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Welcome Everything.

The Failure of management is largely a failure to bring our whole selves to it. What parts of your self do you bring to your work? Do you bring only the management mind, only logic, only the company guidelines? Or do you bring your passions, your values, your soul, your deepest self? Do you react? Or do you respond? Letting go of what you think you know can be the first step to a creative and powerful response. Many of the tools we use in management can actually remove us from the experience and make it harder to respond. Reacting closes down options. Responding opens up possibilities and nurtures trust. This is kindness transformed into a business imperative--responsiveness.


* React or Respond?

* Fearless Receptivity

* Creative and Powerful Responses

* Bringing all of Yourself to your Work

Welcome everything. Push away nothing," the speaker said.

This sounds like a radical idea. "Welcome everything. Push away nothing." Was this some California Zen wingnut notion? Let's check. Out the big windows of the conference room, the hills of San Francisco sparkled in the sunlight, the jumbled white buildings emerging from the morning's rain. The speaker, Frank Ostaseski, sat crosslegged on a low stage, sprays of flowers and a huge calligraphic circle on the wall behind him. He was, in fact, a Zen monk and founder of the Zen Hospice Project. We had been sitting with him all weekend in a discussion of death and dying.

Neither of us is, as far as we know now, close to death, nor is anyone close to us. But death illuminates life. So we came to spend a few days with Frank Ostaseski and share stories of death.

"Welcome everything. Push away nothing." At first blush, the idea seemed to make no sense. It seemed to say, "Just let life walk all over you." But Ostaseski has credentials that cause people to take his words carefully: He has sat with thousands of dying people, not to cure them or fight off death, but just to be with them. Many of these dying people were homeless, or destitute, and had been brought to him by social workers from San Francisco's Tenderloin.

Was there something in this dictum that made useful sense? Did it make sense for more than sitting with the dying? Was there a more general wisdom here? Was there a wisdom that could be applied to managing people?

We extracted this thought: The failure of management is largely a failure to bring to it our whole selves, everything we have to give.

Suppose we were to say to you: You are perfectly capable of doing this job well and powerfully. You are not capable of doing it with one hand.

What parts of your self do you bring to your work? Do you bring only the management mind, only logic, only the company guidelines? Or do you bring your passions, your values, your soul, your deepest self?

React or respond?

Here's a way into that question: Imagine, for a moment, what it feels like to react. Something happens--a diktat arrives from JCAHO or HCFA, a patient slips out of your grasp, a teenage child turns sullen and stubborn. What is it like to react? How does it feel? What do you do? How do you make decisions?

Now set that image aside, and imagine instead what it feels like to respond. Feel that difference.

To react is to trigger the "fight or flight" syndrome. The voice of reaction says, "Holy moly, the barbarians are at the gate, I've got to do something now!" It also says, "This is happening to me!"

When the mind is in reaction mode, we move to simplify things. We attempt to put this experience in its proper category, and then to follow procedures that are appropriate for that category. In reaction, one size fits all.

Joe recently had a serious allergic reaction at a hotel in the middle of the night. He just needed an antihistamine, but his luggage, with the antihistamines, had been lost. He called the front desk to see if they had any. The young man at the front desk classified this as a "medical emergency" and followed procedures: He dialed 911. An impressive crowd of EMTs showed up with an ambulance and a fire truck, found no symptoms they could identify, and followed their procedures: They hooked him up to a heart monitor and an IV line and whisked him to the nearest ER. The ER staff followed several acres of procedures. Two hours and nearly $1,000 later, Joe got what he needed: an antihistamine.

React or respond?

To respond is radically different. On another occasion, a doctor responded to one of Joe's allergic reactions by listening to his experience, helping him alleviate the immediate symptoms, then exploring with him the possible causes of the reactions, and preventive measures. He listened, withheld judgment, explored, and eventually created something larger and more useful--a plan to prevent allergic attacks.

To respond is actually no more than to be with the person or the situation, to bring our whole selves into that moment. To respond, it is necessary that we refrain from filling the space with our own ideas, rules, projections, or solutions.

Fearless receptivity

"Welcome everything, push away nothing," says Ostaseski. "You don't have to like it, or agree with it. This is called fearless receptivity." Receptivity does not mean liking or agreeing with the new HMO rule or the surly teen, it means acknowledging that it is real, it is present, it has its own power.

When we react, the first action is to wall off the problem, to categorize it. This severely limits our ability to notice what is really going on--like the EMTs confronted with a patient who says he needs a common antihistamine.

You can do all the proper things and still not do the right thing.

"Bring your whole self to the task," Ostaseski says. "As health care workers, especially, we are encouraged to leave most of our selves behind. So-called 'professional warmth' doesn't work. Bring your strength, yes, but also bring your helplessness, your wounds, your sadness, your anger."

It might seem difficult, frightening even, to apply this thought to how we manage organizations. What would it take--what would it look like--to bring all of yourself to the organization?

"Find a place of rest in the middle of things--by bringing your full attention to what is actually occurring."

What would it take to focus your whole self on what is unfolding before you?

Give up knowing

"Cultivate a 'don't know' mind. If you don't know the answer, you have to stay very close to what is going on."

What would it take to let go of what you think you know? If you did that, would it become easier to truly listen, to be attuned to the moment?

"The most practical advice would be: Go toward your fear."

What are you most afraid of in managing people? How much energy does it take to avoid it, to cover it up, keep it papered over?

"Strategizing leaves us exhausted. Myself, I'm kind of simple. One of my favorite things is the little tag you see in a used clothing store that says, 'As is.' That's how to take the world: As is."

Many of the tools we use in management to get a grasp on what is happening--the flow charts, the consultants, the accounting reports, the surveys--can be used just as powerfully to hold the experience at a distance, to abstract it, to alienate ourselves and others from it. It's the difference between "malpractice exposure" and "We made a mistake. Your mother died. We are terribly sorry." It's the difference between a "6.7 percent downsizing" and "We have to cut some hours and some jobs. It's awful, and it's going to hurt. What can we do to make it hurt less, and make it go as smoothly as possible? Let's talk."

A person who reacts cannot ask what they would do, only what they should do. A person who responds can ask what's possible here. He or she can see what's not addressed by the flow charts.

Only in responding to others can we trust them. In responding, we cross that distance between ourselves and others. We put ourselves, at least for a moment, in their shoes.

In stable times, it may be that the flow charts, the strategic plans, and the management guidelines are enough. In times like these, we need something deeper, something with greater bandwidth, something that can call on our deepest intuition, judgment, and wisdom.

What the Buddhists call "compassion," what we might call "generosity," what the poet Naomi Shihab Nye calls "kindness," becomes a business imperative. Without it we can only react. Without it we cut ourselves off from our own greatest talents, from the best energies of those who work with us, from the creative power of the community from which we draw sustenance.

Then it is only kindness that makes sense anymore, only kindness that ties your shoes

and sends you out into the day to mail letters and purchase bread.

only kindness that raises its head

from the crowd of the world to say

it is I you have been looking for,

and then goes with you everywhere

like a shadow or a friend. [1]

--Naomi Shihab Nye

Joe Flower is an internationally recognized health care futurist.

Patrice Guillaume is a personal and executive coach. Their company, What If..., is dedicated to bridging the gap between what is and what's possible. What If ... offers a technology of inquiry that helps people and organizations imagine and build toward their own best future.


(1.) "Kindness," Words Under The Words. Portland, OR: The Eighth Mountain Press, 1995, pp. 4243.
COPYRIGHT 2001 American College of Physician Executives
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 2001, Gale Group. All rights reserved. Gale Group is a Thomson Corporation Company.

Article Details
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Title Annotation:management techniques
Author:Guillaume, Patrice
Publication:Physician Executive
Geographic Code:1USA
Date:Mar 1, 2001
Previous Article:Our Doctors are Joining a Labor Union!
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