“Embrace dialectical thinking, stupid!”
That’s the mantra I repeat when I catch myself getting worked up about a deep-seated belief, idea, or cause. Understanding the flip side of the equation helps me to neutralize powerful negative feelings like righteous indignation, bitter disappointment, and utter disgust with the incompetence of fill-in-the-blank.
Dialectical thinking is the ability to view an issue from multiple perspectives. Embracing it helps us recognize that it’s almost always possible to spin the storyline in the opposite direction. The creative tension that links any point to its counterpoint – that’s the so-called dialectic.
I discovered dialectical thinking years ago while reading a Buddhist newsletter. An Auschwitz survivor wrote an article extolling the many “gifts of the Holocaust.” My amygdala shifted into overdrive: I saw red, became tachycardic, and started to dress her down from my mind’s bully pulpit. After calming myself, I allowed her thoughtful ideas to marinate. Her horrific experience in the death camp had rendered every subsequent moment of her life precious and meaningful: the most profound of gifts.
As health professionals and medical leaders, we often find ourselves embedded in a stressful environment that is rife with imperfection, bureaucracy, and unnecessary complexity. We can better manage our frustration with the shortcomings of the environment, and with the humanness of our co-workers and patients, by thinking dialectically:
- What a gift it is that my life’s work is relieving the suffering of others.
- Although it’s sweltering outside, how fortunate I am that I work in this comfortable, air-conditioned building.
- All that pressure on the health care dollar comes from amazing (but costly) scientific advances that have turned heart disease and cancer into relatively manageable chronic diseases – so much more time to enjoy with our loved ones.
- We’ve nearly gotten the upper hand on COVID-19, a pandemic that only 5-10 years ago would have done so much more damage to the human race and our economy.
Although thinking dialectically may sound easy, many of us have trouble installing the “dialectical thinking app” into our brains. A couple of ideas to consider:
- Dialectical thinkers may not be drawn to pre-med studies and medical school. One wonders if they gravitate to fields less arduous than medicine.
- Medical training, with its focus on knowledge acquisition, differential diagnosis, and decisive action in the name of saving lives, may, in and of itself, provide negative reinforcement for dialectical thinking.
In “The Joylessness of Harried Medical Leaders,” I discuss our inadequate training in the “soft skills” that help us to manage ourselves and team relationships. Dialectical thinking and mindful management of self and others are topics to include in the soft skills curriculum (a hypothetical work in progress).
Many psychotherapists and coaches can help their patients and clients learn to think more dialectically, and courses on mindfulness and mindful medical practice may augment your work with an individual practitioner. Alas, so many growth opportunities, so little time.
Steve Adelman is a psychiatrist and can be reached at his self-titled site, AdelMED.
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