Posted on: 23 October 2023
Hello,
I’m Gareth, I’m writing periodically about ‘dialogical practice’ and my learning over the years about the Open Dialogue approach to mental healthcare; something we are adopting here in CNWL.
If you want to catch up on any of my previous blogs, please scroll to the bottom of this page.
To all CWNL staff, If you would like to learn more about Open Dialogue you can go to our Intranet site – Open Dialogue: CNWL Extranet.
Other...
How often do you end up ‘othering’ someone?
It’s amazing how easily done it is:
“We reported that machine to IT weeks ago and they haven’t done anything”
“HR are meant to process those forms”
“The doctors refuse to take part in that task”
“They have a diagnosis of Personality Disorder so we would expect that…”
When we push people outside of our sense of us, we make them something else; something we can empathise less with, something different from ourselves, something… other.
In the 1980s a family therapist named Harlene
Anderson, working in partnership with Harry Goolishian in Texas in the USA. They began developing a more collaborative approach to family therapy. This considered the people we are trying to help to be equal partners in the process.
She has been hugely respected across the family therapy world for decades for her work. She was a key influence upon the team which developed Open Dialogue. I was fortunate enough to meet her and hear her speak at the International Dialogical Summer Meeting in Tornio, Finland earlier this year.
I asked Harlene why it often proved difficult to introduce dialogical practices in to new teams and organisations. She thought for a moment, then responded:
“Who are you othering in your approach?”
“Organisations are only people. You cannot change other people. You can only change yourself in relation to them.”
I have dwelt a lot on those words in the weeks since as I found a lot of wisdom in them.
Harlene spoke about how she found it essential to find something she likes about the people she works with, even if in many ways she disagrees with the person. Can you be curious in what they have to say? Can you be interested in, appreciate and respect them?
She also spoke about how important she found it to not be an expert when working with people:
“who am I to be an expert on someone else’s life?”
To collaborate more with someone, she encourages them to talk about the things which interest them. She guards against her thoughts becoming blaming, pejorative or labelling and is very cautious about interpreting. Harlene instead encourages us to find ways of working which allow us to be at our most creative and flexible.
Jaako Seikkula picked up this theme of Harlene’s and pointed out that it is ‘us’ who create ‘other’. Instead of expending energy on the ideas of ‘other’ which often lead to nowhere positive, he suggested we instead focus on ourselves. What is within your gift of how you are responding? How you are positioning yourself? What could you do differently?
No ‘They’ on the Santa Fe
I imagine there are many of you who are now saying “well that’s all well and good Gareth but there are so many situations where we need to take control and hold people to account”. All sorts of situations spring to mind to do with safety of the person, those around them and the staff. Situations where the team or system are overwhelmed. At times like that it can feel safer for everyone if an expert takes control and tells everyone what to do. When you are scared or overwhelmed it is also easier to pass responsibility on to ‘others’.
Well I cannot think of a more ‘command and control’ situation than running a nuclear submarine. I was recently introduced to a great video on leadership called ‘Turn the Ship Around’. If you have 20 minutes, do take the time to watch it. Captain David Marquet talks about how he was prepared for a year to take command of his first submarine, studying every bit of the ship so that he would be the most expert at everything onboard. However, at the last moment he was switched to commanding a different ship he was not familiar with called the USS Santa Fe, a ship which was considered failing.
David Marquet, Former-Captain, US Navy Seals: Turn The Ship Around! - YouTube
What David quickly had to realise was that in order for the team to function he could not be expert. He had to admit when he did not know the answers (we might say Tolerate Uncertainty). He began inviting his crew members to make suggestions about what needed to be improved. One innovation the team came up with was deciding to no longer use the word ‘they’. This was othering, it passed responsibility to someone else and in doing so solutions were not found. Instead of they, the team had to say ‘we’. E.g.
“why didn’t we do well in that exercise?”
“well engineering forgot to… We forgot to order the right part”
The crew member would usually turn around at this point and get straight on with finding a solution. The team members were retaining Responsibility. This is exactly what we do in network meetings within a dialogical approach. By doing things together we reduce the potential for us and them thinking and instead think in terms of we. All involved are then more likely to retain a sense of responsibility for the issues.
In due course, the Santa Fe went on to be the top performing ship in the fleet and crew member after crew member went on to be promoted to their own commands.
I wonder what it would be like if we had no ‘they’ in CNWL? If instead we tried more to speak and act in terms of ‘we’ and ‘us’.
I love hearing any feedback you have for this blog. You can write to me at: Gareth.jarvis@nhs.net.
Open POD podcast
Have you come across the conversations of our own Amanda Bueno de Mesquita and Fiona Eastmond with Billy Hardy yet? They started up a Podcast to explore dialogical ideas in greater depth. You can download them for free using whichever device you listen to your podcasts through. I have absolutely loved listening to their discussions and learnt a lot from just these first few episodes. Find them now: