Sunday, June 26, 2016
Here I Am
Daddy says if you don't write it, you didn't think it. And Daddy has a coherent mind that follows a train of thought. When I don't write, my thoughts tangle and redund, winding around themselves and chasing their tales.
Here is the tangle of thoughts I would like to unravel and weave into something both practical and beautiful. I would like to spin together strands from a good book I just spotted by chance at the library, "Dignity Therapy" by psychiatrist Harvey Max Chochinov. Chochinov has studied the effects of asking one question to patients:
"What would you like me to know about you as a person, so that I can give you the care you need?". The whole person. The "patient" is the one with the illness. The person is the whole life, the values, the character, the needs, the story. I want to live this in all of my spheres. Where Chochinov is talking about individuals in their final days, I'm remembering the Talmudic advice, something like, "On the last day of your life, reach out to everyone in your world with clear connection, mending, respect, and love. Since you do not know which day is the last one, do this every day." I'm thinking of the window box outside of each resident's room at Kensington Gardens where my Uncle Izzie lived his last days. Most had lovely wedding pictures, photos and mementos of who they had once been, indicators to staff and visitors of the dignity they still deserved, the image they would still like others to see, if they could choose the impression they gave. My Uncle Izzie had one item in his window box, a framed calligraphy piece: "Yea, though I walk through the valley of the shadow of death, I will fear no evil, for I am the nastiest son of a bitch in the valley". I must find the exact wording. A saying goes, "We do not change as we grow older. We simply grow more clearly ourselves". We stop being g able to pretend. I have somewhere in my papers a poem by Yevtushenko that begins, "As we grow older we grow honester. That's something".
That question from Dr. Harvey Chochinov:
The Patient Dignity Question (PDQ)
The PDQ is a simple, open-ended question: "What do I need to know about you as a person to give you the best care possible?"
Research has shown that this single question can identify issues and stressors that may be important to consider when planning and delivering someone's care and treatment. The intent is to reveal the "invisible" factors that might not otherwise come to light – and to identify these concerns early in the process.
Why not ask this question as we enter any encounter? With anyone? Like "Namaste", I bow to the holiness in you. Like the letter Lucy Calkins sends out to the parents of every child in her class at the beginning of the year, inviting them to tell her about this unique little child they have entrusted to her for the school days of the year. Calkins' book is called "Living Between the Lines", a way to encourage children to bring their whole lives into their writing.
I have nothing to write about?
Well, tell me, what do you do, when you are not at school.
Nothing.
Nothing?
Nothing. I just feed the pigeons.
And soon the little boy is writing a beautiful life story of the pigeons he feeds. He is writing between the lines. His teacher has simply invited him to bring his whole self to school.
For awhile in my therapy I liked asking the Miracle Question from Solution Focused Brief Therapy:
“I am going to ask you a rather strange question. Imagine you go to sleep tonight. In the middle of the night, a miracle happens and the problem that prompted you to talk to me today is solved! But because this happens while you are sleeping, you have no way of knowing that there was an overnight miracle that solved the problem. So, when you wake up tomorrow morning, what might be the change that will make you say to yourself, ‘Wow, something must have happened—the problem is gone!’”
But in my experience, people don't want the miracle question. They don't want to focus on a specific and visualized outcome. They want me to accompany them on their journey.
If you don't write it, you didn't think it. I am beginning, just beginning now, to think it.
Here I Am
Daddy says if you don't write it, you didn't think it. And Daddy has a coherent mind that follows a train of thought. When I don't write, my thoughts tangle and redund, winding around themselves and chasing their tales.
Here is the tangle of thoughts I would like to unravel and weave into something both practical and beautiful. I would like to spin together strands from a good book I just spotted by chance at the library, "Dignity Therapy" by psychiatrist Harvey Max Chochinov. Chochinov has studied the effects of asking one question to patients:
"What would you like me to know about you as a person, so that I can give you the care you need?". The whole person. The "patient" is the one with the illness. The person is the whole life, the values, the character, the needs, the story. I want to live this in all of my spheres. Where Chochinov is talking about individuals in their final days, I'm remembering the Talmudic advice, something like, "On the last day of your life, reach out to everyone in your world with clear connection, mending, respect, and love. Since you do not know which day is the last one, do this every day." I'm thinking of the window box outside of each resident's room at Kensington Gardens where my Uncle Izzie lived his last days. Most had lovely wedding pictures, photos and mementos of who they had once been, indicators to staff and visitors of the dignity they still deserved, the image they would still like others to see, if they could choose the impression they gave. My Uncle Izzie had one item in his window box, a framed calligraphy piece: "Yea, though I walk through the valley of the shadow of death, I will fear no evil, for I am the nastiest son of a bitch in the valley". I must find the exact wording. A saying goes, "We do not change as we grow older. We simply grow more clearly ourselves". We stop being g able to pretend. I have somewhere in my papers a poem by Yevtushenko that begins, "As we grow older we grow honester. That's something".
That question from Dr. Harvey Chochinov:
The Patient Dignity Question (PDQ)
The PDQ is a simple, open-ended question: "What do I need to know about you as a person to give you the best care possible?"
Research has shown that this single question can identify issues and stressors that may be important to consider when planning and delivering someone's care and treatment. The intent is to reveal the "invisible" factors that might not otherwise come to light – and to identify these concerns early in the process.
Why not ask this question as we enter any encounter? With anyone? Like "Namaste", I bow to the holiness in you. Like the letter Lucy Calkins sends out to the parents of every child in her class at the beginning of the year, inviting them to tell her about this unique little child they have entrusted to her for the school days of the year. Calkins' book is called "Living Between the Lines", a way to encourage children to bring their whole lives into their writing.
I have nothing to write about?
Well, tell me, what do you do, when you are not at school.
Nothing.
Nothing?
Nothing. I just feed the pigeons.
And soon the little boy is writing a beautiful life story of the pigeons he feeds. He is writing between the lines. His teacher has simply invited him to bring his whole self to school.
Dignity Therapy
"Practice until you see yourself in the cruelest person on Earth, in the child starving, in the political prisoner. Continue until you recognize yourself in everyone in the supermarket, on the street corner, in a concentration camp, on a leaf, in a dewdrop. Meditate until you see yourself in a speck of dust in a distant galaxy. See and listen with the whole of your being. If you are fully present, the rain of Dharma will water the deepest seeds in your consciousness, and tomorrow, while you are washing the dishes or looking at the blue sky, that seed will spring forth, and love and understanding will appear as a beautiful flower." ~Thich Nhat Hanh
Here I Am
Daddy says if you don't write it, you didn't think it. And Daddy has a coherent mind that follows a train of thought. When I don't write, my thoughts tangle and redund, winding around themselves and chasing their tales.
Here is the tangle of thoughts I would like to unravel and weave into something both practical and beautiful. I would like to spin together strands from a good book I just spotted by chance at the library, "Dignity Therapy" by psychiatrist Harvey Max Chochinov. Chochinov has studied the effects of asking one question to patients:
"What would you like me to know about you as a person, so that I can give you the care you need?". The whole person. The "patient" is the one with the illness. The person is the whole life, the values, the character, the needs, the story. I want to live this in all of my spheres. Where Chochinov is talking about individuals in their final days, I'm remembering the Talmudic advice, something like, "On the last day of your life, reach out to everyone in your world with clear connection, mending, respect, and love. Since you do not know which day is the last one, do this every day." I'm thinking of the window box outside of each resident's room at Kensington Gardens where my Uncle Izzie lived his last days. Most had lovely wedding pictures, photos and mementos of who they had once been, indicators to staff and visitors of the dignity they still deserved, the image they would still like others to see, if they could choose the impression they gave. My Uncle Izzie had one item in his window box, a framed calligraphy piece: "Yea, though I walk through the valley of the shadow of death, I will fear no evil, for I am the nastiest son of a bitch in the valley". I must find the exact wording. A saying goes, "We do not change as we grow older. We simply grow more clearly ourselves". We stop being g able to pretend. I have somewhere in my papers a poem by Yevtushenko that begins, "As we grow older we grow honester. That's something".
That question from Dr. Harvey Chochinov:
The Patient Dignity Question (PDQ)
The PDQ is a simple, open-ended question: "What do I need to know about you as a person to give you the best care possible?"
Research has shown that this single question can identify issues and stressors that may be important to consider when planning and delivering someone's care and treatment. The intent is to reveal the "invisible" factors that might not otherwise come to light – and to identify these concerns early in the process.
Why not ask this question as we enter any encounter? With anyone? Like "Namaste", I bow to the holiness in you. Like the letter Lucy Calkins sends out to the parents of every child in her class at the beginning of the year, inviting them to tell her about this unique little child they have entrusted to her for the school days of the year. Calkins' book is called "Living Between the Lines", a way to encourage children to bring their whole lives into their writing.
I have nothing to write about?
Well, tell me, what do you do, when you are not at school.
Nothing.
Nothing?
Nothing. I just feed the pigeons.
And soon the little boy is writing a beautiful life story of the pigeons he feeds. He is writing between the lines. His teacher has simply invited him to bring his whole self to school.
For awhile in my therapy I liked asking the Miracle Question from Solution Focused Brief Therapy:
“I am going to ask you a rather strange question. Imagine you go to sleep tonight. In the middle of the night, a miracle happens and the problem that prompted you to talk to me today is solved! But because this happens while you are sleeping, you have no way of knowing that there was an overnight miracle that solved the problem. So, when you wake up tomorrow morning, what might be the change that will make you say to yourself, ‘Wow, something must have happened—the problem is gone!’”
But in my experience, people don't want the miracle question. They don't want to focus on a specific and visualized outcome. They want me to accompany them on their journey.
If you don't write it, you didn't think it. I am beginning, just beginning now, to think it.
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