Knowing Self

Sheila McGovern, FoNS Person-centred Practice Facilitator

This is one of the areas we explore early in the process when we work with groups who want to bring about meaningful culture change within their teams and workplaces.

Why is this so important?
Because we can only truly support others in their growth if we first take the time to understand and work on ourselves. Culture change often requires us to unlearn old habits and relearn new ways of thinking and working – and that process starts with self-awareness.

“Knowing self” is essential because it encourages us to ask ourselves the challenging, reflective questions that help uncover the assumptions and hidden biases we may hold. This self-exploration is crucial when we are trying to change “how things are done around here”.

If we cannot recognise and confront our own habits and patterns first, we will struggle to truly understand what needs to change and will be less able to support others in challenging and reshaping theirs.

One of the tools we use to support this process is the Who am I as a person? activity from Chapter 1, page 5 of the Fundamentals of Person-Centred Healthcare Practice by Brendan McCormack et al, Wiley Blackwell.

I have loved seeing the insights participants get from completing this activity. In a safe and supportive environment this seemingly simple exercise can spark a powerful new conversation with ourselves – one that is both enriching and transformative. It can and has become the starting point of a whole new relationship with self. As facilitators of this exercise, it is of course important that we have also engaged in this activity so that we have experience of what might be happening for the people we are working with. Any time I have completed the activity, the results have been slightly different than the last time. This feels like an indication of my evolution as a human being in the world and how learning has changed who I am as a person.

When we facilitate this exercise, we offer participants to share what they feel comfortable sharing with another person in the group. It is important that when we do work on self that we don’t have to feel pressure to share everything we are learning about ourselves straight away and with everyone. Our insights are valuable and should be honoured as such and shared when and with whom we feel safe.

Another self- exploratory tool I have worked with when recently taking part in an Introduction to Dramatherapy course at Queen Margaret’s University, Edinburgh was the amazing poem, House of Changes by Jeni Couzyn.

After being introduced to the poem, we carried out an activity where we looked at what our internal house might look like. It was powerful, but I must add that reading the poem itself affected me deeply. I recognised myself in every character and as I speak it again today I have so much compassion for all those parts of me that I see as familiar. I feel that it’s a great reminder that many of us as healthcare professionals will have our own lived experience of physical and mental health issues and sometimes, that reality, can get lost in the day to day work.

I have shared this poem with many friends, and it has created much discussion.

I would be interested to know what you hear in it if you feel like sharing but also offer you a quiet prompt to please be kind to yourself when partaking any work on self. John O’Donohue, another of my favourite writers, reminds us in his lovely book Anam Cara, to be gentle with ourselves when scraping the “clay away from our hearts”.

It is important to know ourselves to grow but relentless self-scrutiny is not helpful and does not lend itself to healthy growth.

HOUSE OF CHANGES

My body is a wide house

a commune of bickering women,

hearing their own breathing

denying each other.

Nearer the door

ready in black leather

is Vulnerable. She lives in the hall

her face painted with care

her black boots reaching her crotch

her black hair shining

her skin milky and soft as butter.

If you should ring the doorbell

she would answer

and a wound would open across her eyes

as she touched your hand.

On the stairs, glossy and determined

is Mindful. She’s the boss, handing out

punishments and rations and examination

papers with precise

justice. She keeps her perceptions in a huge

album under her arm

her debts in the garden with the weedkill

friends in a card-index

on the windowsill of the sittingroom

and tape-recording of the world

on earphones

which she plays to herself over and over

assessing her life

writing summaries.

In the kitchen is Commendable

the only lady in the house who

dresses in florals

she is always busy, always doing something

for someone

she has a lot of friends. Her hands are quick and

cunning as blackbirds

her pantry is stuffed with loaves and fishes

she knows the times of trains and

mends fuses and makes

a lot of noise with the vacuum cleaner.

In her linen cupboard new ironed and neatly folded,

she keeps her resentments like

wedding presents – each week

takes them out for counting not to

lose any but would never think of using any

being a lady.

Upstairs in a white room

is my favourite. She is Equivocal

has no flesh on her bones

that are changeable as yarrow stalks.

She hears her green plants talking

watches the bad dreams under the world

unfolding

spends all her days and nights

arranging her symbols never sleeps

never eats hamburgers

never lets anyone into her room

never asks for anything.

In the basement is Harmful

She is the keeper of weapons

the watchdog. Keeps intruders at bay

but the others keep her

locked up in the daytime and when she escapes

she comes out screaming

smoke streaming from her nostrils

flames on her tongue

razor-blades for fingernails

skewers for eyes.

I am Imminent

live out in the street

watching them. I lodge myself in other people’s

heads with a sleeping bag

 strapped to my back.

One day I’ll perhaps get to like them enough

 those rough, truthful women

 to move in. One by one

I’m making friends with them all

unobtrusively, slow and steady

 slow and steady.

©Jeni Couzyn 1978 From Life by Drowning: selected poems published by Bloodaxe Books, 1985

I would like to thank Jeni Couzyn for her beautiful writing and for allowing me permission to share her poem here.

Working on self is a good place to start when aiming to support others in culture change. When we create the opportunity to work on ourselves and confront our own conscious and unconscious biases, we can make real change in the world. Next week I will be sharing thoughts on a discussion we had as FoNS facilitators of Resilience Based Clinical Supervision on the topic of supporting ourselves and others to have more open conversations around bias and racism in healthcare.