Its how the light gets in....again

I started writing this blog in 2011 when I was diagnosed for the second time in my life with breast cancer. And as I sit down to write this I find myself poised to write about something I didn't expect to at all. Perhaps I should have.

 I wanted to write a blog then for a few reasons "I suppose for me this is also about finding my voice in this fairly unique situation I find myself in and using that voice to share and shed my own burdens. And also the love and laughter that these times can evoke."

Blogging has been in some ways quite life changing. I rediscovered a joy of writing, I have connected with fellow bloggers across the world; laughed with them, raged with them, grieved for them too. And as my health improved and the cancer receded, I have blogged about many other things, enjoying the freedom to explore my thoughts around person centred care, about leadership, even about politics.

But this weeks news is bringing the blog right back to its original subject; breast cancer. I have been diagnosed this week for the third time with a primary breast cancer. I'm still making sense of that news, if there is sense to made. I'm working out the practical logistics as I plan for surgery in the new year. I'm working and making space for tests, appointments and the impact of results. I'm summoning up the energy to tell people ....I had forgotten how exhausting that is. And I'm feeling the love of my family and friends as they take in the news and reach out with their warmth and care.

It's a familiar world in many ways which helps minimise the sense of shock but I really didn't expect to be here...yet. But here I am and if I'm honest I'm pissed off more than upset! You know the lovely quote about "it's not about waiting for the storm to pass, it's learning to dance in the rain" well that's not quite where I am yet. The storms have been real this last week here in Scotland and rather than dancing in them instead I want to stamp in the puddles.

I really laughed with Helen Mirren when she said she wishes she had told more people to "fuck off" in the past. But it's less about people for me ( although Donald Trump would be first in the list) and more about cancer.

You know I think maybe I've been a bit too polite with it in the past; let it sneak into my life unannounced and rob me of my wellbeing. I have accepted its intrusion and although I have fought the impact, I was the one I punished in the process. I pushed myself to show it hadn't beaten me, I have worked too hard to make up for lost time, I have smiled when I've wanted to weep. I have said I'm fine, way too many times for it to be true.

So there are two things I want to say as my life is invaded yet again.

1.    I am going to be kind to myself by saying yes to any kind and loving offer, by paying attention to my needs, by enjoying all the wonderful people and things I have in my life, by nurturing my recovery.......and

2.    I hear you, cancer, but whatever the outcome of this stage of the journey- you aren't the boss-that's my job.

so here is the wonderful Mr Cohen with a very timely reminder- The Anthem  ....And breathe.....

"The ways of truth and love have always won". Gandhi

" We need a systematic approach to foster humanistic values, of oneness and harmony. If we start doing it now, there is hope that this century will be different from the previous one. It is in everybody's interest. So let us work for peace within our families and society, and not expect help from God, Buddha or the governments." Dalai Lama

It's been hard this last few weeks to have the words to describe the myriad of emotions that have affected me. In some ways I envy those who purport to have certainty in what should be done to respond to the terrorism we see affecting so much of our world. And of course it had an impact on me because as a European, terror came very close to home.

I have no easy answers to share, no wise idioms to make it all ok. I understand some the complexity of the factors that have brought us to where we are now; I know that we in the UK have played our own role in that, like so many others in the West. I know too that some powerful global companies, not least the arms traders will always benefit from war. 

I see the hypocrisy of our relationships in the Middle East. We have all played our part in creating the monster of the so-called IS. And it's monstrous behaviour is hard to believe. This film from channel 4 news shockingly shows its behaviour within Syria towards children http://www.channel4.com/news/syria-children-of-the-caliphate-isis-amputation-evan-williams. And we wonder why there is a tide of humanity washing across Europe? 

But still I'm reminded of how compassion and care for others can transform the human experience. How even where people have witnessed the unimaginable, the impact of  nurture, safety and the love of strangers can bring life back into eyes and an inner flourishing that was previously unimaginable. I hope that is already happening for the refugees who arrived in Scotland last week.

Sadly last week we also witnessed those who welcomed the Syrian refugees to our country this week, themselves attacked by disgusting racism. The shameful anti-Muslim behaviour we have seen here in Scotland and more widely is to be deplored and we should all challenge it wherever we see it. What has led us to this?

Our focus on individuality in recent times has impacted on empathy and compassion but what I do know is we can change that again. We can learn to be more compassionate, to show more empathy, to understand that through care and connection we can all thrive given the right conditions. We can learn that what helps a community flourish is not self-interest but it's investing in what helps everyone thrive. And for those of you who fear we are too far gone to be different let's remember that even where it seems evil behaviours have triumphed, there will always be the signs of goodness too.

Out of the devastation of the Second World War, the welfare state emerged. It took only 10 days after Hiroshima was flattened by the A bomb for flowers to grow. Cumbria in a different way seemed forever changed after the foot and mouth disease a few years ago,but the lack of sheep grazing meant the flowers bloomed again and the ospreys returned. We are programmed to flower, to bloom in the right conditions. We can flourish as a community if we create the right conditions. But a flourishing community or country is not one that turns against others, it's one that shows love and compassion to others, especially when they are vulnerable. The best way to challenge the profoundly immoral is to demonstrate  moral courage.

I started this blog owning my sense of powerlessness and  distress given the recent events. But I also know that change can only start with ourselves. One person at a time we can change how we are in the world. So ultimately we hold the difference -each and everyone of us-not powerless after all.

Sanitising aging and loneliness?

I noticed some social media activity around the John Lewis advert on Friday and thought, "I'm not getting sucked into watching it"...muttering about cynical manipulations. But I gave in, after all it was a distraction from work.

I watched it without knowledge of the content so was more prepare for cuteness than the grief it evoked in me. The story is about an isolated elderly man...living on the moon.

Now in my defence I had been viral and although, after a day in bed I was a little better, robust I was not. But the strangely the image of the social isolation the film told of didn't create an empathy for the story teller, it distressed me. At one level it awakened my own feelings of upset, guilt and helplessness from when my own Mum was still living alone. No matter what we did and other support we organised it wasn't enough to assuage the loneliness and fear that Alzheimer's had worsened drastically.

The advert of course didn't intend that; it is aimed at cleverly ensuring we know the message of Christmas is about love and giving and of course safe in the assumption that the aspiring middle classes would go nowhere else other than John Lewis to purchase those very things. Oh yes and just in case we want to do some good and you look very carefully, you can give to Age UK as well. Christmas all tied up in a pink bow, even loneliness and aging sanitised by a donation through PayPal. But for me at least it was a step too far. It's slick marketing has unwittingly exposed a searing truth of where our society is failing. We seek happiness through things rather than through connection. Social  isolation and inequalities in our society too are ever more visible each year and consequently harder to ignore. Let's remember its Lidl not Waitrose of the John Lewis Partnership who were the first supermarket chain to pay the living wage to all.

This year, like many of you, I have collected for and donated to foodbanks (whose frequent users are the working poor), donated to a school uniform bank and plan to do something for Christmas too. Consequently for me its a paradox to see the need across our communities and think its fine to increase the consumerism that is the fuel for the unchecked capitalism that leads to such inequality and need.

As we feed the beast that a secular Christmas has become perhaps we can also step back and see what we can do ourselves to make a difference. Maybe it's to get to know our neighbours, or support the lonely ( young and old) this coming winter, or  donate to a charity that's making a difference, or even volunteer with an organisation like Contact theElderly and which will enrich your life too. Whatever it is we can all do something and be the change we want to see in the world.

So back to that advert, I did donate to Age UK happily as I know their services really helped my Mum for a time. But next year I suggest that John Lewis ( and other retailers guilty of the same and less community orientated) learns from this and donates its money for the advert to a charity and pays all its people the living wage.

But you'll have to excuse me as I'm off now to take an older woman to tea, my monthly volunteering with Contact the Elderly. I phoned her earlier and she said what a lovely surprise it was to be going out on a lonely Sunday afternoon. Her delight made my day. Now that's the gift that keeps on giving.

Data with a soul...power of stories

"Are you sitting comfortably? Then I will begin"....the opening of "Listen with mother";  the radio programme that reaches back into my childhood. To be honest I have no recollection of sitting down to listen to it, but the phrase conjures up such strong associations I must have listened in; at least now and again. "Tell me a story" is a phrase from my own children's childhood and it guaranteed cuddles on the sofa and time suspended. Those are precious memories but also speak of a society that confines storytelling to childhood. But in truth stories are how we construct our world at any age; our self- beliefs, our organisations, even our nations. 

How often we perceive ourselves through those stories; I was the naughty child or the good one, I was the clever one, the challenging adolescent, the moody one, the fun one and those definitions stalk us into adulthood. A delicate story is woven around us and we can find ourselves playing it out for all of lives for good or ill. But what if that story is of illness, of abuse, or neglect, of lack of love....do we need to carry those stories too?

In our recent and powerful masterclass on storytelling by Marie Ennis O'Connor helped us understand the power of stories in our lives; how we are hot wired to make sense of our world though story and that is true of all cultures. Our stories can serve us well of course, they can be positive and life enhancing but they can also be negative and limit our belief.

But we are not our stories, we can change them and find a different way to relate to them. But perhaps first we have to recognise them, to tell them and to have someone bear witness to them too.

My blog has been a vehicle for my story over the last few years. It's been a vehicle for my ups and downs, my bumps in the road and cul-de-sacs too. It's been a cathartic release, a place to shed tears and happily also share joy. And it's held the boundary of what I have felt able to share, the gap between me and the story. It's helped me retain a sense of myself as separate from my illness, the experience of cancer and allowed me to leave it on these pages and get on with living.

Storytelling in health and social care can help us relate to the impact of illness, to know how experiences impact, to understand how services work in a way that statistics never could. But the masterclass identified the importance of the story being acknowledged, being heard. And can we truly say those stories really change services?  Are they sanitised into neat boxes and only allowed to reinforce our existing stories after all? The culture of healthcare remains remarkably intact in spite of a body of knowledge that points to the need to change. So perhaps it's time to look at the stories we tell ourselves, listen to those who are telling us clearly about what matters to them and start to weave some different stories, that speak of a service that listens, that cares, that works with people as partners in their care, that puts health and wellbeing at the core of its focus.

We can learn to deeply listen to the stories we are told and that we tell ourselves and, importantly, we can change those stories for ourselves, for our organisation and for our culture as a nation even. Brene Brown describes stories as data with a soul, what could be more important than that?

Can coaching approaches transform care systems?

When we think of transforming health and social care, what comes to mind first? Perhaps it's the hi-tech things like robots doing delicate surgery or delivering routine care with cool efficiency; maybe it's gene therapy to enable us to prevent or treat tragic inherited conditions, even medicines unthought of to provide cures we don't dare hope for yet. And I expect some of that will indeed define part of the future, depending on cost.

But would that really be so transformational for most of us, who live with more common conditions, who have perhaps slowly and gradually learned that no magic cure will change our lives? Yes, medicines and treatments might make a difference but even the so called "cures" leave their impact on long term wellbeing.  And ultimately it's wellbeing we seek. 

In the modern world we have learned to seek quick fixes, we look for solutions outside of ourselves and we get angry when that doesn't arrive. What an exhausting, soul destroying process that can be.  

Interestingly at a recent Citizens Wellbeing Assembly, run by the Health and Social Care Academy and Health and Social Care Alliance Scotland as part of the national conversation on a Healthier Scotland, we asked people what keeps them happy, healthy and well. The answer is rarely medication or even health and care services, it's family, it's connection to others, it's meaningful work, it's music, it's pets...it's love and laughter. It's easy to see the themes emerge. Now of course health and care cannot in itself create those things, but what's important is that services are set up to pose the question of what matters to 
you to keep you well and then to organise the services and treatments offered to enable this, to sign post, to connect and indeed sometimes to get out the way.

Transformed services as I understand it will have the individual, their family and community at the centre and services will be part of several options to support wellbeing. That will create a very different engagement with services and within ourselves too. That won't happen without learning to do things differently. Particularly in healthcare, we currently train staff in a fix-it model, with the professional in the role of expert and the service user as passive recipient. We all need to learn to do this differently. 

My experience in this field has taught me that a coaching approach will be an important part of this transformation. Developing person centred coaches is a vital part of enabling this transformation to happen, both in individuals and within the health and care systems.

But why coaching? It is an enabling process that starts from the premise that we all have 
the potential for growth and transformation, it is asset-based and person-centred at its core and is life enhancing for those involved. One such example is an eight week course I have developed, building on my wide experience and learning from projects like the Esther network in Sweden and Buurtzorg in Holland aimed at developing coaches and supporting a person-centred integrated health and care service. Participants report this work is life changing and inspiring, they feel less stressed, more resilient as managers and practitioners, they have already achieved significant impacts through their change projects and ultimately learn the key is in relationship not just with others but with yourself. As one person said they have person-centredness in their DNA.    

So if you ask me how do you transform health and care services, my answer is develop people to build their awareness, their active listening, their deep understanding of person centredness and improve their resilience; make person-centred coaching the linchpin of our future services and we won't just improve the wellbeing of those receiving care, we will improve it for staff as well. 

Audrey Birt 
Independent Coach and Consultant in Health and Social Care and Associate Director of the Health and Social Care Academy.
For more information about this work email me on audrey@audreybirt.com

How stories can change the world

I think its fair to say blogging has changed my life. It's also brought new friends and I'm so delighted to play a part in bring the very special Marie Ennis-O'Connor to Edinburgh and talk about how stories can change the world. Please come and join us, and change how you use stories too. 

http://academy.alliance-scotland.org.uk/event/voice-of-lived-experience-shaping-transformational-change-sharing-experiences-from-an-international-perspective