need help regenerating their brains from all the stress and ACEs in their background.
We must do all we can to empower parents and any care-giver to know how and why to relate well with their children, their elders with dementia or their peers with PTSD or TBI… and each other. We have several generations that missed out on the mental hygiene and mental health-illness services that could have helped them at the time.
With the CDC research on ACEs, we must weave the network of support that engages and empowers communities to be the difference we need to reduce and remove the mental health stigma and prevent each other to added to the stressors at any age.
Interesting. I definitely think that it is important to relate positively and not to go down the negative. It is important to keep the good going and one way is to gravitate towards others doing the same and of course helping our clients do the same. Karen Macke
Hello Ruth, and staff,
I only managed to do 1yr in psychology before I started being unable to function. I’ve read tons of psychology books, have undergone therapy several times and am able to truly help others. In significant ways, but…. although I try applying it, I find myself quite the challenging patient/client!
I used to self-abuse in a myriad of ways: starvation, ruining my looks etc. I am now at the point of trying to find my way towards happiness, joy and healthy coping skills. I hadn’t forgiven myself for all the abuses I’ve encountered from early childhood till adulthood, but having a keen intellect and a self-destructived mind, I find myself sabotaging my progresses constantly.
I have read “why woman hurt themselves” a couple of times and have learnt and understood that stopping this bad “coping skill”: hurting myself, needs to not be sudden but progressive. I haven’t, however, going much information on the process of doing so. HOW do I safely transition. I have in many respects, but my automatic response to hurt, stress, anger at others etc is always to “soothe” myself by self-harming.
Your information is so well presented and innovative; always searching for cutting edge information/approach, advancement etc, that I thought, you might be a great source to inquire from.
Any information you can provide will be most appreciated.
Sincerely,
Suzie
Correction:. I have forgiven myself, “not hadn’t”. Freudian slip?!
Ruth,
I have learned so much from NICABM since my attendance at NICABM’s 2005 Annual Conference at Hilton Head. This has led to my understanding of frozen energy/trauma being a root cause of mental health, addiction, and chronic illness and the importance of mindfulness and/or being in touch with the sensations in our bodies in a kind/gentle way.
This understanding has allowed me to slowly heal. I have also been able to speak out in many situations. I am happy to see that our public education system has started to address trauma in our children’s lives and my community begin to address the wrongs in our criminal justice system.
Thanks to you Ruth, and to all who contributed – wonderful!
Of all the years of therapy, reading, spiritual seeking, and determination for myself to change it was my daughter’s pain that gave me insight. My daughter began to self harm and attempt suicide in the 7th grade. It was DBT and my determination to read every book about BPD and DBT and ACT, learn the skills, practice myself that changed me so I could help my daughter. DBT changed my brain and saved my daughter’s life.
By building a consensus of the idea of healing being expanded throughout the communities, it becomes something that is normal and therefore easier to accept.
thank you for this article. I have learned so much by being with people suffering from mental illness and I start to understand in a deeper way what is humanity and tolerance. Some of the points made in the article are also my guidelines in life – communicating, connecting in a deeper level, understanding the body as a whole, cultivating contacts and expanding . The presence is a key point for me and the only way I can see to reach out for others
I have started practicing meditation, originally with a group but now individually. This practice is definitely beneficial.
Ruth, thank you, I feel what you have accomplished here is a barn raising… By gathering developmental, somatic & varied other life skill/exploration guides together & forming a community around their discussions, you have offered a platform to build on. To help me understand the global impact of individual wellness, I drew a circle and wrote inner peace on the inside & on the outer rim, wrote world peace. Fundamentally the global community is as healthy as its individual members… On a practical note, maybe forming a geographical community resource area, for members, so that the multi-modality care groups can form (both for client support & clinician self support) Bessel Van Der Kolk’s book “The Body Keeps The Score” impressed me in its breadth of research around the varied approaches to treat trauma. I would love to see groups form that offered talk therapy, mindfulness gateway training, EMDR, somatic work, bioenergetic work, spiritual counseling if needed, and a neuroscientist or two with a baseline fMRI to start…could you imagine if these therapies were at the clinicians disposal, say at the VA, as they walked side by side with their client, exploring their difficulties as the need arose (never forcing, as this is often painful work as a hidden self struggles against the habitual flow to emerge). Ok, that was fun to imagine… & I know it is occurring in some research universities and many of your co-teachers have spearhead this in their own practices. So thanks again!
Your work is inspirational and brings the cross fertilization into focus that many people in their fields are unable to organize and access.
Thanks for what you do. It does create change.
“Be the change you wish to see in the world”! This is very good but opens the door of Pandora’s box!
I’ve found that providing examples of people who have had similar experiences and been able to thrive have given hope to clients. I also believe that clients can borrow our hope for them before they are able to develop it for themselves.
This idea of “barn-raising” as an analogy to explain the process of personal growth is a very novel, but realistic intervention. I find that collaboration is crucial in changing old patterns of behavior that is not necessarily beneficial.
What I have found the most inspiring is a collaborative effort in supporting clients. To not feel like you are working in a vacuum or not feel supported in your efforts but to be in an environment that seeks to support both the client and the provider.
This is a timeous article that will help my new project, a national family camp/conference for 2017, succeed. Thank you.
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I have found that my relationship with God is the single biggest driving force to facilitate change in my life. I know the purpose for which I was created and live it! It helps me focus on the things that matter (things of eternal value). It is very satisfying to help others find their purpose too. A lot of people coming through my seminars have low self-esteem and an identity crisis because they do not know they have been created with purpose, let alone living it.
Newton’s laws of inertia and momentum sum up how change occurs. When things come to a head, hit rock bottom, reach a tipping point … those are the powerful motivators.
u got that rigt
As a group we explore a concept.
We seek to determine what that looks like on a personal level & how that can be applied.
People are transparent & honest & are seeking growth & change,personally & corporately.
We encourage on group chat throughout the week.
The practice of yoga has inspired change in my life, including mind body, soul, relationships, practice of teaching, training, counseling, supervision, how I spend my time, what I read, how I respond, etc etc etc!
I found your suggestions of applying the 5 steps of barn raising – curating, convening, committing, cultivating, and repeating are encouraging for the participants as they can see progress in the raising of the barn. I found it is the process of the building with a goal that also builds relationships so progress is established in the mission of the project. In the broader community this process is frustrated and stalled by the institutions that regulate what can be done and by whom it canbe done. Politics government regulations, insurance companies, hospitals, and health agencies are at best not in tune with “barn- raising.” I believe consumers, patients, medical practitioners, nurses therapists and counselors want results. The system needs to be improved to see results in capturing the “barn-raising” techniques. It’s worth an effort to see improvement in the health and mental health systems.
I am nodding joyfully in full affirmation of the “Barn Building” you are proposing! As a spiritual director now living in Santa Fe, I formerly served as an Interfaith Chaplain at several Harvard teaching hospitals. In both facets of my work I have witnessed and personally experienced deep healing and positive, lasting changes that come through a collaborative model such as this.
For twenty years I have been accompanying mental health practitioners as they explore their own spirituality and attitudes toward religion; they usually come to me after realizing in supervision that they are getting triggered by clients whose spirituality and religious beliefs challenge their own (or their lack thereof). Similarly, I have had many folks come for spiritual direction instead of continuing in their needed therapy after feeling that their therapist isn’t comfortable with and/or doesn’t value the importance of their religious/spiritual beliefs. I myself have a deep and broad background in pastoral care and my continuing ed focus has always been in psychology/neurobiology BUT I make it very clear that while there is overlap, I do not have the training or credentialing to help them in that capacity.
For that reason, and because I myself have personally benefited from psychotherapy over the years, I am always looking for mental health practitioners to whom I might make appropriate referrals. Or, better yet, as this model indicates, WITH whom the directee/client/patient and I might collaborate. The most rewarding work I have ever done was as part of a team which included a psychiatrist, a psychologist, and a patient/directee who was diagnosed with DID during the time we were working together. After about eighteen months, the psychiatrist cited the spiritual/religious piece of the work as crucial to the astonishing healing we were witnessing, particularly to the ending of suicidal ideation. One of the patient’s young parts even wrote a manual to educate the broader healing/medical community about why our team had worked so well for her and her co-parts! And yet, when we all considered together the possibility of presenting this model and the patient’s wise words, the psychiatrist sadly acknowledged that if we tried to move forward, she would face censure from the medical community for having included a spiritual director so integrally in the treatment plan.
That was ten years ago… and I still want to build that barn… and then another… and another, each time assessing the particularities of the needs and landscape together with a team. This email invitation in addition to recent NICABM presentations on-line have led me to hope that now is the time. Count me in! And I’d love to hear directly from others interested in working collaboratively in Santa Fe or by Skype from anywhere. Thanks, Ruth!
I see change and growth in individuals each day. But I also see the rules and habits in our current Socio economic culture stay the same, though Christine Lagarde of the IMF does offer us new goals.
There will be a Tipping Point and may it come soon!
I think there’s an important cognitive orientation to “change.” As individuals, we are prone to thinking like either victims of suffering or as controllers of our suffering. The Buddha’s first Nobel Truth was “Life is suffering”. I think we live in a world of individuals who are having trouble accepting that truth. By default, our society is turning its members into “victims” – having more so an external rather than internal locus of control over suffering. Everyday “life” stories seem to all be equal in how devastating they are. For example, a divorce, a job loss, a hip replacement – very difficult life events from which an individual can recover – are experienced and reported on the same level of suffering as other permanently life-altering events like limb loss or chronic pain and chronic unemployability or the death of a child. We’ve lost a vision of internal, emotional, “I can do this” human strength. We’re orienting to narcissism with less and less compassion for the pain of others, making everyone’s suffering worse. We need to stop reacting to suffering as though it shouldn’t be happening in the first place. I don’t know how to create a vision, role models of “emotional” strength without first accepting and owning our self-created and perpetuated expectations that life SHOULD NOT be suffering. Narcissism will make this cognitive shift harder.
Wish there was a like button I could press under your comments. Well said.
To change things in life there has to be a thought and then emotion needs to propel it forward. As I get thoughts i need to at least see some benefit for me or another. If we do not see benefit that creates an encouraging emotion, it seems there is very little drive to accomplish. As I am learning self-love, it attracts others into my life because they want what I have. It is so simple and yet elusive. Yes I need to create the change in me and others follow. Love is attractive to all cultures and races.
Solve your clients issues in yourself and they get it on the inner pathway. It makes all of our efforts so much easier. We all use words however they may not be as necessary as we think.
A feeling of self worth has inspired me to make many needed changes in my life. As a dialysis nurse, this is a valuable lesson. My patients need to make radical changes in order to survive. Helping people realize their own value as a human being can help “lift the fog” of a devastating diagnosis. it may seem elementary, but so many of us struggle with feelings of worthlessness In silence. To make change, it must be worth the trouble. Worth starts with self.
I have been advocating for years within the mental health counseling profession for practitioners to become leaders in understanding how outside societal conditions greatly influence clients lives and that outsides and insides are not 2 separate bubbles- I teach graduate level classes in multiculturalism and diversity as well as gender and sexuality and I stress the importance of contextualizatuon in working with clients as well as understanding oneself as a practitioner.
Choosing to find happiness; an idea presented in many different ways – that each person, regardless of life issues must find happiness within themselves, or they don’t get to me happy. As we know many people struggle and seem to fear the responsibility or doubt their ability to create happiness for themselves. When people personalize past struggles, blame themselves or others, doubt that they deserve to be happy or are afraid, it is difficult to find a happy thought or remember a happy times. This connects to the idea of internal focus and external focus – there is fear to look within oneself. Anything we do, activities, discussion, listening, meditation, prayer, etc… that helps the person to connect internally and to open up that part of themselves to others (increase connection) will help.
Following a path of service, meditation, self improvement and practice of beingness has drawn a few people to me who are also interested in some of these practices. Thus we have held study groups wherever I am located. Together we inspire each other and learn compassion.
I have found we do not learn compassion, we discover it when we our willing to be present in the face of our fears, demons, anger, pain, confusion, disappointment and tears; and manage to accept ourselves regardless, as part of a mystifying human journey, allowing the impact of emotions and story-lines to hold less of a personal attachment; and there low and behold, the embrace of love surfaces and shows us a new face, a face awashed in compassion, of what we otherwise, would have judged as dirty water. Our water ‘clear’, like a clean mirror, not ‘perfect’ mirror, reflects and accepts the clear water beneath the seemingly soiled surfaces of so called ‘others’. This capacity to accept, penetrate, expand, let be, allow, to presence, rather than judgement is the domain of compassion, not learnt but rather permitted, like a door left open. Bless
Nice article/steps, so true and helpful Ruth, thanks. Within the concept of change and your mention of exploring different perspectives. Have you explored any of Ken Wiber’s work around Integral theory and practice and his superhuman operating system. Its a fascinating, look and exploration of how we have evolved as humans in relation to each other, our world and the universe. Stages of development – Moving from 1st person perspective I/me, to 2nd person perspective it, to 3rd person perspective we, and 4th person perspective its. Moving from exclusion/separateness to inclusion, integral, non-dual and oneness.
Wow, this is bigger than 5 steps! Changing the world requires changing the narrative, being the change and for most a major metamorphosis.I have pasted a long blog below because I am so passionate about this.
Since committing to regular mindfulness practice serendipitous events have occurred that have led me to a passionate sense of calling.
My mission to help people access integrative health has, by the evidence of global crises, widened to compassion and action to help our planet.
We are entering an age of transition; a transition from individualism (separation from others), materialism (domination and over consumption) and power and privilege for a few which is at the heart of the environmental devastation and social injustice that plagues our world. Some believe people will look back and call this time the Great Transition. By examining our suffering and joining a new collective story: one of connection, compassion and relatedness our bodies can also heal. Sure, there are lots of ways to balance our bodies including diet, supplements exercise, mindfulness and therapy if needed but that is still looking at the individual (or family in family therapy).
I love, and have taken for my own, Pachamama Alliances aim: work towards an economically sustainable, spiritually fulfilling, and socially just human presence on the planet. We can do this by changing the stories (I started learning about this in Narrative Therapy). Examining the old stories of separation and domination that are full of unexamined assumptions, we are then able to discern the cultural stories that perpetuate inequity and concentrate power and privilege. We can choose to live from and share stories that create the paradigm for a just and sustainable world. (Paraphrased from the Game Changer Intensive, Pachamama Alliance).
Neuroscience, quantum physics, yoga and Buddhist philosophy have demonstrated that we are connected. So as we heal ourselves we can, as a collective take action to heal others, wildlife and plants.
So, I have started with education of myself, sharing with others and will soon move on to aiming for further reach, combining the current need for individual healing connected to the planet. I will be inviting or practitioners of Mindfulness, and others who have developed compassion to really look deeply at this.
I believe that while these five Cs may may have some tactical value, they ignore the ‘power-point’ of
Change : desire. The Amlsh build a barn in a day, because essentially they deeply, deeply Want to.
If tonight you strongly feel like having a glass of Sauvignon Blanc, can imagine the taste on your tongue
I don’t think you’re going to reach out for those 5 Cs.
Have an enjoyable evening, Ruth
Michael
What inspires change in my life? There are a variety of factors that come to mind at this point. They include personal emotional pain, the emotional pain of others, both positive and negative examples of significant people in my life, the encouragement and support of significant others. There may be an underlying common factor among these factors, but I have yet to realize what that might be.
The evidenced based model of FIT – Feedback Informed Treatment is an excellent framework based on client centered care
It starts with the self. We can know ourselves as whole, and always full of new, greater potential. Others have mentioned Self-Compassion and I agree. With Self-Compassion we can see ourselves from that whole and complete place, even while venturing forth into new, unknown territory where we may falter and therefore learn and grow. Just as we would nurture and encourage a baby to walk, and encourage them even more if they fall, because we see their potential and wholeness: when we have mastered Self-Compassion and acknowledged our own wholeness; when we have the courage to try new innovations from an informed, yet imaginative mind and heart: that is when we are well-equipped to help our clients do the same.
I have been inspired by my patients who have invited me to be a part of their journey. I am also inspired by the clinicians who have talked about their own journeys. I am seeing the difference it makes in therapy to offer clients the idea of self-compassion. I see how acceptance of things exactly as they are is critical to being able to make changes. This program is amazing to me.
Hallo Ruth, Thanks for your cources !!! For me contact and cources leaded by compationate personalities is most helpful changing my life – by their sence of humor and love ,this is most meaningfull also for the broder community, I have been inspired by artists like Yoko Ono – her interactive exhibition in Oslo , by reading old books written by philosopher and writer Karel Capek and many others
The greatest facilitation of change for me is firstly to become aware of the need to change and secondly taking responsibility for that. It then needs to be a unified approach. Physical (exercise and being in the beauty of nature), spiritual ( meditation/prayer/ connection to something bigger than myself but also within myself) and intellectual or cognitive( being aware of what I am telling myself and asking if it is true). I like the word ‘transforming’ which is full of hope but also challenge.
Hello Ruth: I really like how you are focusing on “Patient”. Many times in my supporting of people with the many mental, emotional, physical and spiritual challenges there have been a total denial by many professionals that are (treating) them that all of the above are the WHOLE person. To move beyond this concept professionals need to be learning the whole human being. Thanks keep up the great work you are doing.
Mindfulness mixed with Cognitvate behavioural metheds, and meditation is helping my students and ultimately will help our clients in their efforts to change their lives .I am learning that the mindfulness meditation is key to change at an almost at a biological level. Our goal is to help people with addictive behaviours to stay sobar and clean after they have compleated a treatment plan but it all begins with mindfulness meditation.
I agree about exercise and add two items that have helped me keep walking vigorously. My spouse got us both ipods and keeps them loaded with fascinating public radio podcasts (This American Life, TED Radio Hour, On Being, On Point, Fresh Air, On the Media…). NICABM audio interviews are also good! We bought SWIX walking sticks that maximize the benefit of walking to our upper bodies, lungs, and heart. We drive a mile to the park, walk vigorously, each at our own speed, meet back at the car and discuss the ideas we heard on the ride home and over supper. I used to dread taking time to walk, but the addition of fascinating ideas and the upper-body work engages us both completely and keeps our marriage vibrant as well.
For me, personally and in my experience trying to enable change in others, the cultivation of the capacities for inspiration, imagination and intuition is the key to bring change about.
Before change there is the need to feel that you can make it which inspiration can often provide. Imagination gives you the possibility to see with your mind(vision) and intuition, when heard to, can tell you that there is wisdom within.
I believe that the most impactful changes in my life have resulted from a consistent practice in meditation, as well as a commitment to exercise. These practices have eventually led to a heart centered approach to all aspects of life.
As an orthopedic surgeon in New York City dealing mostly with physical disabilities, I found the most inspiring change in my own life and in the lives of my patients, to be physical exercise. On more than one occasion I heard my patient tell me “Dr. Ort you changed my life by convincing me to exercise”. The same applies to my own life. I believe physical exercise, including running, is a form of meditation. It is immediate, concerns only with a present moment and the beneficial effects, physical and mental, are far reaching.This was recently confirmed to me by a wonderful book by Haruki Murakami What I Talk About When I Talk About Running.